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The Wall Street Journal sets the bar for Mitt Romney’s health reform speech today in Ann Arbor. The sum of it is that Romney tried to finesse the core conflict of health care visions.

The raucous national debate over health care isn’t about this or that technocratic detail, but about basic differences over the role of government. In the current debate over Medicare, Paul Ryan wants to reduce costs by encouraging private competition while Mr. Obama wants the cost-cutting done by a body of unelected experts like the one emerging in Massachusetts.

Mr. Romney’s fundamental error was assuming that such differences could be parsed by his own group of experts, as if government can be run by management consultants. He still seems to believe he somehow squared the views of Jonathan Gruber, the MIT evangelist for ObamaCare, with those of the Heritage Foundation.

In reality, his ostensible liberal allies like the late Ted Kennedy saw an opening to advance their own priorities, and in Mr. Romney they took advantage of a politician who still doesn’t seem to understand how government works. It’s no accident that RomneyCare’s most vociferous defenders now are in the White House and left-wing media and think tanks. They know what happened, even if he doesn’t.