Unsurprisingly, the putative GOP nominee for president has published an op-ed on health reform at USAToday. And for a guy who proved as governor of Massachusetts that he knew a lot about the subject, he really phones it in, as though he is trying to prove he’s unlearned everything he used to know.
The shallow nature of Mitt’s “thinking” on health care at present is made especially evident by this op-ed’s focus on what to do after that great gittin-up morning when ObamaCare is repealed in its entirety.
It’s the cookie-cutter GOP approach, with perhaps a slightly greater emphasis on “federalism” to protect Mitt’s own flanks on the Massachusetts plan. The description of that plan, tellingly, is limited to a single sentence that only mentions its alleged difference from ObamaCare. Then Mitt slogs down the road to cookie-cutter land.
He mentions up top the universal GOP desire to replace the employer deduction for health insurance with an individual tax credit. Since it would drive many millions of people out of group coverage into the perilous and expensive individual market, that’s a terrible idea unless it is complemented by new mechanisms for collective purchasing power (you know, like Mitt did in Massachusetts). Not a word about that, not even the usual paeans to state-run high-risk pools. Then there’s a very odd endorsement of the idea that people with preexisting conditions who maintain continuous coverage shouldn’t face pre-existing condition denials. That, matter of fact, is current law. But there’s no endorsement of banning pre-existing condition denials altogether, which is especially significant because Romney also endorses the conservative pet rock of interstate insurance sales.
Here’s a passage I really love:
[I]ndividuals are currently prohibited from purchasing health insurance across states lines, which reduces competition and makes many plans subject to expensive state benefit requirements. The federal government can open up these restricted markets. States could still regulate their insurance industries, but consumers across the U.S. would benefit from lower costs and greater choice.
Those “expensive state benefit requirements” typically just mean basic coverage, along with (in some cases) limits on denials for invidious reasons plus community rating to make premiums affordable to sicker and poorer people. Interstate sales would immediately lead insurers to move to states with the fewest conditions. Without federal regulation–of the sort that Mitt, of course, categorically opposes–this step would create a classic race to the bottom, making state regulation completely ineffectual.
And then you have another conservative pet rock, medical malpractice reform, which, whatever you think about it on the merits, is not a significant contributor to health care costs according to virtually all experts.
And that’s it! Nothing about using the purchasing power of the federal government to change medical practices in ways that improve quality and reduce costs (guess that leads down the road to “government takeover of health care” if not “death panels.”). Nothing specifically about Medicaid, which Paul Ryan, in a budget praised by Mitt Romney, would cut by a third within ten years.
I understand that Mitt’s still in the primaries, and all conservative voters want to know is that he’ll repeal ObamaCare despite his complicity in designing it. Maybe the Etch-a-Sketch could produce something if not better, at least a little more complete, over time.
But I doubt it very seriously. This is not a topic Mitt Romney is going to want to talk much about, maybe ever. His reasonably good ideas for tackling the system as governor became an existential threat to his ambitions to move to the White House. So he’ll leave the health care policymaking to the people in his party who want to take the system right back to the 1950s, and phone in his best wishes.