Perhaps the most head-scratching aspect of the Republican presidential debates has been that no one has been able to land a hard blow on Mitt Romney’s record on health care. But there are several good reasons why it hasn’t happened. These reasons may turn out to be far more consequential than anyone would have thought.
5. Romney has been running for president since 2007. As many others have remarked, Romney has been refining his positions for many years. He is clearly a much stronger candidate this time around than he was in 2008. But there are plenty of other people who run for President every four years, and never improve, so this alone doesn’t explain Romney’s strength.
3. Moderators have not asked Romney a challenging health-care question. The key to tripping someone up in a debate is asking him a question he is unprepared for. It’s not obvious that those who have moderated the GOP debates are up to the task. Romney is well-practiced at answering the “Romneycare is different from Obamacare” question, and delivers his rejoinder with confidence. A stronger line of criticism — one that almost no one has employed — would be to point out how Romneycare has worsened the free rider problem, increased the cost of health insurance, and worsened emergency room crowding. Romney’s successor has been forced to try to clean up the mess by raising taxes and instituting price controls on insurance premiums. Even these points, however, are hard to pursue in a thirty-second format.
2. The eight-candidate, sound-bite debate format plays to Romney’s advantage. Because the debates must give sufficient air time to each of eight candidates, it has been difficult to ask follow-up questions and pursue the weaknesses in Romney’s well-crafted statements. The format of the Palmetto Freedom Forum would have been ideal for discussing health care policy, but that debate focused more on constitutional and social issues. For Romney’s rivals, it was a missed opportunity.
It’s hard to see how this dynamic changes between now and January. And given Romney’s strengths in most other policy areas, it’s hard to see how the race changes if Romney’s rivals can’t make health care an issue.

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