PLANK JULY 30, 2012
Conservatives have spent a lot of time accusing President Obama of trying to bring socialized medicine to America. It’s a grossly misleading charge: For better or for worse, the Affordable Care Act relies heavily on private insurance and involves far laxer regulation than most universal coverage schemes.
No, if you want to see a system with truly socialistic characteristics, you have to look elsewhere. Israel, for example. And guess who just praised that system? Mitt Romney, while addressing a fundraiser in Jerusalem.
Via Zeke Miller at Buzzfeed, here’s what Romney said:
When our health care costs are completely out of control. Do you realize what health care spending is as a percentage of the GDP in Israel? 8 percent. You spend 8 percent of GDP on health care. And you’re a pretty healthy nation. We spend 18 percent of our GDP on health care. 10 percentage points more. That gap, that 10 percent cost, let me compare that with the size of our military. Our military budget is 4 percent. Our gap with Israel is 10 points of GDP. We have to find ways, not just to provide health care to more people, but to find ways to finally manage our health care costs.
Miller notes that Israel has a truly universal health care system, in which the government guarantees every citizen not just insurance but insurance with a minimum set of benefits and full choice of provider. That’s all true. But there’s more to it than that. Israel also regulates the health care system aggressively, with what would, by any reasonable standard, qualify as price controls. Jack Zwanziger and Shuli Brammli-Greenberg wrote about this in Health Affairs:
The national government exerts direct operational control over a large proportion of total health care expenditures, through a range of mechanisms, including caps on hospital revenue and national contracts with salaried physicians. The Ministry of Finance has been able to persuade the national government to agree to relatively small increases in the health care budget because the system has performed well, with a very high level of public satisfaction.
The Washington Post’s Sarah Kliff, who dug up the Health Affairs article, adds that “Israel’s lower health care spending does not look to sacrifice the quality of care. It has made more improvements than the United States on numerous quality metrics, and the country continues to have a higher life expectancy.”
It’s true that Romney did not cite the Israeli system as a model for reform in the U.S. He merely praised its performance. He was merely commending its performance. But that tells us something. Like the better performing European and Asian health care systems, the Israelis get good health care while spending a whole lot less money than we do. And they do it with a lot of government involvement.
So was Romney simply clueless about the details of Israeli health care? Was he too busy trying to ingratiate himself with his hosts to pay attention? Or does he secretly think government-run health care has its virtues? I don't know—and I’m not sure Romney does either.
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