Worry About Costs, Not Mandates

Revelatory Headline: "White House used Mitt Romney health-care law as blueprint for federal law."

I am no fan of Obamacare. The notion that a top down system will control costs flies in the face of the fact that virtually every advanced country on earth that has a top-down scheme to manage its health care system has a rate of growth in costs that matches ours. The only difference is that we start at a much higher baseline, the result of high prices and high availability of services and technology.

Having said that, the oppositional focus on the dreaded mandate to buy insurance may be a really good issue to bring to the Supreme Court but that is about its only real attraction.

If Congress had the guts to call it a tax, as the White House legal team has lately been forced to claim, there would not be a Supreme Court issue to adjudicate. Congress has the power to tax (See Article I, section 8). However, if we are to have an insurance-based health care system, it really cannot work unless there is a large pool of healthy individuals who pay in to the system to support the smaller number who become ill. That is the way insurance works.

Romneycare in Massachusetts was a plan to cover the uninsured by requiring that every able-bodied person in the state have health insurance. It may be a lousy plan because it also has not controlled costs but it is not a lousy insurance plan because it has a large base of policy holders. That makes it a good insurance plan. For Gov. Romney to have had a hand in creating this insurance plan by requiring universal participation is nothing more than an acknowledgment that he understood how insurance works.

It is true that universal health insurance means that everyone pays into the system. But is that not a conservative goal for our tax system? We could have a universal insurance plan with tight cost controls generated by high deductible health savings accounts like Gov. Daniels instituted in Indiana? Combine that with universal participation and we are off to the races for cost control. The absence of such approaches is the real shame of Obamacare.

So if the Obama administration called in the technicians that put together the Massachusetts health insurance plan and it copied some aspects of having universal participation in the plan, that is not a revelation that should derail Romney’s campaign. To call it so is the height of cynicism by those who leaked (?) the information--likely a bit more of our President’s perpetual campaign--nor should it be the rallying cry of the self-righteous who deny the validity of universal coverage but are sure happy that they have their own insurance plan when the feel a funny lump in their neck.