Does Mitt Really Fit?

Before the stampede to brand Mitt Romney as the only viable conservative candidate for '08 goes any further, right thinking folks might want to take a closer look at just how conservative Romney's reign as Governor of Massachusetts really has been. Liz Mair examines the much touted "RomneyCare" plan and has a hard time finding anything conservative about it:

Almost immediately after the bill creating it was signed into law, the Wall Street Journal ran an op-ed, which claimed that, under RomneyCare, "the state is forcing people to buy insurance many will need subsidies to afford, which is a recipe for higher taxes and more government intervention down the road." Not so, said Romney. Despite the potential weight of RomneyCare on the public purse--likely to be exacerbated by the plan's focus on signing up the 20% of Massachusetts' population that is eligible for Medicaid, but not enrolled--Romney said he would not need to raise taxes to pay for the program.

Of course, he was right. RomneyCare has not even been fully implemented yet, and a cost overrun of $151 million in 2007 alone is already in the cards, perhaps because the RomneyCare financial model assumed the wrong number of uninsured in Massachusetts (the Census Bureau puts it at 748,000, but RomneyCare assumes only 500,000). But any needed hike in taxes won't be pushed through by Romney--he'll be out of office when the bill comes due, and when extra federal dollars will likely have to be allocated to Massachusetts to help cover the shortfall between RomneyCare's cost and its budget.

Yes, RomneyCare is reliant on federal funds. So imagine if, as Romney hopes, it is replicated in other states. Even if we do not have federally-mandated universal healthcare a la HillaryCare, we could easily end up with that option's badly behaved little brother--"state-specific" universal healthcare, funded in large part, and at greater than current levels, by the federal government.

That matters because it means more government intrusion into personal healthcare choices. Government will end up funding healthcare at a higher level, and in exchange, making mandates about the kind of coverage you must have, and who may treat you (RomneyCare mandates that individuals must purchase HMO coverage; PPO coverage, often better and more flexible, is not allowed). Moreover, government will end up dictating to businesses and requiring them to incur potentially great costs: RomneyCare mandates that employers with more than 10 workers must assume ultimate financial responsibility if employees or their immediate family members need expensive medical care, and that if such businesses do not insure their employees, they must pay a $295 per uninsured employee fee to subsidize healthcare costs. This threatens employment levels and discourages small businesses from growing.

Ultimately, the entire specter of government engagement in the realm of healthcare hits at a fundamental question. Is healthcare and health itself primarily an individual responsibility, the product of individual choices made in consideration of private matters, or is it a benefit to be assured by the government, without regard to the wishes of the individual?

I know what the conservative response to that question is. But I have my doubts about what Mitt Romney's would be.