Friday, January 21, 2011

Health Care Reform - Romney, Reason and Reality

On Wednesday January 19th, the House of Representatives passed a repeal of the recently enacted health care reform legislation, known as ObamaCare. The vote of 245 to 189 was cast along strict party lines, with only three Democrats joining the victorious Republicans. However the vote is widely viewed as merely a symbolic gesture from the GOP; as the measure is not expected to be brought up on the Democrat controlled Senate floor.

With no “Replace” legislation waiting in the wings to be considered, Americans will have to wait and see what the GOP controlled House majority will devise, if anything. On Thursday, the GOP House leadership did take some initial action to begin looking at health care reform alternatives. Others suggest the GOP might drag it’s feet in replacing ObamaCare, since strategists eye it as a winning 2012 campaign issue for the GOP and its hopes of gaining control of the Senate, as well as the White House.

Against this backdrop, potential 2012 GOP Presidential hopefuls will be jockeying to present their own ideas to voters. Some have the luxury of never having to face the task of resolving health care issues, while some have addressed the issue head on. The GOP presumed candidate with the most experience in health care reform is former Massachusetts Governor, Mitt Romney. His is famous – or infamous, depending on which GOP circles one travels – for enacting a health care plan during his tenure, which nearly everyone has cited as the model for ObamaCare. Surely this issue will be Romney’s biggest hurdle in seeking the nomination. 

While some are quick to throw brick bats at the MassCare plan, others take a more reasoned and pragmatic view of Romney’s actions. The following points were originally posted by Right Speak member Noelle, commenting in a blog post about the virtues of Romney’s plan.

Here, with her permission, Noelle expresses some very good points in drawing distinctions between Obama and Romney’s plans:


This has been an interesting and lively debate. Just to add my 2¢ here, I think Romney's has only 2 challenges in winning the nomination. The first is his health care reform that was passed in MA, and the second is his religious faith. Regarding his faith, that is clearly a ridiculous issue, but that won't stop a few people from refusing to support him.

The legitimate issue is his record on health care reform. I am a conservative; MA is a very liberal state. I'm glad I don't live there and have to live under such liberal "leadership." That being said, health care is a complex issue. Romney and others who worked on it spent a very long time researching, studying, analyzing, compromising, and fighting, to get a result that in the end was overwhelmingly supported by the people of Massachusetts.

There are elements of it that I don't like and that are not well received by conservatives. The problem I see is with those who don't support Romney. Rather than look at the complexities of the issue and plan, acknowledging both the good and the bad, they only talk about the points they don't like. Arguing in sound bites, rather than really showing an understanding of the complexity of the issue.

To say the MA healthcare reform is a model for Obamacare is ignoring some very significant factors:

1.      Romney BALANCED THE BUDGET before tackling the health care issue. Obama didn't.

2.      Romney DID NOT RAISE TAXES to implement the MA healthcare reform.

3.      Romney's bill was 72 pages long. Obama's was 2,700 pages. That is significant because how much is hidden in those 2,700 pages? You can't hide in 72 pages.

4.      The MA healthcare reform bill was found to be constitutional in Massachusetts. The constitutionality of Obamacare is still in the courts, but I believe that it is unconstitutional, and the current VA ruling says so too.

5.      The MA healthcare reform was designed specifically for Massachusetts. It is a relatively wealthy state, with already relatively low numbers of uninsured. Obamacare intends to impose the same solutions on Tennessee, West Virginia, Nevada, Oregon, California, Alabama, and all the rest, even though each state has its own unique issues to address.

6.      Romney succeeded in getting support from both sides of the aisle. He was able to compromise and find solutions that were satisfactory to both. No one group was entirely happy, but all had the opportunity to participate and contribute to the debate. Obamacare was forced upon us all without getting input or support from Republicans.


As realistic, rational and reasonable as these points are, critics will no doubt continue to take the easier path, popping off slogans, platitudes and talk radio mantras. Campaign opponents of Romney will also attempt to make political hay of his reform actions. However, with so many offering so few solutions or even worse - advice bereft of any actual experience - it may turn out, the man who did the most with this issue, will actually be the one voters will listen to.

13 comments:

Anonymous said...

Another important point is that the Massachusetts legislature was 85% Democrat. We cannot expect an 85% Democrat legislature to pass a good health care plan. Mr. Romney did his best to get a good plan. He vetoed eight sections of the bill, and the legislature overrode all eight vetoes.

Aaron G. said...

Doug, Permission to Cross-post at MRC?

ConMan said...

Excellent post Doug!

Romney's constituents presented the problem. He worked with both sides of the Isle to solve it.

Noelle said...

This is an important issue and it deserves thoughtful debate. As Steven R. Covey says, "Think first to understand, then to be understood."

The 2012 nomination process is extremely important, and Romney's record on health care is certainly going to be a central issue in the debates. It is a topic that we must understand in context. I support Romney, and I would encourage those who don't to take the time to really understand his record on health care. It is a record of leadership, of innovation, of hard work, and even of bipartisan cooperation. These are attributes I want in the president.

Mitt Romney 2012

Right Wingnut said...

Is that Pablo next to mitt in the photo?

hamaca said...

RWN, if we accept Pablo's ROS picture as an accurate representation, then this one would not be Pablo as Pablo apparently has a full head of hair.

Pablo said...

Ha, no it is not me. Yes, the picture on ROS is accurate. I am going to respond to this post later when I get a chance. But good job, Noelle!

Anonymous said...

Many regular voters will not see Mitt's health care experience as a problem, if he can make it through the primaries. He has at least been directly involved with health care. As Noelle points out, this debate involves many complex issues, including the mandate that all taxpayers will pay for anyone who can't (or won't) pay for themselves. We must keep our system in the free market, while finding ways to make people be responsible for their own health care. That is a pretty tall order.

AZ

Pablo said...

"Romney BALANCED THE BUDGET before tackling the health care issue. Obama didn't."

No, but Obamacare should lead to a reduction in the deficit in the long term by about $100 billion in 10 years.

"Romney DID NOT RAISE TAXES to implement the MA healthcare reform."

No, because MA had a large fund from the government that is planned on using for health care reform. However, this is a good complaint against Obamacare, because it is being financed in the worst possible way.

"Romney's bill was 72 pages long. Obama's was 2,700 pages. That is significant because how much is hidden in those 2,700 pages? You can't hide in 72 pages."

This is also a fair point, although Obamacare encompasses the whole country, MA only one state. Nevertheless, part of the reform should focus on some of the excessive regulations in Obamacare.

"The MA healthcare reform bill was found to be constitutional in Massachusetts. The constitutionality of Obamacare is still in the courts, but I believe that it is unconstitutional, and the current VA ruling says so too."

That is a fair point, but it is not an argument against the policy points of Obamacare. Just that the constitution forbids it. I am not sure about that, but I definitely do not believe that Obamacare falls under the interstate commerce clause.

"The MA healthcare reform was designed specifically for Massachusetts. It is a relatively wealthy state, with already relatively low numbers of uninsured. Obamacare intends to impose the same solutions on Tennessee, West Virginia, Nevada, Oregon, California, Alabama, and all the rest, even though each state has its own unique issues to address."

True, states should have their own plans, but the problems of MA are similar to the problems around the country -- rising premiums and clauses against those with pre-existing conditions.

"Romney succeeded in getting support from both sides of the aisle. He was able to compromise and find solutions that were satisfactory to both. No one group was entirely happy, but all had the opportunity to participate and contribute to the debate. Obamacare was forced upon us all without getting input or support from Republicans."

This is pure fiction. Obama compromised GREATLY on this bill. Most Democrats (at least the base) would prefer a single payer system like what Canada has. Obama tried to compromise with a government option (like what Sweden has). He was unable to get it, so he adopted the Republican plan of the 90s, 00s. Obama compromised. Republicans did not.

BOSMAN said...

Doug and Noelle

Great article and SPOT ON. As a life long Massachusetts resident I agree with ALL your points.

Noelle said...

In response to Pablo's response to my comments:

Pablo said "No, but Obamacare should lead to a reduction in the deficit in the long term by about $100 billion in 10 years."

This number is based on numbers given to the CBO that are not an accurate reflection of reality. The plan is to collect 10 years of taxes for 6 years of payout. Obama's record thus far has not indicated that he could care less about deficit reduction.

Pablo said "No, because MA had a large fund from the government that is planned on using for health care reform. However, this is a good complaint against Obamacare, because it is being financed in the worst possible way."

The fund from the federal government was already coming in to Massachusetts. It was not additional federal funding, but it was redirected.

Pablo said "True, states should have their own plans, but the problems of MA are similar to the problems around the country -- rising premiums and clauses against those with pre-existing conditions."

Don't forget, as I mentioned Massachusetts is a relatively wealthy state, with relatively low uninsured, and that was prior to the implementation of the health care reform there. I don't think the same plan would work in a poorer state with higher numbers of uninsured. That is why each state needs to work on its own issues. Federalism. It's a good thing.

Pably said "This is pure fiction. Obama compromised GREATLY on this bill. Most Democrats (at least the base) would prefer a single payer system like what Canada has. Obama tried to compromise with a government option (like what Sweden has). He was unable to get it, so he adopted the Republican plan of the 90s, 00s. Obama compromised. Republicans did not."

The only people Obama compromised with were the democrats. Obama did not adopt the Republican plan of the 90s, but rather distorted it. There were several issues put forth by republicans (allowing the sale of insurance over state lines, tort reform) but because of the overwhelming democrat majority in both houses of Congress, the democrats saw no need to include the republicans in the conversation. Certainly a difference is that in Massachusetts Romney was in the minority, and Obama had a large majority to work with. Romney needed to compromise. Obama didn't, and the result is Obama pushed through a plan that was rejected by the majority of the citizens of the United States. If Obama was serious about using Romney's reform as a guide you would think he would consult with Romney, which he did not do.

Pablo said...

Noelle,

Good comments. Let me try to respond.

On your first point about the long term cost of health care reform, Ezra Klein has answered Krauthammer's critique that you mentioned. You can read it yourself here.

http://voices.washingtonpost.com/ezra-klein/2011/01/health-care_reform_doesnt_have.html

I think that Klein has the better argument. But it is certainly debatable.

I agree with the funding point. But it goes back to the previous point: long term Obamacare decreases the deficit, it does not increase it. So funding is a mute point.

Your point about the expensive nature of MA-- true, MA is expensive. But that is why I think that Romneycare has not been terribly effective in lowering premiums overall. I think that Obamacare would do well nationally, especially in areas that aren't as expensive (relatively speaking).

I can't agree with you on the compromise point. Let's answer this step by step: Is Obama satisfied with an individual mandate/health care connector plan? No, he took it because that is all he could get. What did he want? More than likely a single payer system, but openly he fought for a government option. What was the plan of Republicans from the early 90s until 2009? Romneycare -- an individual mandate and a health care connector.

The idea that Republicans want access to health care across state laws is fine, but that is not a health care plan. Republicans spent the summer opposing everything that Obama wanted and offered very few of their own ideas. In contrast, Obama went from wanting a single payer system to getting a national version of Romneycare.

Pablo said...

On compromise: You are right that Obama had to compromise with his fellow Democrats, but Republicans refused to accept anything that Obama proposed. Obama compromised in the sense that he had to give up some things that he wanted.