At BuzzFeed, Andrew Kaczynski breaks the news that, in a 2009 op-ed for USAToday, Mitt Romney encouraged President Obama that he’d be well-served by adopting elements of the Massachusetts Romneycare plan, particularly the individual mandate. [Hat tip, Erick Erickson at Red State.]
In the context of urging on the president “the lessons we learned in Massachusetts” that “could help Washington find” a better way to reform health care, Governor Romney explained, “We established incentives for those who were uninsured to buy insurance. Using tax penalties, as we did, or tax credits, as others have proposed, encourages ‘free riders’ to take responsibility for themselves, rather than pass their medical costs on others.”
This seems very significant. A number of us have expressed concerns that Romney cannot effectively confront Obama on Obamacare, the wrongheadedness and unpopularity of which make it the Republicans’ most crucial issue in the campaign. In response, Romney posits that he is a Tenth Amendment guy who saw what he was doing as right for his state, and perhaps other states, but certainly not a national model to be adopted at the federal level. For what it’s worth, I’ve contended that those claims are utterly unpersuasive (some are downright frivolous). But that hardly matters now. The op-ed demonstrates that Mitt regarded Romneycare precisely as a model the federal government ought to adopt, and that the “tax penalties” by which Massachusetts’s individual mandate are enforced were a good fit for Congress and the Obama administration to impose by federal law.
Besides the individual mandate, Governor Romney’s op-ed also proposed government-managed cures to address the government-caused cost spiral generated by the government-designed fee-for-service structure. Patients, he suggested, should be “required to pay a portion of their bill, except for certain conditions” — to be chosen, of course, by the government. Providers would be “paid an annual fixed fee for the primary care of an individual and a separate fixed fee for the treatment of a specific condition” — said fixed fees to be fixed by the government.
Nowhere does the op-ed suggest that government involvement is the principal cause of cost inflation, and that maybe prices would come down if people paid all their ordinary health expenses out of pocket and had insurance, purchased in a truly free market, for catastrophes and other high-expense conditions. (Romney does argue that the current un-free market in health insurance is preferable to a “single-payer” system of government-provided coverage.) Nowhere does the op-ed consider whether the federal government’s role ought to be limited to policing against interstate fraud, with the states left to deal with other issues — without federal interference and without passing the costs of their solutions along to the rest of the country. And nowhere does the op-ed make any mention of the Constitution.
I’ve asked this question before — and it’s one that ought to be addressed by all the GOP candidates, not just Mitt. But while Romney made much of Rick Perry’s assertion that Medicare is unconstitutional, no one ever asked Romney to explain his theory for why it is constitutional. Do the GOP candidates all accept the premise that the federal government has an open-ended power to do anything in the “General Welfare,” unrestrained by the specifically enumerated powers assigned to Congress in Article I — none of which endows Leviathan with authority over the regulation of health care.