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Defending Romneycare, Cont'd

As you may have heard, Mitt Romney will be giving a health care speech from my backyard today. OK, he's not literally speaking from my backyard. He's speaking at the University of Michigan medical campus, which is about a mile from my house.

But I still feel like he's a guest and, well, I would like to be a gracious host. So let me take some time this morning to defend him from a vicious attack in the form of Wall Street Journal editorial.

"Obama's Running Mate" is the headline. As you might guess, it's a screed about the health care plan Romney signed in Massachusetts and how it compromises his ability to attack President Obama over the Affordable Care Act. The similarities between the two plans, at least when it comes to making insurance coverage nearly universal, are real. So are the political problems they create for Romney, given the conservative electorate's current antipathy towards "Obamacare" and anything that looks like it.

But the most revealing sentence in the Journal editorial is this one:

The only good news we can find is that the uninsured rate has dropped to 2% today from 6% in 2006.

Yes, and the only good news in foreign policy lately is that American forces finally killed Osama Bin Laden.

Seriously, reducing the number of people without health insurance, to the point where nearly everybody has it, is a very big deal. It means many fewer people now face the prospect of medical or financial catastrophe because of illness, a prospect that is very real for tens of millions of Americans but decidedly rare in the rest of the developed world. 

For the record, some surveys suggested more people in Massachusetts (as many as 10 percent of residents) had no insurance before Romneycare took effect. Then again, the baseline isn't really important here. The change is. Reducing the proportion of residents without coverage by about two-thirds, as all of the surveys suggest happened, is no small feat when it happens during a recession and at a time the number of people without coverage nationally is rising. 

Not only does that mean Massachusetts has prevented a lot of unnecessary suffering. It also means the state has pumped money into its economy, producing what the economists would call an automatic stabilizer.

Now, I am the first to concede that insurance coverage alone is not the same as access to health care. But, as I've written many times in this space, studies have shown very clearly that reform has increased access to care. And while the Journal, among others, has argued that the Massachusetts plan has produced waiting lines and exploding costs, the evidence so far doesn't back up those claims.

Of course, the Journal's objection to Romneycare is partly philosophical. That comes through early in the editorial, in a passage making the case against the dreaded individual mandate:

The people who don't buy coverage though they can afford it aren't really a major fiscal problem—unless the goal of the individual mandate is to force them to subsidize others.

Actually, a major goal of health care reform is precisely that: To spread the cost of medical care across society. The thinking goes like this: Serious medical problems frequently reflect bad luck, in the form of genetics, accidents, or exposure to some outside hazard. Forcing the victims of such misfortune to bear the financial burden of medical care individually is not something a decent society allows to happen. 

If the alternative requires forcing the healthy to subsidize the sick and the rich to subsidize the non-rich, so be it. Medical catastrophe, after all, can visit anybody. Contributing to the cost of care is in virtually everybody's self-interest. Journal editorialists may object to this line of thinking, but it's the same underlying philosophy as Social Security, a program that rightly enjoys robust support.

To be clear, Romneycare has plenty of flaws, just like the Affordable Care Act does. But it's been successful at its primary goal of making health care more accessible. That Journal opinion writers and like-minded conservatives find that inconsequential tells you more about their values than it does about Romney.

Update: Meanwhile, for one-stop shopping on Romney's own defense of the individual mandate, Igor Volsky has a comprehensive compilation.