Compare and contrast: Obama and Romney on health care

Via the lefties at Think Progress, a video salute to Mitt’s cavalier assurance at last night’s debate that there’s nothing to get angry about when it comes to health-care mandates. Get ready for a long, long line of liberal attack ads in this vein once it’s clear that he’s the nominee: Even if they end up losing the election, the PR value to the left of having the Republican standard-bearer mimicking O’s rhetoric on ObamaCare is incalculable for the repeal battle ahead. That was always one of the greatest pitfalls in choosing Mitt — at a minimum, the right will have to temper its criticism of mandates during the general election — but darned if we’re not poised to go ahead and choose him anyway. And as Peter Suderman at Reason notes, this clip doesn’t even exhaust the similarities between RomneyCare and its much larger younger brother:

During last night’s debate, Romney also defended his plan from charges that it resembled ObamaCare by arguing that in Massachusetts, “there’s no government plan.” He’s used this line before, but it’s never helped distinguish Romney’s health overhaul from Obama’s: There’s no “government plan” in ObamaCare either, or at least no more of one than there is in RomneyCare. Both ObamaCare and RomneyCare rely on a regulated market and an expansion of Medicaid. Nor is Romney the only one to point this out in order to defend the structure both plans share: In his State of the Union address earlier this week, President Obama touted the fact that “our health care law relies on a reformed private market, not a government program.”

In the end, Romney only ended up reinforcing the similarities between his plan and President Obama’s. It’s hard to make a convincing case that the RomneyCare is somehow dramatically different from ObamaCare while relying on virtually the same arguments employed by ObamaCare’s most prominent defender.

No worries: The line about there being “no government plan” will be included in the inevitable MoveOn version of this clip, replete with copious citations to the new study out this week confirming that RomneyCare was indeed the “template” for ObamaCare. And yet, and yet, if you ask the average Republican about this, the answer you get might not be what you expect:

Republican opposition to the Democrats’ 2010 health care overhaul law is intense, with 73% of Republicans having an unfavorable view of it. By contrast, 62% of Democrats view it favorably.

The survey also found that most Republican voters don’t agree with the attack on GOP presidential candidate Mitt Romney that the health care law he signed as governor of Massachusetts is similar to the federal law. Some 30% said they felt Mr. Romney’s views on health care were akin to President Barack Obama’s, but almost half said the former governor’s views are different, and 22% didn’t answer.

So Romney’s big federalism talking point was enough to defuse this issue for fully half of the Republican electorate, notwithstanding his comfort with mandates in the abstract. I wonder if that’s a testament to the effectiveness of his campaign’s messaging or the catastrophic failure by his opponents to put this issue front and center. Only Santorum has scored real points on it, after all, and only in the debates this week.

Question: Has Romney addressed at length the core ideological problem that most conservatives have with health-insurance mandates, namely, their potential to expand into non-insurance realms? George Will likes to use the hypothetical of Congress forcing overweight people to enroll in Weight Watchers; Romney would oppose that on federalism grounds, but what if the Massachusetts legislature did the same thing as a cost-effective way to reduce the expense of treating obesity-related illnesses later? Would that be constitutional? (The Commerce Clause wouldn’t apply but privacy/bodily autonomy rights might.) Should we shrug it off on grounds that residents who object can vote with their feet and move to Vermont or New Hampshire? What’s the limiting principle on your freedom to decide how to spend your money on your own health? Exit quotation from NPR, quoting a professor at the Harvard School of Public Health: “Romney has given in this entire presidential campaign last evening what I believe is the most effective and persuasive rationale and defense of the individual mandate.” Terrific.

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