Former governor Mitt Romney may very well have hoped he could put health care behind him with his major speech in Ann Arbor, but judging from the results so far of the National Review Online poll, it’s clear he still has a lot of work to do: By a margin of about seven to one, readers said they thought the speech hurt him.

It’s hard to hate Obamacare and love Romneycare. For example, Romney continued to defend the individual mandate — the most despised part of Obamacare — as right for Massachusetts but wrong for the country.

Four years after reform, Massachusetts still has the highest health-insurance premiums in the country. For small employers, the rise is about 14 percent beyond those in the rest of the nation.

And it’s increasingly difficult to get a doctor’s appointment. A recent survey by the Massachusetts Medical Society reveals that fewer than half of the state’s primary-care practices are accepting new patients, and the average wait time to get an appointment with an internist is 48 days. The result: The use of hospital emergency rooms in Massachusetts by people seeking routine care has increased. This was another problem Romneycare was supposed to fix.

The five-point plan that Governor Romney outlined to structure the health-reform initiative he would undertake as president is sound and based upon solid principles. But it’s hard to see how voters will give him a chance unless he admits that the health plan he developed for Massachusetts went seriously wrong.

He was emphatic about calling for repeal of Obamacare and said he will issue an executive order paving the way for the states to get a waiver from the health-overhaul law while Congress works to repeal it. 

But you can’t use an executive order to wipe out two massive new federal entitlement programs, $550 billion in new and higher taxes, a vast expansion of Medicaid, and federal mandates on individuals, businesses, and the states. Waivers are not a solution. 

In a political debate, President Obama would be sure to point out that there is little contrast between Romney’s call for these initial waivers for the states and the president’s call to give states an early waiver to implement Obamacare their own way.

Full repeal is the only solution. Earlier this year, the Republican House passed a repeal bill within a few weeks of taking power. If there were a majority in the Senate supporting repeal, then a new president could have a bill to sign on his desk within a month or two of taking office.

Voters needed to see more contrast today, and they would demand it in a general-election battle.