Romney and the Mandate

You know what?  I actually feel sorry for Mitt Romney today.  The poor guy is caught in a quagmire.  He signed into law arguably the most effective and comprehensive healthcare law in the country when he was Governor of Massachusetts.  It looks a lot like the one passed by the Federal government a year ago, especially when it comes to what is called the individual mandate, which requires people to purchase private insurance if they cannot get it through their employer, do not already get it from Medicare or some other entitlement insurance program, and provided they can afford the premium.  He was hailed as a political star with a bright future in 2008, after he signed his state’s healthcare plan into law.  Now, he is the victim of a fickle electorate.

A little history is in order.  The individual mandate was put forward by Republicans in the 1990s as a free market alternative to a single-payer system being considered by Democrats.  Just to be clear, 15 years ago, the mandate (now called socialism) was a Republican solution to expanding and bringing down costs of American healthcare.  I just want to make sure you understand what I just said: the mandate was thought up and promoted by Republicans.

Fast forward to 2009.  Democrats were fighting amongst themselves to determine how best to reform the system.  Some wanted the single-payer option, which would have literally been socialized care.  Others thought they were being more accommodating toward Republicans if they used the mandate as their centerpiece instead.  Obama was against the mandate at first, but he saw that it was the only way to meet his goals without a single-payer option.

They were all completely taken off-guard by Republican charges that their own individual mandate was, in fact, socialism.  What?  That’s a gross misunderstanding of what the mandate does. 

The problem with the system as it is now (the mandate doesn’t take affect until 2014) is that people without insurance, whether by choice or not, receive the care they need anyway.  The costs of their care are covered by hospitals, who are not able to turn people away, and those costs get spread around throughout the array of services that the hospital provides.  This means that the costs of everything the hospital does must be increased to cover the costs of caring for patients that they cannot be reimbursed for.  As costs of care go up, insurance reimbursement rates go up, and the costs of are covered by increases in premiums.  It’s a very complicated cause and effect, but this has been going on now for decades and is a primary reason why your insurance rates have been increasing so much on a regular basis.

The reality of the current system is that hospitals and insurance companies are forced to socialize (yes, private corporate socialism is no different than government socialism) the costs to everybody to cover the costs of people who are too poor or irresponsible to have health insurance.  Republicans recognized this in the 90s as corporate socialism and put forward a solution that would make sure that people who were doing the responsible thing (having insurance) didn’t have to pay extra for those who were not.  The mandate makes sure that people who can afford insurance don’t spread their costs to everyone else.  Sounds reasonable to me, but it apparently sounds likeChinato the Tea Party.

I can even understand the notion that the mandate isn’t appropriate at the Federal level.  The original Republican argument two years ago was that the Feds should let the states decide how they wanted to fix healthcare.  I disagree because states who decide not to have a mandate end up allowing costs to be socialized, but let’s go with it.  This means that if a state, likeMassachusetts, decides to have a healthcare mandate (similar to an automobile insurance mandate), it should be able to do so as a sovereign entity.

The Tea-Party-infiltrated Republican Party now seems to think that state mandates are too heavy-handed as well.  Romney, because he followed the traditional Republican (though not original; go read up onLincoln’s ideas that shaped the original party platform) philosophy of local control, is now being crucified by other conservatives for supporting a state mandate.  He understood that the mandate prevents socializing costs by making sure that the costs are placed squarely on the shoulders of those receiving care.  If this isn’t conservative ideology of personal responsibility, I don’t know what is.

I really do feel badly for him.  He will lost a lot of conservative support because he made a once-conservative decision.  Of course, the President is seeing this as an opportunity to make sure Romney is a weaker candidate than he otherwise would have been.  I’m not saying that I want him to win (I don’t), but I feel for any politician right now who thinks that he or she can make a safe policy decision and be consistently rewarded for it by their own party.  The electorate is fickle, and Republicans have given more power to the Tea Party than they ought to.  Politics can change in an instant!

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One thought on “Romney and the Mandate

  1. I think he’ll be my choice, if he can win the primary. Doesn’t look hopeful right now. Maybe he should run as an independent? Huck is out. Oh man, if Newt gets it I may just have to vote for you know who.

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