Jackson Hole News

Romney, Richardson Need to Get Real

It’s Up to Voters to Raise the Bar

By Gil Brady, 8-31-07

“Republican Mitt Romney & Democrat Bill Richardson (below) appear in Jackson last week”/photos by Gil Brady & Andrew Wyatt

Washington, D.C. – After a week of lolling about the free world’s financial and political capitols—where the medias’ cult of tacky hyperbolic scandals is a 24-7 sensory-experience in New York and D.C.—it was restorative to reflect upon covering last week two ‘08 presidential candidates first campaign stops in that discriminating outback of modern America known as Jackson, Wyo.

Ahhh...last week: A now bygone era of idyllic America I shall call “B.L.C,” or “Before Larry Craig,” where serious political journalism and citizen participation went hand-in-hand with democratic esprit d’ corps. A time before the nation lost its collective head over the balding Idaho senator’s unsavory airport restroom escapades.

In comparison, both Mitt Romney and Bill Richardson impressed me as intelligent, personable, fully-dressed and formidable politicos who appear to have the right stuff to be president.

They also struck me as shrewd and charismatic performers whose sometimes pat answers to probing queries designed to get beneath their target-market rhetoric raised even more questions left unanswered.

Universal health care, great! But at what cost?

Liberal bloggers and conservative pundits have been quick to praise the righteousness of Romney’s universal health care triumph for Massachusetts. Setting his sights even higher, he has now vowed to bring his ‘health care plan in every pot’ philosophy to Washington as a model for the nation should he become president.

“We’re going to make health insurance affordable. We’re going to get on track to have every citizen insured. And we’re going to reduce the rate of growth in health care spending,” Romney told McClatchy Newspapers prior to unveiling his health care plan last Friday in a speech before the Florida Medical Association.

While Romney is making national health care a centerpiece of his clean-cut campaign, he is also one of the few Republicans who can discuss universal medicine as a national moral imperative without sliding into the unelectable drunkenness of OD’ing on Michael Moore’s well-meaning entitlement Kool-Aid.

What is not clear, however, is what his hope to level the playing field of the health care marketplace might ultimately cost Americans.

Equally unclear is how Romney’s national proposal would likely differ from his widely heralded universal health plan as governor of Massachusetts.

Romney’s grand synthesis appears well-designed to repel the big government handout “socialism” tag that had plagued earlier efforts by liberals to make affordable, universal health care for all Americans an inalienable right on par with free public education ever since Truman’s failed “Fair Deal” platform nearly 60 years ago.

As correctly pointed out by The Wall Street Journal on Monday, and in keeping with his decentralized, free-market approach to governing, Romney would give the states maximum flexibility to tailor their own plans—to hopefully cover their lower to middle-income uninsured—by turning “today’s open-ended Medicaid entitlement into federal block grants to the states, and do likewise for federal uncompensated care funds.”

To be fair as well as frugal, Romney’s vision would likely include trying to restore parity in the tax code by allowing individuals to deduct the costs of their health care, as businesses who provide health care for their employees presently enjoy. According to the WSJ, the present tax code inequity “creates third-party payer problems for the insured and raises prices for everyone else.”

The former Bay state governor is also a big fan of pre-tax health savings accounts and malpractice reform by setting caps on punitive and non-economic damages. 

Ideally, Romney’s platform would lower health care spending and premiums and make insurance cheaper for states to cover those who cannot cover themselves.

But can slashing current medical costs be done without sacrificing quality of care by gutting appropriate legal protections for consumers that hold doctors who engage in egregious malpractice liable for the often irreversible harms their errors, negligence and hubris can inflict?

To deliver his ambitious plan on a national scale would Romney, and an allied Congress, be compelled to lower costs even further by deregulating the health care industry? Would Wall Street’s lusty deregulatory zeal, that is always lurking in the wings, allow insurers to compete by selling policies across state lines, as the WSJ appeared on Monday to be goading Romney into proposing in a final act of fidelity at the altar of unrestrained, free-market economics?

Would a Congress and a president pressured to deliver on one or the others’ campaign promises feel compelled to create a “regulatory marketplace” where consumers call the shots on which state’s regulatory scheme is cheapest, individually, regardless of whether that scheme mandates coverage for say non-emergency chiropractic visits, in vitro fertilization as well as possibly life-saving but costlier experimental procedures?

Would this initial Wild West horse trading spark a race to the bottom where soon competing health care plans are only covering the barest of medical necessities, while shortchanging low-end consumers on the fuller coverage of pricier plans designed solely for the well-off? Wouldn’t all this deregulatory baiting-and-switching just be another fancy screwjob that maintains the current status quo of plans offering high quality, comprehensive medical coverage fit only for the wealthy and their now pumped up share-holder profits?

In the WSJ’s analysis, Romney would not push a national plan that deregulates health care to this degree, calling such a move a “Camel’s nose”.

I wonder, however, if elected would President Romney be able to maintain his noble promise and not be forced to sellout the quality and scope of coverage to fulfill his national health care pledge?

While Romney’s heath-care-speak is chock full of savory morsels, Richardson, by contrast, offers no specifics in his present plan regarding consumer parity in the tax code, deregulation or medical malpractice reform such as caps on liability.

According to his campaign’s Web site, Richardson’s heath care plan would provide sliding tax-credits to Americans who need help obtaining medical insurance, and control interest rates for those who have racked up health care debt on their credit cards.

Richardson’s plan, which parallels the private-public hybrid model of most Democratic candidates, will irk those who demand European-style socialized medicine.

His proposal for insuring the nation promotes choice without new taxation and would create “affordable” options by letting working families buy the insurance plan that members of Congress enjoy, expanding Medicare for Americans in the 55-64 age group, increasing existing programs for the poor and allowing children to ride the coattails of their parents’ coverage for an extended time. Though every American would be required to obtain coverage, they’d pay 10 percent less for going private.

To defray the estimated $104 billion-$110 billion cost per year of his plan, Richardson would cut medical costs with preventive care, lower prescription drug prices, reduce the hidden costs of uncompensated care by requiring insurance companies to cover people with pre-existing medical conditions, and reduce bureaucratic and administrative waste through technology.

Richardson’s savings projections seem unrealistic: how much cutting of bureaucratic waste can be accomplished within a public-private system is still unknown.

There are also looming logistical questions and messy practical details regarding letting regular folks purchase the same insurance plan of federal workers — like who’ll pick up the tab for the increased administrative costs incurred by increased demand?

Richardson is practical, however, in calling for reigning in medical costs by calling for services grounded in scientific evidence and rewarding medical providers based on their results with patients.

However, under Richardson, Romney or any universal plan certain experimental procedures and protocols might not be covered, which raises a whole new set of ethical issues and dilemmas.

Just ask anyone with a relative battling end-stage colorectal cancer.

Both men are experienced in running state governments and meeting the needs of diverse constituents. And their plans to bring universal health care to needy Americans at the national level could, under the right plan, be easier to sustain than at the state level.

“It’s much harder to sustain universal coverage at the state level,” Leif Wellington Haase, director of New America Foundation’s California program and former health care fellow at The Century Foundation, told The Santa Fe New Mexican earlier this month. According to Haase, risk pools are much larger at the national level, and the federal government can better adjust for ups and downs in the revenue cycle.

While solving America’s health care crisis is rightly the nation’s top domestic priority, unfortunately it strikes me as less important than nailing down where every presidential contestant is coming from in terms of how they interpret foreign affairs and how their interpretation might inform their foreign policy.

Faith & foreign policy

As Senator Joe Biden is fond of making clear in his new campaign ads, “The next president will be left with no margin for error. Hear me? No margin for error. He or she better know more than his or her advisers. They better have been tested. They better not blink.”

Conservative commentators have been quick to scold the media’s obsession with Romney’s Mormonism as a sort of bigotry on par with their fixation with John F. Kennedy’s Catholicism during his run for the White House 47 years earlier.

Equally so, the pundits have been at a loss to explain how a man as qualified and experienced as Richardson still languishes at the Joe Blow, no-name-recognition obscurity of a Mike Gravel, and is probably less well-known around America’s kitchen tables than Dennis Kucinich, despite his greater popularity over both in the polls.

Unlike Kennedy, who came to power during the Cold War, when anxiety over nuclear annihilation and paranoia of communist infiltration at all echelons of American society were popular collective fears akin to our present day neurosis of terrorists next door, the “religious question” for Romney, who supports Bush’s Iraq policy, though he now slams its mismanagement, seems entirely relevant for a candidate pushing for escalating the war by throwing another 100,000 troops into the bloody fray.

It also seems especially on point for a candidate who told his supporters in Jackson last week that he believes America and western civilization are on a collision course with “radical Jihadists” who want to drag it back to the “8th and 9th centuries.”

Where on earth, or in the current on the verge of breaking army as reported by Fred Kaplan in Slate, Romney plans on rounding up another 100,000 boots to fight is as unclear as is deciphering whether his recent campaign utterances should be understood in the context of bloated primary rhetoric, to rally his perceived base, or true political conviction to inspire the nation.

Because of his hard-charging and unqualified views, it is Romney who is forcing curious journalists to badger him over how much of his platform is based on theology and how much on reality — not the other way around.

After nearly eight years of a president who has justified his messianic foreign policy adventurism on the assumption that “freedom is God’s gift to humanity” right-thinking and wrong-thinking Americans have every right to know precisely what Romney is thinking when it comes to proposing an escalation of the so far unsuccessful military-solution to Iraq.

Richardson too, because of all his savoir-faire and plain-spoken man of experience brilliance, leaves me wondering about how much he would ultimately deliver on his steadfast promise as president to end the war through an immediate troop withdrawal.

(On the role of religion, prayer and their power to alter the course of big events, two weeks ago in Iowa Richardson told a national television audience that though he believed prayer was an important but ultimately private matter, he did not believe it or his Catholic faith could have changed the outcome of hurricane Katrina or the recent Minneapolis bridge disaster).

Nonetheless, would Richardson really bring the troops home toute suite, as he has promised in his stump speeches? Or would a man as well-versed in the rituals and obligations of international diplomacy own up to the perils of a precipitous withdrawal, and how turning our back on Iraq might forever cement America’s moral hypocrisy in the Arab world and Middle East; thus, jeopardizing U.S. authority to advance other vital geo-strategic goals of a President Richardson administration?

I don’t have the answers to these questions, only the respective candidates do.

But ignorance is no reason for any American not to continue to hector some clarity out of those running for the highest office in the land, at a time of great uncertainty, about which course to take is best and why before the less curious settle on anyone candidate for either party’s nomination.

Before the die is cast, it’s critical that voters extract precise answers from the candidates now, not later when the best and the brightest stand to be silenced by a superficial primary process more attuned to raising the self-importance of a handful of states than letting the cream rise to the top.

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