Is Romneycare a "government takeover" of healthcare?
Absolutely not. A true government takeover is where the government owns and controls the insurance companies and hospitals. Countries with socialized medicine, such as Canada, France, and Britain, have government-run insurance plans and hospitals. In countries with socialized medicine, where the government has "taken over" the healthcare industry, private companies play a very small role in the overall healthcare industry. The government is largest provider of healthcare services to its citizens.
Romneycare is nothing like socialized medicine or a government takeover. In fact, Romneycare empowers and strengthens the private market by requiring people to purchase health insurance plans from private insurance companies. It is significant to note that nearly all major private insurance companies and hospitals supported Gov. Romney's healthcare bill in 2006. Also, according to FactCheck.org, some of the most strident critics of Romney's plan are the groups that support socialized medicine.
A prominent surgeon and New York Times bestselling author, Atul Gawande, wrote a piece for The New Yorker magazine on Jan. 26, 2009 which states:
Massachusetts, where I live and work, recently became the first state to adopt a system of universal health coverage for its residents. It didn't organize a government takeover of the state's hospitals or insurance companies, or force people into a new system of state-run clinics. It built on what existed. Repeated surveys have found that at least two-thirds of the state's residents continue to support the reform.
Is Romneycare bankrupting the state of Massachusetts?
Not at all. Numerous unbiased organizations such as FactCheck.org and The Massachusetts Taxpayers Foundation - a think tank funded by business - determined after a 2009 study that the cost of Romneycare is "relatively modest" and "well within initial projections." They go on to say,
"Despite claims to the contrary, the Foundations recently released analyses of the cost to taxpayers of achieving near-universal access to healthcare showed that the average yearly increase was only $88 million, well within original estimates. Critics ignore the fact that the fundamental problem is not the costs of Romneycare but rather the unprecedented collapse of state tax revenues."(Fact check me here, here and here)
Another important note on the overall costs of Romneycare is that the Democratic legislature and the succeeding governor of MA modified Romneycare and added significant costs to the bill. This fact should not be overlooked. The following are some cost-containment items Romney tried to institute in Romneycare, but was overriden by the Democratic legislature:
1) Romney fought for a "higher deductible" option of health insurance that would pass the state's minimum-coverage guidelines - that idea was rejected by the legislature. Every healthcare purchaser knows that higher deductible plans are cheaper.
2) Romney didn't like that the states minimum coverage required expensive features that only a few people would use and some people would morally object to such as "unlimited in-vitro fertilization" and abortion. Romney believed that consumers should be free to choose a healthcare plan with the benefits they wanted, not be dictated by the government what features their healthcare plan must contain. Benefit-rich healthcare plans are expensive, and that is what the MA legislature required every citizen to purchase. (source - No Apology, paperback edition, pg. 194)
3) Romney tried to veto coverage for dental care, and optical care (much to my chagrin), all of which were overridden by the legislature.
4) A medicaid expansion for children was added to the bill by the Democratic legislature.
5) Romney wanted to control costs by having everyone, even the poorest of citizens, pay some portion of their premiums for their health insurance. But the succeeding governor decided to give it to the poor absolutely free. Romney also argues that giving healthcare absolutely free to poor citizens creates a strong incentive for people - particularly the unhealthy - to move into the state. Imagine the increased costs "free" healthcare creates for the government. (source - No Apology, paperback edition, pg. 194)
6) Governor Patrick also set the state's share of the premiums above a level Romney thought was affordable. Those who recieved subsidies on their health insurance, now could rely on the government to pay a bigger portion of their premiums. (source - No Apology, hardback edition, pg. 175)
7) Gov. Patrick also added an expensive prescription drug benefit after Romney had left the governorship.
All of these modifications to Romneycare had a major impact on costs. Romney can't be blamed fully for the costs of the program.
Did Mitt Romney Intend for RomneyCare to be Adopted Nationwide?
No. The best way to see if Romney intended for RomneyCare to be adopted nationwide is to read interviews of Gov. Romney right after the health care law was passed in 2006. One such early interview was on NPR on April 8, 2006 where he said this:
Q: Stepping back, what impact do you think this will have outside Massachusetts? Around the country, people are watching because they know this is big. Some on the far left don’t like it because it’s not a single-payer universal coverage program. Some on the far right don’t like it because they don’t like government telling people that they need to get insurance. But the great majority of people, both on the left and the right, believe that this is a step forward.
Q: Can this model be used in other states? My guess is a lot of states will choose to adopt one or another of the measures we’ve put in place here. But most will give it a little time and watch to see what our experience is. That’s the great thing about having 50 states and the principle of federalism. Let us experiment ourselves. Let us learn from one another.Note that Romney emphasizes that states will learn from one another and adopt whichever policies would work best for their state. States are free to accept or reject the policies passed in Massachusetts. Romney never intended there to be a federal mandate upon the states to implement RomneyCare. (Hat tip to Charles Mitchell at EFM)