John C. Goodman

This is a speech Mitt Romney should have given last year. It may even work this year. If he waits until next year, I'm afraid it will be too late.

My fellow Americans,

As governor of Massachusetts, I presided over the most important state-level health reform in our nation's history. From that experiment I've learned a great deal about what works and what doesn't work in the ongoing effort to lower costs, raise quality and improve access to care.

We accomplished four things that are worth emulating nationwide.

First, we cut the number of uninsured by more than half in my state. If that were replicated nationwide, we would have 25 million newly insured citizens.

Second, we insured the uninsured mainly by using money already in the system (for Medicaid and emergency room care), not by raising taxes or cutting benefits for the elderly and the disabled — as ObamaCare does.

Third, we created tax fairness. Massachusetts is the only state in the union where employees get the same tax relief for health insurance, whether it is provided at work they purchase it on their own. This is in contrast to the arbitrary and unfair way the tax system treats people in other states and the much greater unfairness people will be subjected to under ObamaCare.

Finally, we put partisanship aside and sought everyone's help in achieving these goals. Left and right, Democrat and Republican — all worked together toward a common end.

On the other hand, there are things we did that I would not recommend to others.

First, there is no need for a mandate. In Massachusetts, as in other states, people pay lower taxes if they insure and higher taxes if they do not. We have added additional subsidies and fines in my state to make being insured even more attractive. These financial incentives alone account for almost all of our success in insuring the uninsured. Once the government starts dictating the content of everyone's insurance plan, however, the special interests set in, bloating the benefit package and making it prohibitively expensive. By making health insurance expensive and one-size-fits-all, mandates actually defeat the goal of universal coverage.

Second, while increasing the number of people with insurance, we did not create one new doctor or one new nurse. Nor did we deregulate and allow insurers and providers of care to get out from under a mountain of regulations that prevent cost-effective products. As a result, the wait to see a new doctor in Boston is longer than in any other U.S. city. Our emergency room traffic is higher today than before the reform!


John C. Goodman

John C. Goodman is Senior Fellow at The Independent Institute and author of the widely acclaimed book, Priceless: Curing the Healthcare Crisis. The Wall Street Journal and National Journal, among other media, have called him the "Father of Health Savings Accounts."