In a crowded field for the Republican presidential nomination, only two candidates have real records of achievement on healthcare reform: Gov. Rick Perry and former Massachusetts Gov. Mitt Romney.
Romney fell for the conventional wisdom that Americans believe it is the government’s responsibility to ensure “universal” coverage. This resulted in his collaboration with a heavily Democratic state legislature to implement a mandate on residents to carry health insurance with a massive expansion of subsidized healthcare to achieve so-called universal coverage.
How far did this go to achieve a long-standing liberal vision? Sen. Edward Kennedy was at the signing ceremony!
The results have included rapidly rising costs, healthcare plans on the verge of insolvency and a level of government control that is allowing Romney’s Democratic successor to impose politically determined prices and fees through the Massachusetts health system.
Perry’s record is different. Although he tried (and failed) to assert executive power to vaccinate schoolgirls with Gardasil, which protects against human papillomavirus, he otherwise tried to reduce, not increase, government interference in people’s healthcare. His successful tort reform reduced medical-malpractice premiums and attracted doctors to the state.
This priority displeases those who believe the government’s most important job is to impose universal coverage. Perry’s critics point to the state’s uninsured rate. At 26 percent, it’s the highest in the country. For many, that’s enough to give Perry an F on healthcare.
That take is dangerously superficial. What ultimately matters when evaluating healthcare policy is, well, health — the “outputs” of the system, like mortality rates and incidence of disease. And on those counts, Texas under Perry has fared quite well.
According to the United Health Foundation’s America’s Health Rankings, Texas ranks 35th in immunization coverage, 42nd in the number of primary-care physicians and 46th in the rate of cholesterol checks.
That all seems to paint a dismal picture.
But what about health outcomes in the Lone Star State? Are they as poor as these statistics imply? Hardly.
According to the same report, Texas is actually one of the top states in the nation when it comes to incidence rates for some major diseases. The state ranks seventh for the lowest number of heart attack deaths per 100,000 population and 10th for strokes. It clocks in at 11th for cancer deaths.
So, it’s hardly clear that throwing more taxpayer money toward healthcare would have improved health outcomes. In fact, Perry’s limited-government approach to healthcare deserves some of the credit for the Lone Star State’s stellar rate of economic growth.
Texas has a particularly limited Medicaid program. About 17 percent of state residents are enrolled — lower than the national average of 19 percent.
Spending per Medicaid patient in Texas is low as well. The state’s program allocates about $4,555 per enrollee per year — about $600 less than the national average of $5,163.
Texas’ refusal to lavish taxpayer money on government-run healthcare has led to greater economic freedom and job creation. The state has added more than 1 million jobs since Perry took office in December 2000. That’s an 11.3 percent increase. Over that time, national employment dropped by about 1 percent.
Perry’s hands-off approach didn’t result in disastrous health outcomes, as his critics contend. Instead, it helped fuel the job growth that is his biggest selling point.
The American people have voted with their feet. Texas’ significant population growth — 15 percent of the nation’s between 2000 and 2009 — indicates that Americans value jobs more than government expansion of Medicaid dependency or the political goal of universal coverage.
Some of these new Texans used to be Bay Staters; Massachusetts lost residents over the period. President Barack Obama, Romney and all advocates of government-controlled healthcare should take note.