For the candidate afflicted with “Romnesia,” you never know when you hear that he’s making his “closing argument” if that is indeed the case, or he’s got three or four more in his pocket. But that’s the label BuzzFeed’s Zeke Miller is giving to Mitt Romney’s speech in Ames, Iowa, today–a place, you may recall, that he strictly avoided when Iowa Republicans kicked off the presidential cycle with a straw poll in the summer of 2011.

But anyway: the guts of Mitt’s final pitch is that he and Paul Ryan are thinking big and bold while Barack Obama is petty and timid:

Four years ago, candidate Obama spoke to the scale of the times. Today, he shrinks from it, trying instead to distract our attention from the biggest issues to the smallest–from characters on Sesame Street and silly word games to misdirected personal attacks he knows are false.

This is pretty rich coming from the guy who has spent much of the last month relentlessly pandering to the coal industry. But at any rate, what’s interesting about the “big and bold change” stuff is that it’s true: but not in any way he’s admitting. To hear his “closing argument,” here’s a sample of what he and Paul Ryan are fighting for:

We will save and secure Medicare and Social Security, both for current and near retirees, and for the generation to come. We will restore the $716 billion President Obama has taken from Medicare to pay for his vaunted Obamacare.

We will reform healthcare to tame the growth in its cost, to provide for those with pre-existing conditions, and to assure that every American has access to healthcare. We will replace government choice with consumer choice, bringing the dynamics of the marketplace to a sector of our lives that has long been dominated by government.

I’m sure you know by now how Mitt ‘n’ Paul plan to “save” Medicare. The “save Social Security” bit presumably refers to “reform” plans they haven’t had the guts to reveal, though Ryan was an early backer of partial privatization and Romney has talked vaguely about means-testing benefits.

But it’s the “health care reform” claim that is really incredible. By repealing Obamacare, Romney and Ryan would eliminate health insurance coverage for 30 million people who would otherwise be covered beginning in 2014. The Medicaid block grant they propose would according to the most credible indeeliminate coverage for another 17-23 million people. That’s 47-53 million Americans who will have to find some other way to secure health care or simply do without. And what are the “reforms” proposed instead? The Romney campaign has already been forced to admit that its candidate’s deep concern for people with pre-existing conditions extends only so far as preserving current laws allowing people to pay both employer and employee shares of health premiums after they’ve lost their jobs, or try to buy terrible, expensive policies through state risk pools. But believe it or not, the big and bold Romney/Ryan agenda would make things worse by the “market-based” reform of interstate insurance sales, which would create a race to the bottom sure to eliminate most of the protections available to poorer and sicker people.

I won’t even get into the hypocrisy of talking about getting government out of health care while demanding that the single-payer Medicare program keep paying insurance companies and providers $716 billion in unnecessary reimbursements. But the gap between what Romney is saying on health care and other issues, and the reality of his agenda, already gigantic when this campaign began, has only grown. If you like your dishonesty big and bold, he’s your man.

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Ed Kilgore

Ed Kilgore is a political columnist for New York and managing editor at the Democratic Strategist website. He was a contributing writer at the Washington Monthly from January 2012 until November 2015, and was the principal contributor to the Political Animal blog.