Political Animal


May 24, 2012 8:58 AM What RomneyCare Means Now

By Ed Kilgore

Today we’ve got a genuine must-read from Jonathan Cohn at The New Republic: a comprehensive analysis of Mitt Romney’s proposals for federal health care policy.

Taking these proposals seriously is especially important because thanks to conservative criticism, we’ve all gotten used to the idea of associating Romney’s thinking on health care with so-called “RomneyCare,” the Massachusetts health reform plan that was a model for the Patient Protection and Affordable Care Act of 2010.

Even if you think Romney’s lying when he promises to repeal “ObamaCare” in its entirety and gradually replace it with an assortment of right-wing “market-oriented” initiatives largely aimed at restricting insurance coverage, it is abundantly clear that this is one topic on which he will be cut zero slack by his conservative guardians. Besides, the overall agenda Romney would be forced to embrace as Job One (or Job One-and-a-Half after the repeal of ObamaCare) the moment he is inaugurated, implementation of the Ryan budget, constitutes a definitive reversal of everything ObamaCare is intended to accomplish—a true 180 degree turn on health care policy aimed at bringing back the good ol’ days before health care was considered a “right.”

Here’s the lede for Cohn’s assessment of Romney’s proposals:

The gist: Repeal the Affordable Care Act; end Medicare and Medicaid as we know it, by turning the former into a voucher program and the latter into a block grant scheme; unravel private insurance, by changing the tax treatment of benefits and undermining state regulation.
The good. Not much. Once in a while he talks up worthwhile reforms designed to improve the quality of care. He also endorses malpractice reform, which is a worthy idea, although his approach would do in a way that reduced damage awards without improving compensation for actual medical errors.
The bad: Changing the tax treatment of health insurance makes sense if you do it alongside other reforms. But if you do it without those reforms, it undermines employer-sponsored coverage without providing adequate alternatives.
The ugly: Up to 58 million more people could end up without health insurance, relative to what will happen if current law stays in place, according to one credible estimate drawn from the things he’s said so far

Please read the whole thing when you get a chance, and share it with someone who is thinking of voting for Romney as some corporate technocrat who will “fix” the economy and make government a tad more efficient.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.


  • berttheclock on May 24, 2012 9:17 AM:

    At the very least, his attempt to Bainize the ACA plan could create more jobs for the insurance industry.

  • c u n d gulag on May 24, 2012 9:21 AM:

    Mitt will claim to "fix."

    But his handlers goal is to "unravel," or, better yet, destroy.

    In their minds, health care is not a right, it's a privilege - and only for the VERY privileged.

    I've read Libertarian and Conservative takes on health insurance being like car insurance.

    Car insurance doesn't pay for oil changes, new tires, lube jobs, etc.
    And so health insurance shouldn't pay for routine maintenance either.
    Only catastrophic, or well above average, damage.
    And then, you only get paid for the current appraised value of the car (life).
    If you're 20, you're worth more, since you can return to being a productive member of society (serf).
    If you're 50+, well, why throw good money after bad?

    But a human is not a vehicle.
    And if one were, wouldn't you want "My Mother the Car" to get the best treatment, and not be junked?

    And how this will save any money is beside me, since if you don't change the oil once in awhile, your engine will seize, and the car become worthless faster? So you have to pay anyway.
    And may cause a pile-up when it grinds to a halt. Think of an easily communicable disease that went untreated, and becomes widely contagious. Won't that cost more to pay for all of the dead cars, when an oil change would have prevented all of the losses?

    Well, if they didn't have stupid analogies, they wouldn't have any at all, now would they?

  • stormskies on May 24, 2012 9:46 AM:

    Buffoon Romney and the Repiglicans are truly sadistic people. Sadism is of course a requirement in order to be a 'vulture" capitalist.

    And now the screaming insanity from buffoon Romney and the Repiglicans as Obama begins to attack that vulture capitalism called BAIN. "They are attacking success" they squeal over and over.

    You know what Obama should then say ?


    And then document over and over exactly what happened to all those folks who were treated as dirt by sadist Romney ...........

  • c u n d gulag on May 24, 2012 10:04 AM:

    I really don't think Mitt's a sadist.
    He doesn't set out to do evil things on purpose, and then revel in the agony of others. He doesn't look at people like bugs to be tortured for his enjoyment.

    He's a sociopath.
    All he knows of the world, from the top of his head, to the bottom of his feet, and as far as his arms can reach to grab, is that it revolves around him, and that nothing else matters except that which is his, and belongs to him.
    People aren't bugs in this world. They're either "the help," or they don't exist.

    And if he hurts others, it is/was not his fault. It's just that they came into HIS universe, and needed to play by HIS laws and rules.

    He doesn't set out to be Satan. And he isn't.

    He's just a self-centered, unaccountable God - who wants the peon's adulation and devotion, and for them to sacrifice to HIM and his, and for HIM and his.

    In other words, he's one of the worlds richest 3 year-olds.

  • DAY on May 24, 2012 10:12 AM:

    Mitt WANTS to be president. Isn't that enough?

    A comment on gulag's auto insurance analogy: If I am paying $1000 a month (or more!) I damn well want my oil changed. By nubile maidens, -and a loaner, with driver, for the inconvenience!

    Cut that to $100 a month, in case my body is "totalled", and I will spend the $900 savings on a better diet and lifestyle. The human body, after all, is a self regulating and repairing organism, despite the abuses we inflict upon it. Cancer, heart disease, and diabetes are rare among wild animals.

  • DRF on May 24, 2012 10:17 AM:

    I'm always amused to read that key plank of Republican proposals to "reform" health care is tort reform. Tort law, including medical malpractice, is a quintessential state law issue; each state has, over the years, developed its own set of laws and procedures. There is no good reason for the Federal Government to take over this area of law except that Republicans are unhappy that more states haven't adopted rules that they like. (It's also worth noting that states such as Texas that have adopted more physician-friendly tort rules haven't experienced any significant reduction in malpractice insurance costs or health care costs.)

    The other favorite Republican "reform", not mentioned in Kilgore's post, is the reduction of "barriers" to selling health insurance policies across state lines. In effect, the Republicans want to prohibit states like New York and California from imposing their own statutory requirements on the sale of insurance to residents. Such state rules include requiring coverage of certain medical procedures and requiring certain minimum financial standards for insurers. Again, Federalising these rules simply means requiring each state to live with the "lowest common denominator", i.e.the state with the lowest, most minimal requirements for insurers. This is Federalism at its worst.

  • stormskies on May 24, 2012 10:21 AM:

    Gulag: We all have our own views on whatever. To me this guy is in fact sadistic. Anyone who puts personal profits ahead of the pain created by those who get fucked because of that priority are in fact sadistic to me. I would suspect as well if those that did get fucked over by buffoon Romney, the jobs lost, their pensions destroyed, and so on, would probably feel the same way.

  • Diane Rodriguez on May 24, 2012 10:35 AM:

    This idea of unregulated free-for-all competition for medical care is ridiculous unless your goal is to have everyone but the wealthiest die off. Oh wait....

    People will seek health care in emergencies rooms and seek treatment for illness later rather than at the onset, taking up more expensive critical resources. Just like many people do now. The rising cost of caring for the uninsured will make premiums out of reach for any but the wealthiest.

    I thought the Republican take on health care was obvious enough but NOW Romney is on this "better" education kick. Jeebus what a flaming asswipe. An overall strategy to keep them stupid, pregnant, lower the life expectancy and make sure they can rise only to sharecropper status. The Republicans are truly terrifying.

  • 2Manchu on May 24, 2012 10:37 AM:

    "He also endorses malpractice reform, which is a worthy idea,"

    If it was as huge of a problem that the supporters of tort reform claim it is.

    But the idea that there are all these frivolous medical malpractice lawsuits winning huge settlements is a myth.

  • Spring Texan on May 24, 2012 10:37 AM:

    Despite public belief, if you are not an ob/gyn and in most states, malpractice costs aren't necessarily all that high and are NOT a big factor in medical costs.

    For instance, this California doctor's malpractice insurance costs are -- ta da! -- $2,947.48 for the WHOLE YEAR! (his whole website, http://truecostofhealthcare.org , is excellent on the realities of medical costs). He is not unusual.

  • boatboy_srq on May 24, 2012 10:52 AM:

    If the goal is to bankrupt each and every US citizen the moment they require more than routine annual physicals or semiannual dental and vision exams, then Romney's programme sounds perfect. If, in turn, it is the US Government's intention to enshrine health as a "blessing from God" and its absence a sign of "judgment upon the sinful/unworthy" then again, Romney's plan is spot-on.

    IF, however, the United States of America wants to maintain ANY pretension that it is not transforming into some radical Post-Protestant theocracy (or if penury is not an expected nearly-immediate outcome of childbirth, accidents, retirement or general ill health) then this approach should be condemned in the strongest possible language by any and all authorities.

  • c u n d gulag on May 24, 2012 12:30 PM:

    S'cool - I can certainly see your point, and how someone can feel that way.

    I prefer to save the word "sadist" for true sadists - like Cheney, and to a slightly lesser degree - W.

    Let's just agree to disagree.

  • sjay on May 24, 2012 8:41 PM:

    California is the wrong state to use as support for the argument that malpractice reform would be insignificant as that state's Medical Injury Compensation Reform Act (MICRA), restricting non-economic damages to $250K, is the poster child for tort reform advocates everywhere. Others argue that Proposition 103, strictly limiting insurance rates, is the real cause of the significantly lower malpractice insurance costs in that state.