Romney's Gross Misunderstanding...And Two Alternatives

Several of the candidates have been found to have made egregious
misstatements in the href="http://edition.cnn.com/2008/POLITICS/01/05/nh.debates/?iref=mpstoryview">New
Hampshire debates.  FactCheck.org, the organization
made famous by Dick Cheney when he href="http://www.washingtonpost.com/wp-dyn/articles/A12901-2004Oct6.html">erroneously
referred to it as Factcheck.com, has href="http://www.factcheck.org/elections-2008/nh_debate_the_gop_field.html">an
analysis of the Republican candidates' statements.  



There is a lot of material there.  The one that really stands
out for me pertains to the issue that is most important in the coming
election: health care policy.  This particular error was made
by Mitt
Romney.



Their summary:

Romney claimed that the 47 million Americans who lack
health care are not covered because they say "I'm not going to play.
I'm just going to get free care paid for by everybody else." Experts
say that very few who are offered insurance turn it down and that the
uninsured get worse care.

Part of their analysis is this:

...The National Academies report that "only 4 percent
of all workers ages 18 to 44 (roughly 3 million people) are uninsured
because they decline available workplace health insurance, and many do
so because they cannot afford the cost." A 2007 study published in
Health Affairs found that 56 percent of the uninsured were neither
eligible for public coverage nor able to afford insurance without
assistance. This study also found that 20 percent of the uninsured
could have afforded coverage, but even leaving aside other factors like
being turned down for insurance, that’s hardly 47 million
people refusing to “play.”



Romney is also misleading when he implies that the uninsured are simply
choosing between toeing the line and freeloading as two roughly equal
ways of obtaining health care...

They have more details on their site.



Romney's statement, on the surface, could be interpreted as showing
that Romney has a gross misunderstanding of the issue, in addition to
getting most of the facts wrong.  



What is particularly galling about this is that Romney claims to have a
great idea for health care.  From one of his href="http://www.mittromney.com/Issue-Watch/Health_Care">campaign
sites:

I think it appeals to people on both sides of the
aisle: insurance for everyone without a tax increase."



- Governor Romney, USA Today, July 5, 2005

What he is referring to is the Massachusetts Health Care Reform Plan
(MHCRP).  It is sometimes referred to as href="http://www.huffingtonpost.com/byron-williams/another-massachusetts-mir_b_18657.html">another
Massachusetts Miracle.  Romney bills it as a plan
that makes Democrats celebrate and Republicans salivate*. 
However, instead of being embraced by both sides, it has drawn
criticism from progressives ( href="http://www.tompaine.com/articles/2006/04/07/massachusetts_mistake.php">Massachusetts'
Mistake, on TomPaine.com) and libertarians ( href="http://www.cato.org/pub_display.php?pub_id=6407">No
Miracle in Massachusetts, on Cato.org).
 It does have the support of some
conservatives, notably the Heritage Foundation.  In fact, the href="http://www.heritage.org/" rel="tag">Heritage
Foundation href="http://www.mediatransparency.org/story.php?storyID=126">was
instrumental in designing the MHCRP.



I don't think that it is fair to Romney to conclude that he simply does
not understand the issue.  Rather, it is more likely that he
has a very slanted, very peculiar understanding of the issue.
 The reason I say that is that, despite the criticisms
mentioned above, it is true that there are elements within both the
Democratic and Republican parties that embrace the plan. Those are the
elements that embrace corporatism.  That is the idea that,
rather than government helping individuals, it should give assistance
to corporations.  



At first is seems odd, but this is a principle that unites href="http://en.wikipedia.org/wiki/Hillary_Clinton" rel="tag">Hillary
Clinton and Mitt Romney.  Equally counterintuitive,
it is opposition to corporatism that unites href="http://en.wikipedia.org/wiki/Dennis_kucinich">Dennis
Kucinich and href="http://en.wikipedia.org/wiki/Ron_Paul" rel="tag">Ron
Paul.  Of course, both Kucinich and Paul have very
different approaches to health care policy. href="http://www.dennis4president.com/go/issues/a-healthy-nation/">Kucinich's
plan is Medicare For All.   href="http://www.ronpaul2008.com/issues/health-care/">Paul's
plan is for a truly free market approach. What the two plans
have in common, is they both are focused on solving a problem for
individuals (as opposed to providing an opportunity for corporations).
 



Although I favor Kucinich's plan, I could live with Paul's.
 The idea behind Dr. Paul's approach is that in a truly free
market, companies are motivated to provide services (or goods)
efficiently.  Perhaps that would work.  In a
corporatist environment, companies are also motivated to maximize
efficiency, but it is an efficiency of a different sort.  What
they maximize, is the efficiency with with they extract money from
people's pockets.  The efficient delivery of goods or services
may occur, but if it does, it is a byproduct.  



Cognitive tip: whenever someone uses the word efficiency,
ask them how they calculate efficiency.  Efficiency is a
quotient; it is calculated from two numbers: units of benefit produced,
divided by the number of units or resource expended to obtain that
benefit.  If it is not crystal clear to you what the units
are, then you are likely to be misled.



In the case of health care, one might assume that efficiency refers to
units of health care delivered per dollar spent.  However, if
that is not stated explicitly, then it is likely that the person using
the word actually is referring to the inverse of the price-earnings
ratio. That is, the company's after tax earnings (benefit) divided by
the market capitalization (resource).



Dr. Paul's idea is that a free market will lead to a tight coupling
between the two ratios (units of health care delivered per dollar
spent, and tax earnings divided by the market capitalization.
 



The assertion that the two are always tightly
coupled is the big lie of corporatism.  So now you see that
the title of this post was misleading.  I don't really think
that Romney has a gross misunderstanding.  Rather, I think he
is telling the big lie.



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*Romney does not really say that, but for years I've been wanting to
make a satirical play on the Boca Burgers advertisement.