The last couple of days brought some good news. Several days ago, Mitt Romney was regarded as the inevitable, presumptive Republican nominee with back-to-back victories in Iowa and New Hampshire. Now, it is clear that Rick Santorum won Iowa narrowly; and Newt Gingrich steamrolled Romney in South Carolina. We thus have three distinct winners in the first three states.
If Mitt Romney does not get the nomination, Newt Gingrich's remarkable exchange with Juan Williams Monday night will turn out to be one of the great historic turning points in the history of presidential primaries.
But let's not presume that Newt Gingrich is a classical constitutional conservative. Consider, for example, his position on health care. I have posted about this previously.
Recall the grand constitutional design. Limited, enumerated powers are granted to the federal government; and all other powers are reserved for the states or the people.
But over the last several years, before entering the presidential race, Newt Gingrich helped establish and run a Center for Health Transformation. What are some of its listed strategies?
1. "Health justice"
2. "Secure electronic health records with expert systems to maximize accuracy, minimize errors, reduce inefficiencies and improve care"
3. "Create a buyers’ market for pharmaceuticals by building a transparent system for individuals, doctors, and pharmacists of price and efficacy information about prescription drugs and medically appropriate over-the-counter drugs. The system would have an open formulary with an “after-pay” rather than a co-pay (a 'Travelocity' for drug purchasing)."
4. "Establish an intellectually credible, accurate system for capturing the cost and benefits of better solutions, better technologies and better outcomes in order to create a technically correct model of return on investment for solutions resulting in better outcomes at lower cost."
5. "Develop a real-time continuous research database and discover-develop-deliver ability..."
6. "Knit together these electronic systems into a virtual public health network for health protection against natural outbreaks and a bioshield against deliberate biological attack"
7. (T)urn health and healthcare from a problem into an opportunity, making it the leading creator of high-value jobs and foreign exchange earning in American society (including as a first step the creation of an undersecretary of commerce for health).
We need to be a bit concerned when, like Obama, Republicans talk about using federal powers to achieve "health transformation" or "health justice".
Let's look at Newt's campaign website for his stated position on health care. It turns out that his campaign positions parallel some of the above ideas quite closely. But there are others:
1. Reward quality care by changing the Medicare and Medicaid reimbursement models to take into account the quality of the care delivered and incentivizing beneficiaries to seek out facilities that deliver the best care at the lowest costs.
2. Reward health and wellness by giving health plans, employers, Medicare, and Medicaid more latitude to design benefits to encourage, incentivize, and reward healthy behaviors.
3. Stop health care fraud by moving from a paper-based system to an electronic one. Health care fraud accounts for as much as much as 10 percent of all health care spending, according to the National Health Care Anti-Fraud Association. That's more than $200 billion a year. Compare this to the 0.1% fraud rate in the credit card industry thanks to its high-tech information analysis systems.
4. Inform patients and consumers of price and quality so they can make informed choices about how to spend their money on care. Patients have the right to know this information, but finding it is virtually impossible.
Some of the above positions might sound, on the surface, like pretty good ideas. However, many of them seem to require an even greater power grab on the part of the federal government. The power grab would be less than that seen with Obamacare; but it would far exceed constitutional conservatism nonetheless.
Newt Gingrich's stated positions on the judiciary and the social issues are stronger and more consistent than those offered by Mitt Romney (notwithstanding his personal life.)
With his strong rhetoric during debate, he gives the appearance of being more solid than Romney on various domestic issues. However, close examination of his health care positions suggests that might not entirely be the case. He clearly has statist tendencies with respect to health policy. We should not forget that presidential candidates who communicate big ideas on domestic policy might be at risk of exceeding genuine constitutional limits.
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