Mitt tried to explain the truth but failed

By now it should have become clear that I believe there are two paths to follow with health care.  The Republican Plan to allow wealth and state governments to ration healthcare or the Democrats Plan to have some overall safety net that ignores wealth and will have to ration some stuff though the Oversight Cost Control Panel that the Healthcare Affordability Act provides for.

The former will have poor people suffering in the streets someday while the latter threatens to bankrupt the government's finances if not implemented well.

So here comes Mitt Romney, the designer of the Healthcare Affordability Act for all practical purposes, to explain why it was good for Massachusetts but not for the whole country.  He could have said, we don't have as many obese poor people in Mass as there are in the predominantly rural states that vote Republican so Mass can afford it but the U.S. cannot.  That would have had an element of truth to it, but he would have insulted all the obese people in Republican states.  He could have said, it is a state's right's issue and Medicare and Medicaid should be put under the control of each state.  That could have had an element of truth.  But how would Florida afford it and the Republican Fat Cats in the rich states don't want all those poor obese people moving from the Republican States to the Democratic States, that would upset the electoral college arithmetic that provides support for not raising taxes.

So here is what I think Mitt was trying to say and didn't want to put the idea squarely out there into the debate because the Republican point of view will lose the 2012 election hands down.  It was good for Mass because it got all the uninsured into the insured system and then costs can be controlled.  And Mass does have more people with insurance because it is wealthier and has fewer uninsured then the U.S. as a whole.  The only way the U.S. can afford it is to raise revenue and ration certain things through Medicare and Medicaid.  But rationing is another word for "Death Panels" and the Republicans will not support either revenue increases or Death Panels.  So the only path the Republicans are leading us down on health care is either bankruptcy of the system or putting it all in the hands of the private sector insurance companies and letting them ration and make profits and in general provide frustration to the general population.  Of course, this path allows the wealthy (and here I mean the really wealthy because if you only have $100,000 to $200,000 to live on in retirement, you won't have enough) to buy extra insurance and access to get around all this.  Of course, Mitt understands this but knows the truth won't win the Republican nomination or the 2012 election.

This is not easy for the Democrats to explain either.  Medicare for all would provide the highest level of cost control, but that couldn't pass the realty of putting all the Health Insurance Companies out of business.  In any case, some rationing will occur eventually in some formal setting as opposed to the way it occurs now based on wealth and access to insurance.  But at least they want a middle road.  Revenue increases and some basic health care coverage for all.  Get the uninsured into the system and figure out a way to reduce emergency room usage for things are not emergencies.  Look for other ways to control costs.  Malpractice Reform would not hurt either but that is a bill still waiting to be passed.

Sorry for the length again, but this is something I am passionate about.  I think in my next career I want to figure out a way to provide affordable (this is a huge issue, $20,000 is affordable for me, but not John Doe who makes $50,000 a year) healthcare for all with minimal rationing, but I don't know enough now to be a real expert.  This is a vey complicated subject.  However, I do know that obesity and "end of life" desire for low probability "Hail Mary" treatments are probably the biggest hurdle to controlling costs once emergency room access is controlled.  Unfortunately, until 2014 we will be making little progress on this and the Republicans would send us back to the starting line in 2013 if they get a chance.