Now, if we're precise, Romney didn't champion the brand of universal health care that this magazine stands behind. But we'll happily set aside those policy differences to revel in the aesthetic pleasures of the moment. Romney is a straight-laced conservative who has far more of a Sun Belt sensibility than a Boston one. He also happens to desperately crave the Republican presidential nomination. So, whether he's acting out of concern for his fellow human beings or merely reaching out to downscale Republican voters struggling with their own medical bills, it just doesn't matter to us. He's still lending the cause of health care reform a conservative imprimatur--making the world safe for, or at least more politically hospitable to, a policy revolution.
Of course, Democrats will always be the more vocal champions of universal health care. Any way you dress or undress the issue, it inevitably involves expanding government's reach. But Romney has begun to hint at an important new twist in the debate: the emergence of a genuinely conservative case for health care reform. Such a case would start with the ethic of personal responsibility. Because our society is unwilling to let dying people go without life-saving medical treatment, doctors and hospitals dole out billions in uncompensated care to the uninsured every year--a cost they inevitably pass on to the insured in the form of higher premiums and taxes. Yet there are always some people who could buy health insurance but don't, because they would rather spend the money elsewhere. Forcing these people to pay into the health care system--as Romney's plan demands--merely asks these "freeloaders" to carry their share of the load. Take that, Grover Norquist.
Republicans also fancy themselves the champions of small business. But a major selling point for universal health care is that it would encourage, rather than impede, entrepreneurship. Contrary to what lobbying groups like the National Federation of Independent Business say, the only way to make insurance both affordable and widely available to small businesses is to create large insurance pools, allowing them to take advantage of the economies of scale that large corporations now enjoy. Only the government can accomplish that.
And, speaking of corporate America, it, too, stands to benefit from universal health care. Today, companies pour good money after bad on futile efforts to squeeze employee health costs, supporting a tremendous infrastructure dedicated to the purchase and management of private health benefits. And, in the case of large manufacturers like the auto industry, they are locked into financing retiree benefits that cripple them in the global marketplace. The best universal health care plans would eliminate much of the infrastructure. Even more modest efforts, like the one Romney signed, would still distribute the cost burden more broadly while evening the economic playing field both at home and abroad.
We don't mean to oversell Romney's plan--something, surely, the governor will do all by himself in the course of his impending presidential run. In fact, the people of Massachusetts have a right to be wary. The heart of the plan is a requirement that every citizen buy health insurance, the same way states compel drivers to carry auto insurance. To help make insurance available, the law would create a cooperative through which individuals and small businesses could buy coverage at lower group rates, while also subsidizing insurance for the poor directly. But plenty could go wrong with this scheme. The subsidies could be too small and the insurance offered too meager, driving poor people into even steeper financial trouble; the funding for the plan, which already seems a bit shaky, could prove seriously inadequate. And, in any event, it's almost impossible to imagine a similar scheme working on the federal level, at least without a lot more money. But that's a debate over how to give everybody health insurance, not whether. And, thanks to Romney, it's a debate we're now more likely to have.
By The Editors