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January 13, 2012 9:28 AM Romney Debates Romney About Health-Care Reform

By Michael Kinsley

OK, let’s go through this one more time. In 2006, Mitt Romney, as governor of Massachusetts, guided to passage, signed with a flourish and implemented with fanfare a health-care reform law for his state.

It was intended to achieve universal health coverage — a long-standing liberal goal that was not even on the Democrats’ national agenda, let alone the Republicans’, at the time. Of the available models, Romney chose one developed in part by the conservative Heritage Foundation. Its central provision was an “individual mandate,” requiring everyone to carry health insurance (and subsidizing those who couldn’t afford it).

Cut to Washington, 2010. President Barack Obama also chose the individual mandate as his model for health-care reform. As Heritage had argued, it is hard to imagine any other workable alternative to the dreaded “single-payer” (that is, a truly nationalized health-care system, as in Britain). Obama’s people consulted with Romney’s in formulating their plan, which passed Congress on a close party-line vote and immediately became an object of vilification for Republicans, who vowed to replace it. As I said, before they had “Obamacare” to attack, Republicans had shown no interest at all in addressing the problem of tens of millions of Americans without health insurance.

Different But Not

Romney, running for president again after losing in the Republican primaries in 2008, joined in the attack. He promised not just to work for Obamacare’s repeal, but also to defund it and allow all 50 states to opt out from his first day in office. But isn’t Obamacare almost exactly like the plan Romney had implemented in Massachusetts? Oh, no, no, no: The two plans are very different. How so? Well, the Massachusetts plan is a state plan, whereas Obamacare is a federal plan. Furthermore, two out of three Massachusetts residents approve of their plan, according to polls. What’s more, Romney says, if they don’t like it, they can change it. That’s what’s so wonderful about federalism.

This is about as far as the argument has gotten, and Romney may well get away with stopping here now that he’s almost sure to get his party’s nomination for president. It will be hard for Obama to make too much of an issue of the resemblance of Romney’s plan to his own since (unlike Romney, apparently) he still approves of his own plan.

But Romney shouldn’t be allowed to get away with stopping here. This tale makes no sense whatsoever. Here are some remaining questions Romney needs to answer:

Why would he have imposed the individual mandate on the people of Massachusetts if it’s such a terrible, terrible idea? Is he himself one of the two out of three people in his state who still supports this terrible idea, or has he changed his mind? What is it about the people of Massachusetts that makes a health-care arrangement suitable for them when it is so unsuitable for all other Americans? Romney says that it “wouldn’t be honest” for him to say now that the Massachusetts plan was “a boneheaded idea.” Does this mean he still thinks it is a good plan? Individual mandate and all? How can that be, if Obamacare, by contrast, is so awful that, if elected, he will rush from his swearing-in straight to the Oval Office in order to kill it?

Romney has said, correctly, that Obamacare doesn’t adequately deal with the issue of controlling costs. He says that, as president, he will do that because it is a national problem. How does he decide what is a national problem, on which the president must act, and what is a state problem, to which there might be 50 appropriate solutions? What other aspects of health care are national and therefore exempt from his deep enthusiasm for federalism? For that matter, what are other issues — inside and outside of health care — which he, as president, will ignore in order to let each state find its own solution?

One Romney Idea

Romney’s one concrete suggestion for health-care reform is repealing the law that forbids insurance companies from selling insurance across state lines. This would create something that doesn’t now exist — a national insurance market — and dramatically increase competition, thus helping to control costs. It’s a good idea, but, of course, it is exactly the opposite of what he claims to believe is needed in general: Outside competition would make it nearly impossible for states to regulate health insurance, leaving that power and obligation to the federal government. How does Romney resolve this apparent contradiction?

That is enough, for the moment. It’s obvious — isn’t it? - - that Romney is just blowing smoke. The real story is clear: He wanted to achieve something important and good for the people of his state, namely universal health care. But he chose the wrong horse — who could have guessed that an idea from the Heritage Foundation would become “liberal” anathema in the Republican primaries?

It’s annoying, but it’s more than that: It’s disqualifying. To talk such nonsense and count on the hubbub of the campaign to clothe its naked contempt for the voters is an insult to all of us.

Romney radiates this insult. He shines with it. This is what people mean when they talk about how smooth he is, about the perfection of his hair. He will do or say anything to be president. But his ruthlessness is not of the bitter, Nixon sort. It’s the bland impatience of entitlement. It says, “I’m supposed to be elected president. Why are people bothering me with these questions?” George W. Bush had this too, but his was at least mitigated by an apparent sense of personal insecurity. (Of course, Romney’s own sense of being a giant among pygmies can only have been enhanced by the collection of rivals he has been debating.)

When has Mitt Romney ever triumphed over adversity? (There have been times in his life he worried about getting fired, Romney has said. But his campaign couldn’t provide any examples.) Or — better still — when has adversity ever triumphed over him? I’m not asking for one of those gruesome “narratives,” beloved of political consultants, in which candidates mine their own tragedies — or, worse, their children’s tragedies — for cheap sympathy. If his life has been smooth sailing, that’s great. But how can we trust someone who has never faced adversity, never faced any big moral test, and can’t even pass the tiny moral test of telling the truth when the lie is obvious?

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