Mitt Romney has come out swinging against the health care plan he helped create, tackling the issue head on during a recent speech in New Hampshire. He seemed to be promoting a new narrative for his handiwork in Massachusetts—you know, the health care plan that his office once said was built on “a culture of insurance” and “personal responsibility.” Boston Globe politics editor Glen Johnson reminds us that Romney himself said last year the Massachusetts law was the “ultimate conservative plan” because it required individual responsibility. But the other day he told the New Hampshire crowd that Obamacare, which is patterned on the Massachusetts law, “is bad law, bad policy, and it is bad for American families.”
Apparently spooked by potential presidential opponents—conservatives such as Mike Huckabee, no less, who liken the Massachusetts plan to Obamacare—Romney now argues that Massachusetts had its own peculiar problems that the state tried to address. Don’t quite know how uninsured people were unique to Massachusetts, but okay. Romney wants voters to believe that he now wants states to solve their own health care problems. “One thing I would never do is to usurp the constitutional power of states with a one-size-fits-all federal takeover,” he told cheering voters in New Hampshire. Mitt Romney, meet John C. Calhoun.
The press has picked up something new to say about Romney—he’s in favor of state’s rights, and health care is the place to begin protecting those rights. His message: scrap the federal law and let the states do their own thing. Never mind that states have a long history of failed attempts to solve the health care mess. Romney’s new storyline, however, obscures some legitimate questions the media should be probing about Massachusetts reform and what it means for the federal law if it is eventually implemented. That requires reporters to move off the standard political story that merely passes along what the candidates utter, whether true or not.
An AP story noted that Romney said “some things worked; some things didn’t,” but the reporter didn’t delve into the what-didn’t-work stuff. Neither did Politico. Both stories brought up Huckabee’s new book in which he called the Massachusetts plan—renamed Romneycare by Republicans—“socialized medicine.” As we’ve pointed out, it is not socialized medicine, but sticking a sentence in a story referring to Huckabee’s campaign talk conveys to the public that it is.
There’s plenty to talk about when it comes to the ills of Massachusetts health care, a couple of which Johnson mentions in his piece. The law doesn’t address the escalating cost of medical care and what he calls “tangential challenges such as increased waits for primary care doctors.” Small businesses are still seeing double-digit premium increases, and individuals are struggling to pay theirs. And it’s far from clear that the state’s medical-industrial complex will agree on proposed solutions to the cost problem, such as global payments—one inclusive payment to docs and hospitals that’s supposed to replace the expensive fee-for-service model. The stakeholders are raising the predictable red flags. The president of the Massachusetts Medical Society argues that global payments could present obstacles to primary care docs who serve poor people. The president of the health plan trade group says the burden should be placed on doctors not insurers.
Today, a new study on medical bankruptcies attacks the skimpy policies that Massachusetts residents must buy if they want to fit the premium into their family budget. A study published in the American Journal of Medicine by researchers Steffie Woolhandler, David Himmelstein, and Deborah Thorne found that bankruptcies resulting from high medical costs persist in Massachusetts because the insurance policies people are mandated to buy don’t always cover their expenses. The researchers report that the least expensive individual coverage available to a fifty-six-year-old person in Boston carries a premium of $5,616, a deductible of $2,000, and covers only eighty percent of the next $15,000 of covered services. Consumers might face a similar problem under federal law.
Campaign coverage is in the early stages, so there’s a lot of time for the media to figure out new ways to keep a critical eye on the candidates. Their audiences might even take them more seriously if they could raise the bar.
Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.