The trouble with the Obama-Romney definition of “affordable” is that in practice it means subsidies, and once the government provides “free” health care, the private sector and entitlement state are fungible. Government inevitably dictates choices that used to be left to markets, as Mr. Santorum and Newt Gingrich pointed out. And, sure enough, due to the subsidy gusher that Mr. Romney opened, Massachusetts is now moving to impose price controls on private insurance and tightly regulate the type of care patients can receive.

Mr. Romney did concede on Tuesday that “I didn’t get the job done in Massachusetts in getting the health-care costs down,” and that’s for sure, even as he still endorsed the individual mandate that was supposed to reduce insurance costs. Bay State spending for uncompensated care incurred by “free riders” has increased every year since the plan passed, while a 2010 study coauthored by Mr. Romney’s chief economic adviser, Columbia Business School dean Glenn Hubbard, found that it increased insurance premiums by 6%…

Mr. Obama’s unbridled expansion of government means that the election will present the electorate with the largest philosophical choice since 1980: To continue the trend toward a larger and growing government and the ever-higher taxes to pay for it, or to modernize the 20th century’s broken government institutions. Republicans do not want to wake up in 2012 to discover that they have nominated someone who is unprepared, and maybe unwilling, to lead the reform of government that America needs.