Another Perspective

Obamacare vs. Romneycare — A Crucial Difference

There are conservative reasons why Romneycare was backed by conservatives.

By 2.15.12

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As the Maine primary and CPAC straw poll have again pushed Mitt Romney into the front of the pack, Rick Santorum continues to focus on Romneycare and its apparent similarities to Obamacare, as he and Newt Gingrich promised to do after Romney's win in Florida.

But are the similarities all that Governor Romney's opponents portend?

I don't love Romneycare but it is worth noting a few things about it before the real battle begins in earnest -- again. Former statements from Obama on healthcare demonstrate that the two healthcare plans, while similar in some ways, present vast differences in the essential origins and motives that separate Barack Obama and Mitt Romney from their infamous healthcare plans.

First of all, when Romney took on the uninsured in Massachusetts, working with both parties in Boston, he did so with the blessing of the Heritage Foundation. The idea was, essentially, people who were getting a free ride with respect to their healthcare would now have to pay. No more getting healthcare for free. This time you had to pony up some cash or buy insurance from a private carrier. The Heritage Foundation, a longstanding bastion of Conservatism, thought it bold, conservative thinking as they helped to craft its design.

From a Heritage Foundation article on Romney's plan in 2006:

… to allow people to go without health insurance, and then when they do fall ill expect someone else to pay the tab for their treatment is a de facto mandate on providers and taxpayers. Romney proposes to take that option off the table, leaving only two choices: Either buy insurance or pay for your own care. Not an unreasonable position, and one that is clearly consistent with conservative values.

Like it or don't like it, this idea, currently known as Romneycare, was the brainchild of Conservatism. Of personal responsibility. In 2006, long before Barack Obama had even thrown his hat into the presidential ring, the Massachusetts answer was "clearly consistent with conservative values" in its requiring recipients of healthcare to pay for a service that they would otherwise have received for free -- rather, on the backs of Massachusetts taxpayers. Newt Gingrich supported its "tremendous potential" and "real solutions" -- Gingrinchian praise for "creating a sustainable health system" in Massachusetts. 

But that is not the most significant aspect of this Romneycare vs. Obamacare battle: Newt's praise and Conservative origins.

The most significant aspect of this war of words stems from a common logical fallacy known as post hoc ergo propter hoc, which suggests that if event O follows event R, event R must have caused event O. In the present case, event R would be Romneycare and event O would be Obamacare. Romneycare, they say, brought about Obamacare. Or, said another way, Obamacare came from Romneycare (first fallacy), so it must be just like Romneycare (second fallacy).

Before we get too lost in the weeds, it might be interesting to see what Romney's and Obama's original goals were. 

As stated by Romney back then, "you will be free to choose but your choices will have consequences." Buy insurance or pay for your healthcare. Romney's goal was finite and simple: to require the few who were sapping the Massachusetts' taxpayers to ultimately pay for healthcare either by paying the state or by paying an insurance provider. These people who had no health insurance -- fewer than 10% in Massachusetts -- would now have to contribute if they wanted healthcare. That was it. Insurance companies were not nationalized. Massachusetts did not become the default healthcare provider in that state. It is not what I would have done, but it was seen as bold and it was the kind of "outside the box" thinking that many from both Parties admired. Newt included.

So, back to the goals or the intentions of Obama and Romney. We know what Romney's goal was. His goal was to involve the private sector of Massachusetts in insuring a small percentage of the Massachusetts' healthcare pie.

Obama's goal prior to signing Obamacare into law was much, much bigger.

In 2003, he said, "I happen to be a proponent of a single-payer universal health care plan." From that speech:

I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its gross national product on health care, cannot provide basic health insurance to everybody. And that's what Jim is talking about when he says everybody in, nobody out. A single-payer health care plan, a universal health care plan. That's what I'd like to see. But as all of you know, we may not get there immediately. Because first we've got to take back the White House, we've got to take back the Senate, and we've got to take back the House.

But more recently Obama said:

I have not said that I was a single-payer supporter because, frankly, we historically have had a employer-based system in this country with private insurers, and for us to transition to a system like that I believe would be too disruptive.

I think he meant what he said earlier and he meant what he said later. It just depends on what the meaning of "system like that" and a value on just how disruptive is "too disruptive." I won't attempt to parse his words. The proof is in the Affordable Healthcare Act. It has disrupted and it will continue to disrupt. "That system" is exactly what we got. And "that system" will, if left unchecked, get us what he wanted in 2003 -- a system with just the right amount of "disruptive."

The fact is, Obamacare was originally going to be single payer. It was going to be European -- as close to it as Congress would allow. But that was curbed. What they got, instead -- what we got, instead -- was the first step. Obamacare. The first step toward single-payer, universal healthcare coverage. That's a lot bigger than just under 10%, and it is a heckuva lot more disruptive.

And that is the crucial difference. Romney never said, never touted, never promised that "we may not get [single-payer] immediately" or even a little later than immediately. Much of the criticism against Romneycare is deserved, as is the scrutiny. But Romneycare is not Obamacare because Obamacare is just getting started.

One was an end in and of itself. The other is (still) a means to an end.

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About the Author

Robert P. Kirchhoefer is a Washington, D.C. attorney who previously worked in banking and finance.