Romney's Rush to Critique Clinton Missing The Facts
If ever there was an issue that cried out for a serious national debate, it is health care. Unfortunately, the Republican presidential candidates prefer partisan sloganeering to honest discussion, with Mitt Romney the most egregious example.
Romney couldn't wait Monday to criticize Hillary Clinton's new health care proposal. He called it a "European-style, socialized medicine plan" and staged a photo-op in front of St. Vincent's Hospital in Manhattan to denounce the proposal as "HillaryCare 2.0." It amounted to a canned press release in search of the facts.
Clinton presents an irresistible target for Republicans, particularly on health care. Her new plan leaves many questions unanswered and, given her record on the issue, she must overcome inherent skepticism from many Americans who believe she wants to dictate the kind of health care they receive. But it is a far different plan than the one she authored in 1993.
Instead of engaging in a debate on the merits of her proposal, the Republican candidates eagerly rushed to attack it as rampaging big government. It is one more example of why campaigns have left so many Americans disillusioned with the political process.
Romney above all others in the GOP field should have used more caution in the way he responded, given his own admirable record on health care in Massachusetts -- a record that he has decided to run away from rather than embrace.
The reason Romney is more vulnerable in the way he responded is that, in broad strokes, what Clinton proposed on Monday bears a striking resemblance to the plan he proposed and then negotiated through the Massachusetts legislature when he was governor. The plan's passage was one of the most acclaimed achievements of his term in office.
Both plans call for an individual mandate requiring everyone to purchase health insurance. Both feature subsidies to help low income families pay for that insurance. Both create pooling mechanisms to help make insurance more affordable. Both impose a tax on large companies that do not provide health insurance to their workers.
Clinton proposed no new government entities to administer the plan, although her aides acknowledge that some additional people would have to be hired within the existing bureaucratic structure to handle some aspects of it. The Massachusetts plan actually did create a new regulatory agency, although it is a fairly lean and not very costly addition to the state bureaucracy.
There are differences in some details of the two plans -- the subsidies available for purchasing health care, the size of the tax on big companies that don't offer insurance, the scope of the basic benefits package, the tax credits offered to small businesses to provide insurance. But as Jonathan Gruber, an economist at MIT, told me today, the two plans are "very, very similar."
Gruber advised Romney as governor in the development of the Massachusetts plan and now is a member of a board overseeing its implementation. He said Clinton, Barack Obama and John Edwards consulted him as they were preparing their proposals this year.
Gruber said what Clinton proposed is far different from the plan that never came to a vote in Congress in 1994. He is dismayed by Romney's response and what he called "misleading Republican rhetoric" to the Clinton plan.
"Romney deserves the credit for what he did in Massachusetts," Gruber said. "He provided the intellectual leadership for much of what is going on. He should be basking in his glory and instead he's running away from it, and I'm very disappointed."
As a presidential candidate, Romney has said he would not try to take the Massachusetts plan national. He argues that he prefers to allow states to develop their own approaches to covering all their citizens. As president, he says, he would make sure the federal government provides waivers, flexibility and encouragement to the states to innovate, rather than imposing a one-size-fits-all federal solution.
Kevin Madden, Romney's spokesman, said the former governor is the one candidate in the race with a record of delivering on the goal universal health care as an elected official. Comparing Romney's approach with Clinton's, Madden said, "What you have here is two fundamentally different world views on how you achieve coverage."
Romney, however, has said little about whether he would provide federal resources to help states pay for covering everyone with insurance. Most of the plans coming from the Democrats peg the cost of universal insurance at about $100 billion annually.
Clinton's plan illustrates the lessons she learned from the debacle of 1993 and 1994. It is a more cautious and evolutionary approach, starting with the recognition that most people who already have insurance through their employers probably want to keep it. Her aides said she has come to realize that the plan she authored during her husband's presidency sought to impose too much change at once.
Policy experts will say nothing is more complex than attempting to repair what is broken in the nation's health care system while preserving what is best about it. Anyone who tries will have to defend his or her proposal against legitimate question and criticism -- and then seek to develop the political consensus to turn concepts into legislation.
Democrats and Republicans have dramatically different ideas about how to fix the system, with GOP candidates favoring market-based changes designed to increase competition, as Karl Rove pointed out in an op-ed piece in today's Wall Street Journal. Romney's argument that a national solution won't work deserves discussion as well.
Gruber framed the debate this way: "The Democrat want to cover the uninsured. The Republicans do not, or at least it's not a priority for the Republicans. The voters can now choose.... Should we put $100 billion into solving this problem or not? I'm not saying we should, but there's no blurring of the lines. There is a choice."
That's a defining difference on a big issue -- but only if the candidates treat it seriously. Romney and the Republicans failed that test in their first response to the Clinton plan.
For more on Romney and health care, watch an exchange on the subject from his visit to the Red Arrow diner in Manchester, N.H earlier this year.
Washington Post editors
September 18, 2007; 1:25 PM ET
Categories: A_Blog , Dan Balz's Take , Hillary Rodham Clinton , Mitt Romney
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