United Liberty

While none of his rivals have landed a punch on the health care issue — though it seems like Rick Santorum is on the right path, it is certainly something that Mitt Romney will continue deal with during his campaign as he bobs and weaves from his own past statements; as the Wall Street Journal notes:

The exchange began when Rick Santorum scored Mr. Romney for lacking health-care “credibility,” since the 2006 Bay State reform “was the basis for ObamaCare.” If the first claim is for primary voters to decide, no one who knows anything about health policy on the left or right would deny the second: When Democrats wrote the Affordable Care Act in 2009 and 2010, they borrowed liberally from Mr. Romney’s model.

If the plans are not identical in every detail, they share major phenotypes: an individual mandate to buy health insurance or else pay a penalty; large transfer payments to subsidize the middle class; and much more government control over how insurance plans are structured, how medical services are delivered, and how both are priced.

“This is something that was crafted for Massachusetts,” Mr. Romney responded in Las Vegas, repeating his stock answer. “It would be wrong to adopt this as a nation.” The former Governor says Mr. Obama’s plan “must be repealed” and then states can experiment with their own health-care solutions.
[…]
But the larger and more important point is that Mr. Romney continues to defend his Massachusetts plan as a success for precisely the same reasons that President Obama says it should be imposed on all states. In reality, the Massachusetts plan is not a success and its problems are the best refutation of the duo’s arguments.

As the fight on healthcare seems set to reignite, it’s a good time to think a bit about some of the problems with health care and how a free market solution might actually reduce health care costs in the long term.  I can hear the more progressive readers right now, wailing and gnashing their teeth, but hold your horses for just a moment.  Some of these, even progressive might like.

Certificates of need

In many places, in order for a hospital to expand, there is a requirement for a “certificate of need”.  This certificate requires government approval for any new service.  In short, it’s a cap on competition.  For example, here in Albany, Georgia,Phoebe Putney Memorial Hospital is the only hospital permitted to offer birthing services.  HCA Palmyra, a private hospital, has been trying for years to offer these services and have been getting blocked.

Phoebe has a lot of services, and is able to effectively block any health care group that wants to cross it.  As a result, Albany has a much higher healthcare cost compared to other cities its size.  The reason for this is that the certificate of need prevents competition.  Competition drives down prices, which means a lower total cost to health care.  Even if you calculate in insurance paying for it, the insurance companies want the lowest price possible.  They’ll direct you to where the cost is minimal.

Even President Obama agrees, competition in healthcare is good.  I agree.  Certificates of Need prevent competition and protect the current providers.  This wouldn’t be tolerated in any other industry, so why in healthcare?  Get rid of these certificates and let competition drive down costs.

Produce more doctors

While most candidates are ignoring spending — the real problem with the budget, Ron Paul is taking this issue head on. Yesterday, Dr. Paul proposed $1 trillion in spending cuts as a part of a signficant budget and regulatory overhaul:

Ron Paul’s opinions about cutting the budget are well-known, but on Monday, he got specific: The Texas congressman laid out a budget blueprint for deep and far-reaching cuts to federal spending, including the elimination of five Cabinet-level departments and the drawdown of American troops fighting overseas.

There’s even a symbolic readjustment of the president’s salary to put it in line with the average American salary.

“Our debt is too big, our government is too big, and we have to recognize how serious the problem is,” Paul said during an afternoon speech in Las Vegas ahead of Tuesday’s GOP debate there.

The plan, Paul said, would cut $1 trillion in spending his first year in the White House and create a balanced federal budget by the third year of his presidency.

Paul isn’t just speaking in platitudes and slogans here. He’s serious about restoring fiscal sanity. This plan would eliminate five cabinet positions and their agencies (Energy, HUD, Commerce, Interior, and Education) and freeze spending for remaining executive agencies and departments at FY 2006 levels. It would repeal also ObamaCare and Sarbanes-Oxley, and allow young workers to opt-out of federal entitlement programs.

Despite the Department of Health and Human Services axing the unsustainable CLASS Act, which was passed as part of ObamaCare last year, the White House says that President Barack Obama will veto any attempt to repeal it:

President Obama is against repealing the health law’s long-term-care CLASS Act and might veto Republican efforts to do so, an administration official tells The Hill, despite the government’s announcement Friday that the program was dead in the water.

“We do not support repeal,” the official said Monday. “Repealing the CLASS Act isn’t necessary or productive. What we should be doing is working together to address the long-term care challenges we face in this country.”

Peter Suderman notes over at Reason that the Congressional Budget Office has laid the path to repealing the law since it won’t result an impact on the deficit, but the position of the White House obviously makes that difficult.

So why not support repeal? We all know the supposed “savings” of ObamaCare weren’t real, which has been acknowledged by Medicare Actuary Richard Foster. The CLASS Act is evidence of that and repealing it would provide Republicans with substantive rhetoric to use against Obama and Democrats showing that the lied to Americans about the program.

While Republicans haven’t been able to repeal ObamaCare in its entirety like they’d hoped, it does continue to fall apart piece by piece as the Obama Administration axed part of the health care reform law at the end of last week:

Late Friday afternoon is the golden hour for making announcements that you hope won’t get much attention. The news coming out of the Department of Health and Human Services right now is no exception: The Obama administration has halted work on health reform’s Community Living Assistance Services and Support, or CLASS, Act after finding it too difficult to implement.

The action stands to reduce expected revenues from the health reform law by $86 billion, as well as raise questions about why the provision was included in the health reform law to begin with.

There has always been concern about the CLASS program’s long-term stability. The long-term insurance program relies on voluntary enrollment. If only a small group of unhealthy people — those who anticipate using the services — sign up, the program could quickly destabilize.

Back in 2008, Rush Limbaugh endorsed Mitt Romney for the Republican presidential nomination. You can argue that it was mostly an anti-McCain endorsement, but Limbaugh was rather convincing assessment of Romney’s conservatism:

I think now, based on the way the campaign has shaken out, that there probably is a candidate on our side who does embody all three legs of the conservative stool, and that’s Romney. The three stools or the three legs of the stool are national security/foreign policy, the social conservatives, and the fiscal conservatives. The social conservatives are the cultural people. The fiscal conservatives are the economic crowd: low taxes, smaller government, get out of the way.

But yesterday, Limbaugh launched into a rant about Romney on his show declaring to his listeners that the Republican frontrunner is “not a conservative”:

Romney is not a conservative. He’s not, folks. You can argue with me all day long on that, but he isn’t. What he has going for him is that he’s not Obama and that he is doing incredibly well in the debates because he’s done it a long time. He’s very seasoned. He never makes a mistake, and he’s going to keep winning these things if he never makes a mistake. It’s that simple. But I’m not personally ready to settle on anybody yet — and I know that neither are most of you, and I also know that most of you do not want this over now, before we’ve even had a single primary! All we’ve had are straw votes. You know that the Republican establishment’s trying to nail this down and end it. You know that that’s happening, and I know that you don’t want that to happen, and neither do I.

On Tuesday, MSNBC reported that the advisors assistedMitt Romney in drafting the Massachusetts health care also aided the White House with coming up with what would become ObamaCare:

Newly obtained White House records provide fresh details on how senior Obama administration officials used Mitt Romney’s landmark health-care law in Massachusetts as a model for the new federal law, including recruiting some of Romney’s own health care advisers and experts to help craft the act now derided by Republicans as “Obamacare.”

The records, gleaned from White House visitor logs reviewed by NBC News, show that senior White House officials had a dozen meetings in 2009 with three health-care advisers and experts who helped shape the health care reform law signed by Romney in 2006, when the Republican presidential candidate was governor of Massachusetts. One of those meetings, on July 20, 2009, was in the Oval Office and presided over by President Barack Obama, the records show.

“The White House wanted to lean a lot on what we’d done in Massachusetts,” said Jon Gruber, an MIT economist who advised the Romney administration on health care and who attended five meetings at the Obama White House in 2009, including the meeting with the president. “They really wanted to know how we can take that same approach we used in Massachusetts and turn that into a national model.”
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The White House visitor logs suggest that, if Obama officials didn’t talk directly with Romney, senior presidential aides did consult with others — like Gruber — who played important roles in helping to craft and implement the Massachusetts law.

In what some see at the Republicans beginning to coalesce around the eventual nominee, New Jersey Gov. Chris Christie, who decided against a bid for the GOP nomination last week, endorsed Mitt Romney yesterday:

New Jersey Gov. Chris Christie says he is backing Mitt Romney for president as “the man we need to lead America” and said attacks on his Mormon religion are “beneath the office of the president of the United States.”

Christie announced his endorsement at a surprise appearance in New Hampshire with the former Massachusetts governor on Tuesday.
[…]
A senior Romney adviser told NBC News that Romney secured the endorsement on Saturday when he and his wife, Ann, met with Christie and his wife, Mary Pat, at the Christie home.

Romney described Christie as an “American hero” who has battled to “rein in the excesses of government in New Jersey.”

Christie’s support — which was considered to be coveted among the GOP field — could come with his network of donors and admirers.

I’m not trying to downplay the importance of this endorsement; but, was anyone actually surprised by this? It was obvious that Christie wasn’t going to get behind Rick Perry. Jon Huntsman, the only other candidate that would be up his alley, is doing terribly in the polls and the other candidates in the race seem are too far out there for him. Not to mention that a prominent Christie fundraiser immediately went to Romney after his guy opted against a run.

Despite his dwindling poll numbers and poor debate performances, Rick Perry is still hammering Mitt Romney over the health care law that he signed in 2006, which served as the blueprint for ObamaCare.

The ad, made by the guy that did Tim Pawlenty’s epic campaign videos, hits Romney hard with frequent imagery between the GOP frontrunner and President Barack Obama and uses his own words against him. It repeats the fact that Romney removed the line from his book about taking RomneyCare national; now that it has become politically unpopular:

As you know, the Supreme Court will hear the challenge to President Obama’s health care reform package.  In particular, the individual mandate that requires everyone to have health insurance meeting certain government standards.  Those who fail to do so will face a tax penalty, because the one thing we don’t have enough of in this country are tax regulations.

I’ve never been particularly shy about my desire to see the individual mandate overturned.  The idea that the government can require us to purchase a product has ramifications that go far beyond the health care debate.  The concept could easily be imported to other products and seen as a way to boost the economy, just as an example.

Imagine struggling American car companies.  Now imagine Congress requiring that every American household must buy one new American made car or face a stiff tax penalty.  Or buy solar panels to put on top of their homes.  The list is nearly endless, and all can be backed by good intentions whether it be American jobs or the environment.  However, all would have precedent in the individual mandate.

Of course, there’s a flip side to the individual mandate.  You see, that mandate is essential because it requires young, healthy people who normally wouldn’t worry about insurance to have it.  This spreads the risk across more people, which is good because the healthcare reform law requires insurance companies to take everyone and not price them according to their risk factors.  So an overweight, middle aged man with severe hypertension can’t be charged a premium based on his risk of stroke.  For the insurance companies to still make a profit, they need the individual mandate.