Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
Much thanks to Peter for playing devil's advocate (that is, my advocate) vis-a-vis Romney on last week's podcast with Mark Levin. But there's one point that Peter, Mark, and most at Ricochet, I believe, are not quite getting.
First, understand that the Republicans' current mantra of "Repeal and Replace" is misguided -- not the "Repeal" part; the "Replace" part. The Republican Party is in desperate need of humility on the subject of non-Medicare healthcare reform. We have precious few immediate or workable solutions to the problems of price, the uninsured, free-loaders, pre-existing conditions, and so on. (There's a reason a smart guy like Gingrich supported the individual mandate until the day before yesterday.)
Yet with this promise of "replace", Republicans are unwisely promoting an expectation that we'll pass some nifty "big ideas" of our own to replace Obama's bad "big ideas". That's a problem, since we've got stinkers, too. For instance, among the House's "conservative" solutions to the pre-existing conditions problem is a federally funded, irresponsibility-subsidizing scheme of "high risk pools" (info here, if you dare), a plan which is as unworkable as it is likely to grow and metastasize. Yep, our current predicament is that even in the event Obamacare is repealed, Mark Levin will still get his convoluted healthcare Leviathan, but it'll come from Republicans -- with a little bipartisanship thrown in to make it stick.
There's only one way out of this fix: Republicans must undo that pathological manner of thinking among Americans that has them looking to Washington for solutions -- particularly on matters as complex and varied and frustrating as healthcare.
Which brings us to Romney, that infuriating rascal I'm tasked with defending. (We all have our roles.) There's a bogus charge around here that "Romneycare gave us Obamacare". No so. In fact, the opposite is true: Romneycare nearly saved us from Obamacare. Recall the Scott Brown election. Brown voted for Romneycare as a state senator, then won the Kennedy seat by promising to vote against Obamacare. So contrary to conservative lore, the near salvation of the Brown election was not a rejection of the individual mandate or some other aspect of Obamacare -- save one: the national aspect of it. That's right. Gov. Romney convinced liberal Massachusetts (!) that it should stop looking to D.C. Cue the Hallelujah Chorus.
This is not to say Romneycare will "work" ("work" being defined differently by the people of Massachusetts than by the people of Texas, which is as it should be). Likely it won't now that Democrats have expanded the mandate way beyond its intended scope of catastrophic-care-only coverage -- which has increased prices, which will increase subsidies, and away they go. And maybe even in a pristine form (as, say, Gingrich supported for a decade or two) Romneycare would fail. In any case, it's a Massachusetts problem, not mine, and such are the pitfalls of state-level experimentation. Ah, federalism.
Further, this is not to say there's nothing useful for Republicans to do in Washington post-repeal. We can pass a few laws to help our states find answers: e.g., block granting Medicaid and eliminating both the subsidy for employer-provided health insurance and the restrictions on interstate insurance markets. Then our 50 states can muddle toward solutions -- in a frustrating, imperfect, trial-and-error sort of way ; i.e., the only way possible. (A suggestion: encourage HSA's.) But such modest federal action will be politically acceptable only if we manage to turn the gaze of Americans away from Washington and toward their state capitals.
That last part is not so easy to do, but we know it's possible: For all his faults, Gov. Romney did it.
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Comments:
Apr '11
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
Dave Carter
Both. That's what makes him electable, see? · 2 hours ago
You have been, if I am not mistaken, a big supporter of Gingrich for a while. Newt says he will repeal it, but just this last September variously said he would "keep about 10 percent of it" and would retain "maybe 300 pages" of the bill.
Apr '11
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
Sisyphus
I am not disputing that he has promised to do so. Under the "duress" of a campaign. After trying to avoid doing so and after years of promoting federal RomneyCare in his public appearances and his book (since redacted in later editions).
I weigh a candidate's actual record far more heavily than public statements in office. Campaign promises are of value only to assess whether the candidate's logic reflects a reasonable understanding of the issues. Case in point, in all four general elections with Bush presidential candidates, these patrician statists ran as Reagan variants. And then there are Obama's promises.
Your claim that setting aside campaign promises as a prediction of future conduct as illegitimate is, regrettably, not born out by any experience with the democratic process.
I'd appreciate it if you'd reread my comment and see if I was referring only to recent statements, or asking you to put aside his record, or referring only to statements to Republicans. Fighting federal control over healthcare has been an unwavering Romney focus for decades.
What I said was illegitimate, btw, was claiming that his promises were ambiguous, as Drew claimed. This is simply not so.
Dec '10
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
DocJay
The medical establishment routinely gave charity to the impoverished and elderly as well.
You are very correct that cost controls escalated costs considerably. · 4 hours ago
Back then there were a lot of Catholic and other faith based hospitals that took their missions very seriously. Physicians and hospitals lived their oath's and provided care regardless of payment.
Doctors had a different kind of relationship with their patients. When I was in grade school, any serious illness meant a house call by the family doctor. I can remember having chicken pox, measles, etc, and our family doctor stopping by every couple of days to check on the progress.
Jul '10
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
James Of England
... You'll note that reducing the numbers of the Medicare rolls is an explicit and key element of Romney's healthcare reform package.
And yet, Medicaid/MassCare enrollments continued to increase at the same rate as before RomneyCare:
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
Yes, the government-engineered quasi-socialist market that we have today is failing, as designed. The only reforms earning liberal support through the years are aimed at failing up, from their perspective, up toward the nirvana of single payer healthcare (c.f. liberal resistance to Health Savings Accounts through the years).
Government already directly pays roughly 50 cents of every health care dollar in the United States and directs the expenditure of most of the rest through regulation and tax policy.
Ever wonder why your employer provides your health insurance but not your auto insurance? Why is it that, uniquely, health insurance is in most cases not insurance at all? Insurance is the pooling of resources against the possibility that something bad might happen. In contrast, health "insurance" has become a tax-advantaged means for funding predictable, routine expenses. If I created "lunch insurance," offering it tax-free to employees, it wouldn't take long for the restaurant industry to find itself with the the same problems of escalating prices and bureaucratic red-tape as the healthcare biz.
Edited on February 8, 2012 at 4:34amDec '10
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
No, but, we need to privatize it with a free market solution.
Apr '11
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
wmartin
Dave Carter
Both. That's what makes him electable, see? · 2 hours ago
You have been, if I am not mistaken, a big supporter of Gingrich for a while. Newt says he will repeal it, but just this last September variously said he would "keep about 10 percent of it" and would retain "maybe 300 pages" of the bill. · 2 minutes ago
And his "replace" involves recreating a functional equivalent of Obamacare's mandate, but relabeling it a tax credit. He calls his plan "a variation on" Obamacare. To be fair, Newt's not all that ambiguous. He'd partially repeal Obamacare.
Happily, with the results coming in tonight, it's looking ever more as if we're promised a candidate who will fully repeal Obamacare, whether that candidate is Rick or Mitt.
Apr '11
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
Sisyphus
James Of England
... You'll note that reducing the numbers of the Medicare rolls is an explicit and key element of Romney's healthcare reform package.
And yet, Medicaid/MassCare enrollments continued to increase at the same rate as before RomneyCare: · 35 minutes ago
To better formulate a response, it'd be helpful to know if it was a deliberate misunderstanding, if you genuinely thought that I was referring to RomneyCare, which has essentially no Medicare component, rather than to his plans for Medicare if he's given control over it, or if you were responding by changing the subject.
Jul '10
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
George Savage
If I created "lunch insurance," offering it tax-free to employees, it wouldn't take long for the restaurant industry to find itself with the the same problems of escalating prices and bureaucratic red-tape as the healthcare biz.
Cato had a nice bit on San Marino's lunch insurance.
A sample:
May '10
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
DocJay
The inevitable will come. I am OK with it. I have not sent out a regular insurance bill for nearly 7 years. I love the HSA high deductible method.
Your link looks like a well made lobbyist bullet point presentation. It also seems to favor big players rather than start ups.
Question, if my ending state run monopolies and allowing cross state competition is not a decent cost saving idea then why was the threat of repealing that the very reason the industry signed on to obamacare? · 3 hours ago
Don't get me wrong, Doc- a national retail market is a necessary, but not sufficient element of the ultimate solution. I agree about cross-border competition, thus far blocked by a coalition of hospital associations, NAIC, and the Blues.
The bullet presentation was by Penn Prof. and AEI scholar Scott Harrington- no lobbyist- at an AEI conference called "Beyond Repeal" (highly recommended for all of you), all about how to kill PPACA dead and replace it with sensible policies.
May '10
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
Matthew Gilley
There's the "can do" attitude that's made the Minnesota GOP the fearsome electoral machine it is today! (Just kidding, just kidding...)
I'm not sure how far you think we can go with clarifying amendments, but surely we can agree there's a better way to build this mousetrap other than turning every ER into a free clinic. · 3 hours ago
No argument there, Matt- to see the mess, follow VDH through Salinas and look at the ER there that serves as first-line clinic to all the illegals. I'm just pointing out that this particular law, however burdensome the implementation is, is not remotely unpopular, so getting rid of it takes a lot of capital and a saleable replacement for the concept.
Jul '10
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
James Of England
...
To better formulate a response, it'd be helpful to know if it was a deliberate misunderstanding, if you genuinely thought that I was referring to RomneyCare, which has essentially no Medicare component, rather than to his plans for Medicare if he's given control over it, or if you were responding by changing the subject.
Post 18, I close with the following point:
Post 22, you close with the following:
And my response is in #44 showed the smooth growth curve of Medicare through the adoption of RomneyCare. Obviously, Gov. Romney had little hope of influencing age-mandated Medicare enrollment. Romney did not stymie Medicaid enrollment through effective competition.
Reducing the age-driven Medicare rolls is a horse of a completely different color.
Thank you for your responses.
Edited on February 8, 2012 at 5:31amApr '11
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
Sisyphus
Post 18, I close with the following point:
Post 22, you close with the following:
And my response is in #44 showed the smooth growth curve of Medicare through the adoption of RomneyCare. Obviously, Gov. Romney had little hope of influencing age-mandated Medicare enrollment. Romney did not stymie Medicaid enrollment through effective competition.
Reducing the age-driven Medicare rolls is a horse of a completely different color.
My objection was to any · 1 minute ago
OK. I was confused by your quoting my response about medicare. Romney's talked about the Medicaid mandate being a federally established thing. I agree that giving Massachusetts sovereignty over its medicaid will not reduce Massachusetts medicaid enlistment. I suspect federalism will reduce the rolls in some 40+ states, which is good enough for me.
Apr '11
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
George Savage
Yes, the government-engineered quasi-socialist market that we have today is failing, as designed. The only reforms earning liberal support through the years are aimed at failing up, from their perspective, up toward the nirvana of single payer healthcare (c.f. liberal resistance to Health Savings Accounts through the years).
When you say it is designed to fail, which designer do you refer to? The chief architects of the current system, pure government programs for the elderly, poor, and veterans aside, were FDR's war labor board and Ronald Reagan. Surely you don't mean that they intended to sabotage American healthcare?
May '10
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
Thanks for the responses everyone. A couple points:
1) The very fact that there's reasonable people here disagreeing about so much demonstrates that most of these matters are best left to the states, which is mostly my point.
2) Nobody's addressed those convoluted "high risk pools" that House Republicans are supporting. I don't blame you. Question: Do you want our candidate defending such schemes in a debate against Obama? No? Well that's the kind of back-and-forth we'll get in a "our federal plan is better than your federal plan" confrontation. We'd tie. Maybe.
Much better to go with "Let's allow our states to work this stuff out", an argument that (I think) Romney is best suited to make. Not only is it the better position on the merits, it's also easier to defend. And that will draw a clear distinction with Obamacare -- far more than some wonky argument about how "risk pools" or whatever are somehow superior to such-and-such.
3) King Scott of Reusserland would stick everybody with Health Savings Accounts and call it a day. Problem solved.
Oct '10
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
I'm not a Romney fan, but Yuval Levin and Ponnuru articulate a much better defense of Romneycare than Romney ever has, over at NRO:
Edited on February 8, 2012 at 2:03pmRe: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
wmartin
Dave Carter
Both. That's what makes him electable, see? · 2 hours ago
You have been, if I am not mistaken, a big supporter of Gingrich for a while. Newt says he will repeal it, but just this last September variously said he would "keep about 10 percent of it" and would retain "maybe 300 pages" of the bill. · 11 hours ago
Sorry, WMartin, but I'm afraid you're mistaken. I've spoken highly of his ability to actually advance conservatism in debate and actually put the left on defense for a change, but I've not endorsed him. I've not come out and endorsed anyone by name, actually. My preference though, to spell it out, is Santorum to Gingrich, and Gingrich to Romney, and Romney to Obama. I'm not blinded by any of their defects. Santorum has the most consistent conservative instincts I believe, though some of his votes trouble me. Gingrich is inconsistent, though by far the most powerful messenger. Romney is not temperamentally of the breed, but he'd run rings around the current resident at 1600 Pennsylvania Ave.
Jun '11
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
My 2 cents: I agree that "replace" should be as limited as possible. Ideally the employer tax break should go, could that be achieved. I'n not even a fan of HSA's myself; they are another patronizing time comsuming paperwork hoop to jump through if you would like to keep a little more of your own money. How 'bout folks just save their money for a rainy, or sick, day, and the money not used to subsidize HSA's just lowers tax rates a bit? I do agree that catastrophic insurance is the only sensible way to go.
Jul '11
Re: Romney's Not-So-Modest Accomplishment - or - What Mark Levin Doesn't Get
Duane Oyen
Don't get me wrong, Doc- a national retail market is a necessary, but not sufficient element of the ultimate solution. I agree about cross-border competition, thus far blocked by a coalition of hospital associations, NAIC, and the Blues.
The bullet presentation was by Penn Prof. and AEI scholar Scott Harrington- no lobbyist- at an AEI conference called "Beyond Repeal" (highly recommended for all of you), all about how to kill PPACA dead and replace it with sensible policies. · 15 hours ago
If it is repealed, we sure better have some solid plans to deal with the problems. I saw a few items like you posted having actually been part on a small level for a GOP sponsored national conservative physician think tank which had competing ideas to reform.