In their “debates,” the candidates tell us what their pollsters are telling them, and even more precisely what “the base” of their respective parties--those voters who will name the nominee in a crescendo of primaries next January and early February--tell them through the one-way windows of focus groups.
Unless Fred Thompson or Newt Gingrich can storm the ramparts of Republicanism with the sudden force of “I Like Ike,” the GOP is down to Mitt Romney and Rudy Guiliani.
Their statements on health insurance indicate the base of the Republican party likes the “system” very much as it is, and will paint any one who proposes to change it with the broad brush of “socialized medicine.”
Guliani, who maintains a consistent lead in the national polls, has courageously not yielded conservatives on abortion and gay issues. But he and his advisers obviously think insuring the medically uninsured is too much, or, at the very least, a big government idea that would remind conservatives of his expansive ideas about marriage and personal choices.
Besides, crying socialized medicine may work against his most dangerous opponent, Mitt Romney.
So Rudy moves briskly to the front of the stage, and energetically tells you those other folks, but not he, would bring you the monster of socialized medicine. And, he can prove it; once viable candidate Senator John McCain worked with Senator Ted Kennedy--grrrrr--to sponsor a patient bill of rights, and, even worse, Mitt Romney, when governor of Massachusetts adopted the idea of the individual mandate for health insurance, like for automobile insurance.
And then, Rudy refers to his ideas for a personal health insurance policy that you receive early in life and remains with you even after your hair is gone. His guru, Sally C. Pipes, says this can be done by simply invigorating the individual insurance market, “putting it on a level playing field, and giving the industry the incentives and ability to innovate (WSJ, June 27, 07).” And then she starts playing with the federal tax code and federal-state insurance regulation, just as if she both knows what to do with it, and can make it happen.
Romney is a particularly interesting case. As governor of Massachusetts just last year, he worked with an overwhelming Democratic legislature to hammer out a law that passed the House 154-2 and the Senate 37-0. And he signed.
It is supposed to bring to the Commonwealth nearly universal health insurance by mandating individuals who do not obtain health insurance at work buy their own policies. It has been in force just days, and appears to be, at the very worst, decreasing the number of uninsured.
Mandate means you gotta do it, or else. So individuals who can afford health insurance and don’t buy it, get penalized on their income tax; and individuals who don’t have the money get government subsidies; and employers with 10 employees get fined (“play or pay”) if they don’t provide employee health insurance, and so on.
Massachusetts is only one of several states--including Republican Governor Arnold Swartzenegger’s California--that feel they can no longer wait on federal action to improve health insurance coverage, a big, perhaps ultimate, story unto itself.
Wouldn’t you think a presidential candidate would shout to the world--or at least to the 46 million Americans without health insurance--his achievement? If he chooses not to praise each provision of the law, he should at least brag about his ability to work with an opposing legislature to pass such a law to help his state’s citizens.
But Mr. Romney, he of the handsome features and perennial smile, does not mention this achievement. He knows Rudy and the fearless eight will call it “socialized medicine,” and among Republican primary voters anything that widens health insurance coverage is worse than a straw comforter with bedbugs.
Romney, who has shamelessly flip-flopped on abortion and gay rights, has decided he can only be silent about his greatest legislative achievement. But how long will those other fellows shut up about how he--in an unforgivable moment of weakness--actually wanted nearly everyone to have health insurance?
Dr. Roy can be reached at firstname.lastname@example.org