During a town hall in Florida this afternoon, Mitt Romney said his health care plan would “treat individuals like consumers” and allow everyone to purchase individual health insurance policies across state lines. “Funny thing how markets work if you have real consumers,” he added:

ROMNEY: I believe that in health care, the right answer is to get it to work more like a consumer market and less like a government dominant monopoly like it is today.

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But a “consumer-driven” market doesn’t actually work for health care, where individuals are tasked with making life and death decisions without the specialized medical information and in many instances don’t have the choice of refusing treatment.

Certainly a level of competition in the insurance market makes sense — and the Affordable Care Act establishes state-based exchanges that encourage insurers to compete for business. Under the ACA model, insurers will have to offer a basic set of benefits and will be competing on cost without necessary sacrificing quality of coverage. Romney is proposing something entirely different. He wants to spur competition by allowing insurers to circumvent consumer protections in certain states and sell bare-bone policies to the healthiest beneficiaries.

Someone’s “son” or “daughter” — as Romney puts it — may experience short term savings as long as they don’t become sick, but once they do (inevitably) fall ill, their plans won’t offer coverage for the treatments they need and they will either go bankrupt trying to pay for their medical bills out-of-pocket or spend substantially more on comprehensive coverage. These more substantial plans will also experience an increase in costs because they will be overrun with the sick people who are either uninterested in a bare bones “competitive” policies — they don’t offer coverage they need anyway — or can’t qualify for them.

In fact, even if one were to sweep these concerns aside and enact Romney’s consumer-driven model, it would have little impact on national health care costs. That’s because the individuals who would want a cheaper plan are generally healthier and make up “a tiny fraction of healthcare spending.” As ER administrator and physician Liam Yore explains, “They’re not getting $30,000 stents or prolonged ICU stays, or needing complex chronic disease management. Conversely, those who are high consumers of health care simply cannot be made more price sensitive, since their costs are probably well beyond what they could pay in any event, and for most are well beyond the limits of even a catastrophic health insurance policy.”

ThinkProgress filed this report from a town hall in Hampton, New Hampshire.

During a campaign stop in southern New Hampshire Saturday, Texas Gov. Rick Perry (R) defended his state’s record on health issues, declaring, “We have some of the finest health care in America in Texas.”

Speaking to a town hall in Hampton, Perry discussed the “specific actions” he took in Texas to help small businesses, singling out the state’s record on health care for praise. After claiming that Texas had “some of the finest health care in America”, Perry went on to tell Granite Staters that this was the type of “environment” he wanted to bring to Washington, DC if he were elected president.

PERRY: We have some of the finest health care in America in Texas because they know they can come there and invest. There are more doctors, nurses, researchers going to work on Monday morning in Houston, Texas at the Texas Medical Center than any other place in the world. You talked about the cancer and what was happening in this country, one of the great states and where it’s happening in the fight against cancer is in the state of Texas because we invested $3 billion in finding cures for cancer. Health care is so important to a company and whether it’s going to relocate there. If you have good health care, if you have the biomedical research that’s going on. So creating that environment and transferring that to Washington D.C. is what I’m all about.

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The rich or well-insured benefit from the state’s world class health care services, but Texans without insurance or independent wealth have a hard time accessing even the most basic preventive health care services

Indeed, Texas has the highest rate of uninsured residents of any state, over 10 points higher than the national average at nearly 26 percent. One reason why Texas’ record on health care is so lacking is that it has “among the country’s most restrictive Medicaid eligibility thresholds,” preventing thousands from getting insurance and treatment.

Even the changes that Perry touts, including tort reform, haven’t stopped areas of Texas from having some of the highest per capita health care costs in the nation, as a New Yorker investigation revealed.

Far from being the “finest health care in America,” Texas boasts significant problems in both access and cost. These are some of the principal issues that will be mitigated by the Affordable Care Act, a law that Perry wants to repeal in order to make American health care look more like it is in Texas.

Twenty medical specialty groups have written a letter urging the the congressional super committee to scrap the Independent Payment Advisory Board (IPAB), a committee created by the Affordable Care Act that is tasked with finding health care savings. “The signers include several specialty medicine groups, including the Alliance of Specialty Medicine, the American Association of Neurological Surgeons, the American College of Radiology and the American Society of Anesthesiologists. The groups represent more than 350,000 physicians.”

The Hill’s Julian Pecquet has the details:

“Today, the price tag for repealing the IPAB [Independent Payment Advisory Board] is relatively small, so Congress should seize this moment and repeal the IPAB now before the cost to do so becomes prohibitive and access to care problems become acute,” their letter says. “Also, because IPAB funding is authorized to begin on October 1, 2011 and board members can now be appointed, there is urgency for repeal before this board is established.”

The letter recaps industry criticism of the board, claiming its 15 appointed members will take Medicare payment policy out of the hands of elected lawmakers; that it will be required to start recommending cuts starting in 2014 based on spending targets that physicians say are too low; and that it would hurt seniors’ access to care if physicians pull out of the program because of low reimbursements.

To my eyes, the very fact that health care providers are so worried about the board suggests that it has real cost saving potential — both in terms of paying providers less and encouraging them to provide quality health care services more efficiently. So press on with the IPAB or even extend it beyond Medicare and Medicaid, perhaps the mere threat of reductions will inspire hospitals and doctors to take matters into their won hands and begin doing a better job coordinating care. Some are already doing just that.

“Virtually all Massachusetts residents who have gained coverage since the landmark 2006 law passed are now in a government health care program,” WBUR’s Martha Bebinger reports, attributing the significant increase in private insurance to the recession and loss of employer-based coverage:

Many experts agree the recession has played an enormous role in this shift from private to public coverage. Since the coverage law passed in 2006, 411,000 more residents of Massachusetts have health insurance; it’s the largest insurance expansion in the country. In the first few years, the expansion was fairly evenly divided between private and public insurance. That’s no longer the case.

According to Nancy Turnbull, an associate dean at the Harvard School of Public Health, “virtually everyone” of the Massachusetts residents who have received health care coverage with the implementation of the new law are enrolled in a public plan. “It’s virtually everyone because the number of people who have employer coverage has gone down,” Turnbull said. “That’s not at all surprising, that’s happening all over the country.”

That’s surprising because I covered many news conferences where supporters of the law stressed the success of shared responsibility. They used that analogy of the three-legged stool (individual, employers and state government all doing their part) over and over.

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One can look at this in two ways. From a budget perspective, the spike in eligibility is a significant burden to the state, particularly since health reformers stressed that the law would spread the risk and cost of coverage among individuals, employers and state government. Obviously, Massachusetts still has a long way to go in achieving that goal and lowering health care spending across the board. But reform provided a crucial safety net for families and individuals who would have otherwise gone uninsured, skipped medical care and in some cases lost their lives. That’s a significant achievement that will now allow the state to make the changes necessary — the picture will certainly look better once employment picks up — to be able to afford the program over the long haul.

Fox News host Bill Hemmer suggested that the conservative network was trying to build support for the repeal of the Affordable Care Act in an interview this morning with Rep. Steve King (R-IA). During a segment about the public’s waning enthusiasm for eliminating the law, King expressed concern that Americans were “making accommodations” to the measure since lawmakers are no longer publicly calling for its repeal. Hemmer seemed to agree, telling King that he is appearing on the program to boost support for ending reform:

KING: If we’re not in the news, if we’re not pushing to repeal Obamacare, it doesn’t drive the discussion in the public and the public just begins to move away from it, think okay, the Congress must think it’s impossible. That’s part of what’s going on here.

HEMMER: To be frank and that’s part of the reason why you came on our program today. But I think here is the critical point that Republicans are concerned with. This number [for repeal] is down from only two weeks ago, when it was at 56 percent and a lot of people thought that as long as the system works its way into the blood stream of the American people, that it would be accepted over time. Do you fear that, do you see that happening? [...] Just to be clear on this, back to the question. The longer it’s out there, the more accepting it becomes? That’s what you believe?

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Unfortunately, Hemmer has a history of shilling for the Republican party. In 2010, Hemmer asked Rep. Tom Price (R-GA) about the GOP’s prospects in that year’s midterm elections and in formulating his question, betrayed his allegiance to the GOP. “As you evaluate things right now, some five a half months out, I mean, where do we stand,” Hemmer asked. “How strong a position are Republicans?”

A new Rasmussen poll out today finds that “support for repeal is at its lowest level since May, with only 41 percent of respondents saying they “Strongly Favor it.” Sixty-seven percent either strongly oppose repeal or somewhat oppose it. A Bloomberg National poll from last month also showed that support for repealing the Affordable Care Act is declining, “with just 34 percent of the country now favoring repeal of President Barack Obama’s health-care overhaul, down from 41 percent six months ago.”

Mitt Romney doubled down on his claims that the Heritage Foundation and Newt Gingrich originated the concept of the individual mandate during an interview with the editor & publisher of the Union Leader yesterday. He also made a strong case for the individual mandate and rebuffed Republican claims that requiring people to purchase health care coverage will lead to further government intrusion:

ROMNEY: There are a lot of responsibilities that people have. Someone might say, ‘look I’m just going to expect the government to feed me.’ No, you got a responsibility to feed yourself. You’ve got the wherewithal to feed yourself and care for yourself, you can’t just expect the government to give you free food. We pretty much do insist on people to care for themselves. What’s unusual about health is that an individual says, ‘I’m well, but if I fall into a coma, or get cancer or heart attack, the cost of that treatment is so much larger than my ability to pay, that I can’t care for myself unless I have something like insurance that will cover that exceptional burden.’

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The Obama administration takes this argument one step further in their legal defense of the Affordable Care Act. It argues that health insurance is also unique because its market will collapse unless everyone buys coverage. Since the Affordable Care Act prohibits insurance companies from denying coverage to people with preexisting conditions, it must also ensure that nearly everyone carries insurance. If patients can wait until they get sick to buy insurance, they will drain all the money out of an insurance plan that they have not previously paid into, leaving nothing left for the rest of the plan’s consumers, and eventually destroying the entire individual health insurance market. By contrast, there is no risk that the national market for vegetables or other consumer goods will collapse if Congress does not require people to purchase broccoli, so a “vegetable mandate” simply does not fit within Congress’ constitutional power to ensure that its economic regulations are effective in the same way that a requirement to carry insurance does.