Romney falls short in defense of his RomneyCare

In a speech in New Hampshire on Saturday, Mitt Romney defended the health care plan he implemented as governor of Massachusetts.

It was more complete than prior attempts to defend his plan, which pioneered the concept of an individual mandate. Nevertheless, it was just as problematic.

First, in a rather obvious display of defensiveness, he argues, “Our approach was a state plan intended to address problems that were in many ways unique to Massachusetts.”

But there’s nothing all that special about Massachusetts. Many states have escalating medical costs, numerous uninsured residents and a tort system that adds unneeded costs to the health care system.

The real questions are why Romney chose the arrangement he did (an individual mandate), whether it worked and what it says about his philosophy of governance.

Next is his first semi-admission that his chosen system didn’t work. (“Our experiment wasn’t perfect – some things worked, some didn’t and some things I’d change. One thing I would never do is to usurp the constitutional power of states with a one-size-fits-all federal takeover.”)

So what worked in his mind and what did not? Would he repeal the individual mandate? The Massachusetts health care plan is now plagued by many of the same problems that are inherent in ObamaCare.

Sally Pipes, a conservative health care guru and longtime critic of Romney’s plan, recently wrote in the Washington Examiner: “While the percentage of uninsured Bay Staters has dropped to 2.6 percent (from about 6 percent), the state has never adequately addressed what causes people to go without insurance in the first place: the cost of health care.

“In fact, a substantial portion of Massachusetts’ newly insured still can’t afford to purchase even basic medical services, and are effectively no better off than before the law’s passage. Meanwhile, government health spending is spiraling out of control, adding to the state’s already massive public debt. . . . Nearly 30 percent of Massachusetts residents report that their medical costs have increased since MassCare’s implementation.”

As a Republican presidential candidate, Romney will find it hard to defend a system that resulted in a 12 percent increase in insurance rates (“meaning that basic insurance costs will cut even deeper into the incomes of most participating patients,” as Pipes put it) and that forced businesses to swallow “annual rate increases of 10 to 15 percent since MassCare’s inception.”

For a candidate who is focusing on job creation, he must address the criticism that his plan “made it harder and harder for businesses to stay in the state (and) . . . made the state less attractive for entrepreneurs and investors.”

Romney will also have to overcome the concern that his program’s design demonstrates that he does not have deeply held conservative beliefs. As he gins up his presidential campaign, he is arguing that “The right answer is to believe in America – to believe in freedom, free enterprise, capitalism, limited government, federalism – and to believe in the Constitution, as it was written and intended by the Founders.”

But does a system with an individual mandate, one in which the state micromanages the acceptable minimum level of insurance, illustrate a belief in freedom or in free enterprise? Republican voters will, I think, be skeptical.

Jennifer Rubin writes the Right Turn blog for The Washington Post: voices.washingtonpost.com/right-turn.