Romney addresses his RomneyCare problem
Mitt Romney didn't address his main, and some say fatal, liability in his CPAC speech last month. But Saturday, in a speech at the Carroll County Lincoln Day Dinner in New Hampshire, he tried out his most complete defense to date of his record on health care.
He had this to say about the health-care program he championed as governor of Massachusetts:
Living in New Hampshire, you've heard of our health-care program next door in Massachusetts. You may have noticed that the president and his people spend more time talking about me and Massachusetts health care than "Entertainment Tonight" spends talking about Charlie Sheen.
Our approach was a state plan intended to address problems that were in many ways unique to Massachusetts. What we did was what the Constitution intended for states to do -- we were one of the laboratories of democracy.
Our experiment wasn't perfect -- some things worked, some didn't and some things I'd change. One thing I would never do is to usurp the constitutional power of states with a one-size-fits-all federal takeover.
I would repeal Obamacare, if I were ever in a position to do so. My experience has taught me that states are where health-care programs for the uninsured should be crafted, just as the Constitution provides. Obamacare is bad law, bad policy, and it is bad for America's families.
The federal government isn't the answer for running health care any more than it's the answer for running Amtrak or the post office. An economy run by the federal government doesn't work for Europe and it won't work here.
The right answer is not to believe in European solutions. The right answer is to believe in America -- to believe in freedom, free enterprise, capitalism, limited government, federalism -- and to believe in the Constitution, as it was written and intended by the Founders.
This is more complete than prior attempts to defend his plan, which pioneered the concept of an individual mandate. Nevertheless, it is just as problematic.
First, in a rather obvious display of defensiveness, he argues, "Our approach was a state plan intended to address problems that were in many ways unique to Massachusetts." But there's nothing all that special about Massachusetts. Many states have escalating medical expenses, numerous uninsured residents and a tort system that adds unneeded costs to the health-care system. The real questions are why he chose the arrangement he did (an individual mandate), whether it worked and what it says about his philosophy of governance.
Next up is his first semi-admission that his chosen system didn't work. ("Our experiment wasn't perfect -- some things worked, some didn't and some things I'd change. One thing I would never do is to usurp the constitutional power of states with a one-size-fits-all federal takeover.") So what worked in his mind and what did not? Would he repeal the individual mandate? The Massachusetts health-care plan (MassCare) is now plagued by many of the same problems inherent in ObamaCare. Sally Pipes, a conservative health-care guru and longtime critic of Romney's plan, recently wrote in the Washington Examiner:
While the percentage of uninsured Bay Staters has dropped to 2.6 percent (from about 6 percent), the state has never adequately addressed what causes people to go without insurance in the first place: the cost of health care.
In fact, a substantial portion of Massachusetts' newly insured still can't afford to purchase even basic medical services, and are effectively no better off than before the law's passage. Meanwhile, government health spending is spiraling out of control, adding to the state's already massive public debt.
The numbers are staggering. In seven of the last eight years, per-capita health spending in Massachusetts has increased faster than the national average, according to Alan Sager, a professor of health policy at Boston University.
Overall health insurance costs in Massachusetts are almost a third higher than the national average, with a basic plan costing almost $17,000 for a typical family of four. Nearly 30 percent of Massachusetts residents report that their medical costs have increased since MassCare's implementation.
As a Republican presidential candidate, Romney will find it hard to defend a system that resulted in a 12 percent increase in insurance rates ("meaning that basic insurance costs will cut even deeper into the incomes of most participating patients," Pipes notes) and that forced businesses to swallow "annual rate increases of 10 to 15 percent since MassCare's inception." For a candidate who is focusing on job creation, he'll have to address the criticism that his plan "made it harder and harder for businesses to stay in the state. And it's made the state less attractive for entrepreneurs and investors."
Finally, Romney will have to overcome the concern that his program's design demonstrates that he does not have deeply held conservative beliefs. As he gins up his presidential campaign he is arguing that "The right answer is to believe in America -- to believe in freedom, free enterprise, capitalism, limited government, federalism -- and to believe in the Constitution, as it was written and intended by the Founders." But does a system with an individual mandate, one in which the state micromanages the acceptable minimum level of insurance, reflect a belief in freedom or in free enterprise? Republican voters will, I think, be skeptical.
Despite these weaknesses, there was a commendable portion of Romney's speech, having nothing to do with health care. At the beginning of his address he talked about foreign policy:
The president promised that his unique personal background would give him special insights into foreign policy. What we have seen instead is a president that is unprepared and unequal to the task of leading the free world.
He supported Honduras's Marxist president, but puts off pro-American Colombia. At the United Nations, he condemns Israel, but ignores Hamas's thousands of devastating rockets. His proposed engagement with Iran and North Korea that won him the Nobel Prize -- how has that worked out? Iran is arming Hamas and Hezbollah and rushing toward nuclear weapons. North Korea tested nukes, launched missiles, sunk a ship, and shelled a South Korean island. In the Middle East, the president was silent last year when dissenters took to the streets to challenge Iran's fanatical ayatollahs. And now, with the entire Middle East in turmoil, he and his administration were caught off guard. The president and his team look like deer in the headlights. Instead of leading the world, the president has been tiptoeing behind the Europeans. Newsweek magazine this week said that he hasn't just lost his foreign policy map for the Middle East--he doesn't even have one. This is the first time in a quarter of a century that America has had no discernible foreign policy. Not since the days of Jimmy Carter have we had such a foreign policy vacuum in Washington. And it could not have come at a worse time.
That's as well-structured and thoughtful a critique of Obama's foreign policy as we have heard from a Republican presidential contender. And he should keep it up. The focus for most voters now is the economy, the debt and unemployment, but foreign policy crises have a way of popping up and diverting the political debate, as Obama has learned. Romney is right on the merits and on the politics. Republican voters are going to want a candidate who is willing to challenge Obama on national security and, moreover, determined to project American power and values in the world.
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