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A Conflict of Visions



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What is the proper role of government in our free society? Two contrasting visions are on display in the differences between Obamacare and the health-care reforms proposed by Gov. Mitt Romney today in Michigan.

Governor Romney is an unabashed American exceptionalist. He believes the perils America currently faces were largely caused by government, and that the dynamic character of American society — its energy, charity, discipline, and willingness to innovate and take risks — will create a better country if freed from the burden imposed by excessive government. President Obama believes in the power of government to mold and improve society. Accordingly, he wants to increase the size, scope, and power of government, especially the federal government in Washington, D.C.

In line with his broader view, Barack Obama has created a vast array of new federal regulatory boards, commissions, panels, and bureaucracies. Obamacare raises taxes by almost $500 billion and will increase government spending by an average of over $150 billion per year beginning in 2014. 

Romney’s health-care plan goes in an entirely different direction: It would create no new federal agencies, does not raise taxes, and would aim to reduce federal spending.

Romney seeks to lower the price of health insurance and health-care services by removing current restrictions on individuals and small businesses. His proposal enhances the attractiveness of Health Savings Accounts, allows individuals to buy health-insurance products across state lines, and ends tax discrimination against individuals who don’t get coverage through their employers by permitting them to deduct their health insurance premiums. The plan is especially friendly to small businesses. It would enable them to pool together and buy health insurance through their trade associations. Competition will lead to lower prices and lower prices will in turn make it easier for small businesses to provide insurance to their employees.

At the center of Governor Romney’s reforms is an effort to empower states to find health-care solutions, particularly for the poor and chronically ill. This effort bears similarities to the welfare-reform legislation of the 1990s. He would give the states control over the Medicaid program, allow them to structure health care for the poor as they choose, and continue federal funding at a level that provides for growth but still generates considerable savings for the federal government.

Governor Romney believes that giving control over Medicaid to the States will produce better health care for the poor, just as welfare reform achieved unprecedented reductions in child poverty. President Obama does not; his legislation imposes vast new mandates on the states and increases the cost of Medicaid to them and the federal government, without the kind of flexibility that will permit reform of the delivery system.

One final difference between Governor Romney and the president on health care: Mr. Obama is fighting to save his legislation from lawsuits challenging its constitutionality. Should Governor Romney become president, he will support repealing Obamacare and will issue an immediate order paving the way for a waiver for all fifty states.

During the last campaign, Governor Romney often said that America was reaching a crossroads, or “inflection point” as he called it. He was certainly right about that. 

President Obama sees America’s current troubles as a reason to grow the power of the federal government. Romney sees them as an urgent reason to get government under control and reassert vital elements of the American character, like strength, innovation, and faith in the power of freedom.

The presidential election season is closer than most people realize. The first primaries are only eight months away; the general election will be ten months after that. Of course many people will contribute to that process, and no one can predict what the outcome will be. But Mitt Romney’s speech has begun laying the framework for the great national debate that must and will occupy the nation’s attention during the campaign. That debate will be about issues like health care, but more broadly it will be about competing visions of America in which our freedom and our greatness as a nation are at stake.  

— Jim Talent is a distinguished fellow at the Heritage Foundation and served as a U.S. senator from Missouri.



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