Since announcing his second bid for the presidency, Mitt Romney has argued that health care reform should be left to the individual states and criticized President Obama for enacting a “one-size-fits all” solution through the Affordable Care Act. But that position — which seeks to establish a clear distinction between Romney’s signature health care reform law in Massachusetts and the ACA — is belied by Romney’s repeated suggestions that the federal government should play a key role in expanding access and lowering costs.
ThinkProgress has chronicled the evolution of Romney’s position on health care, from his belief that the Massachusetts should serve as a model for the nation to his support for a federal individual mandate. And now, a 2009 op-ed unearthed by Andrew Kaczynski of BuzzFeed offers yet another contradiction between Romney’s state-centered position on reform and his past support for greater federal involvement in the health market:
Here is where the federal government can do something we could not: Take steps to stop or slow medical inflation.
At the core of our health cost problem is an incentive problem. Patients don’t care what treatments cost once they pass the deductible. And providers are paid more when they do more; they are paid for quantity, not quality. We will tame runaway costs only when we change incentives. We might do what some countries have done: Require patients to pay a portion of their bill, except for certain conditions. And providers could be paid an annual fixed fee for the primary care of an individual and a separate fixed fee for the treatment of a specific condition. These approaches have far more promise than the usual bromides of electronic medical records, transparency and pay-for-performance, helpful though they will be.
In 2007, Romney told Newsweek that his state model could in fact serve as a template for federal reform. “I’m proud of what we’ve done. If Massachusetts succeeds in implementing it, then that will be a model for the nation,” he said and reiterated the same point to NBC several days later. For a timeline of Romney’s changing positions on the government’s role in health care, click here.