Mitt Romney: Massachusetts Dreamin’

Benjamin Zycher Contributor
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With the generic exception of the Flight From Hell, airline routes do not have names. Trains, on the other hand, are more colorful. The Orient Express. The Maple Leaf to Toronto. The California Zephyr. The Barbequed Rib to Kansas City (I’m on yet another of my diets, and my stomach growls as I write.) And then there is former Massachusetts Governor Mitt Romney, whose forthcoming whistle-stop tour in pursuit of the presidency, before even having left the station, already has been christened The Dream On.

Let us now ask the metaphysical question foremost on the minds of train-loving six-year-olds everywhere: Why? Because he cannot beat Barack Obama. Why? Because he cannot be effective in his criticism of ObamaCare. Why? Because while governor of Massachusetts, he sold his limited-government soul (if indeed he had one) to the leftist devils, and pushed through his own version of healthcare central planning, complete with an individual mandate (a requirement to obtain coverage), fines for firms not offering insurance, purchasing exchanges controlled by the state’s bureaucrats, strict one-size-fits-all requirements for what is covered and when, and exploding costs. Not to mention the thunderous shouts of aspiring bureaucrats delirious at the prospect of a host of new agencies, boards, and regulatory bodies.

For those thinking clearly about ObamaCare, Massachusetts is far more than a mere glimpse of the future. Top-down rationing, whether imposed directly or indirectly through price controls on the insurers and the doctors and hospitals, already is beginning to appear in the Bay State. With a vast expansion of “coverage,” but no price mechanism directing additional resources into the provision of healthcare services, good luck finding a physician or getting a quick appointment. Over half of Massachusetts internists no longer accept new patients; so much for the mindless claim that “universal coverage” would relieve the pressures on emergency rooms. (For more on this huge looming problem, see this.) No other outcome is possible even in principle: Expanded “coverage” means ever-greater third-party payment, and thus ever-shrinking private incentives to economize on the consumption of healthcare services. The unavoidable end result will be skyrocketing costs in the aggregate, leaving only one available option for big, powerful, heavy handed, clumsy government: crude, top-down limits on resource use in health care.

Romney, of course, denies all this out of necessity: In the race for the Republican presidential nomination, and in the 2012 general election if he is nominated, he must oppose ObamaCare and point out its obvious looming disasters. And so, given his record in Massachusetts, he will be forced to engage in the kinds of contortions that even a circus would find embarrassing. His Massachusetts program? It is oh so different from ObamaCare. Should the latter be repealed? Yes. Well, not really. Should the ObamaCare individual mandate be repealed? No. Oops: Make that a Yes.

Sadly, against-it-before-I-was-for-it—or is it the other way around?—seems not to have worked out too well for another Massachusetts pol. Even if Romney decides to stand foursquare in favor of repealing the ObamaCare mandate, will that principle apply to the mandate in Romney’s Massachusetts program? Don’t bet on it; but do bet, if he is the Republican nominee, on the certainty that he will spend the whole campaign explaining why his mandate is different from Obama’s, rather than forcing Obama to do the explaining on a whole host of issues. Romney already is trying to argue that an individual mandate, perhaps an abomination if imposed by Congress, is just peachy if imposed by a state legislature. Good luck with that argument: A requirement that individuals obtain health coverage means automatically that the government must define “coverage,” that subsidies be provided for those who cannot afford it, and that price controls be imposed on health coverage so that insurers cannot earn “excessive profits”.

In short: The government has to take over the market for health insurance, a permanent expansion in bureaucratic coercion independent of whether it is the Beltway or a state capital imposing it. Both ObamaCare and RomneyCare establish purchasing exchanges for those with pre-existing conditions or those who cannot afford actuarially-fair premiums. They will have to be subsidized, a process that will draw increasing numbers of people into the exchanges. These people will have disproportionately high health care costs, a classic adverse selection process again independent of whether it is the feds or a state creating it. The exchanges inexorably will become a dumping ground for high-cost people, meaning that the adverse selection process will metastasize, the necessary subsidies will grow, and the health coverage market over time must evolve into a single-payer system.

Oh what a tangled web he weaves when Mitt first practices to deceive. Barack Obama cannot be defeated in 2012 without a frontal assault on ObamaCare. Mitt Romney cannot mount such an attack without repudiating himself. It really is that simple. At a deeper level, the economic, policy, and coercive destructiveness of such systems as Obama-RomneyCare are well known and fully predictable; Romney claims to be a smart businessman, but he supported it while Massachusetts governor, in all likelihood because of political expediency. Do supporters of limited government want a guy like that in the Oval Office?

Benjamin Zycher is a senior fellow at the Pacific Research Institute. Email: benzycher@zychereconomics.com.