Romney answers health care critics

In a lengthy interview with Human Events, Mitt Romney gets grilled on health care and offers a reply to some conservative critics, most notably the Cato and Galen Institutes.

His reply is two-fold. First, that if the criteria for the plan's success is greater coverage, it's worked. And not only has it worked, it's working "almost precisely as budgeted".

That being said, there are aspects of the program he doesn't like, and if he were King, he'd strip the program of some of its "excessive coverages" to help it break even.

Second, he claims the program's costs are unfairly maligned because they're looked at in a vacuum. Health care costs have exploded across the country, including Massachusetts. If you analyze one state, you need to look at the rest, too. One state alone can't quell health care costs, and some changes at the federal level are crucial to enabling success at the local.

Here's the aforementioned arguments, in longer form.

Allan Ryskind: I don’t know whether you’ve seen the National Journal from July 18, but it suggests that there was a $600 million cost to the state in 2007, and now they’re projecting $1.3 billion. It quotes people, liberals and conservatives, who are saying basically that the costs are out of control and there really isn’t any cost containment. The Cato Institute and the Galen Institute, which are conservative, are basically saying the same thing. What do you have to say to that?

Romney: There’s a frequent confusion between two different topics. One is the topic of the Massachusetts Plan which was designed to get people who were uninsured into the insurance system, and that’s working as planned, and almost precisely as budgeted, as forecast by the conferees who put the final bill together. As I indicated, the forecast for FY 2009 was a gross cost of $725 million and it turns out that next fiscal year the forecast of the actuaries is going to be slightly less than that, about $723 million. That’s about as close as it gets. The net cost is about half that figure, about $350 million.

An analysis of our plan was carried out by one of the watchdog groups in Massachusetts called the Massachusetts Taxpayer’s Foundation. It’s largely a business-sponsored watchdog group. They’ve carried out, I think within the last month or so, a complete evaluation of the system and they concluded that it is on budget within the forecast it was originally made, and it is a modest amount of funding to get our citizens insured. Now, I’ve also indicated that I would make some changes to the system if I had the ability to do so. I don’t, of course, but I would rein in what I think are some of the excessive coverages and at the same time I would increase some of the coinsurance payments by beneficiaries and in doing so bring it to break even. But it is in no way an out-of-control or above budget forecasted at the time of the bill’s signing.

Then there’s another issue, however, and that’s the fact that the cost of health care, generally in Massachusetts, like the rest of the nation, continues to rise at a very high rat. Health care inflation in America is very, very high. In Massachusetts, it’s higher than average even. That is not something which we were able to deal with at the state level, and, in my view, that’s something that can be dealt with in Washington in part because the federal government sends out Medicare and Medicaid, which comprise about 50% of all health care spending in this country.

Washington can help make health care more market-oriented rather than the kind of more control or subsidy orientation which it currently has. Our current fee for service system creates the absolute wrong incentives for both patients and doctors and is what’s driving the health care cost in this country higher and higher.

But the Massachusetts experience related to one key area: Getting people insured. That it’s done, and it’s done it at a forecasted cost. Another issue is one which Massachusetts did not deal with, which is how to stop the extraordinary health care cost inflation which afflicts the entire nation.

Here's the Cato report in question.