Monday, April 23rd, 2012
It’s a near certainty that Mitt Romney, former governor of Massachusetts, will be the Republican presidential nominee. Like his rival Republican candidates, Romney has adopted “repeal and replace” as his answer to “Obamacare,” or the Affordable Care Act (ACA) passed by Congress in 2010. But with what would he replace it?
The question is complicated by the fact that the ACA was modeled after a health care reform law championed by Romney while he was governor of Massachusetts. And the Massachusetts law was partly based on ideas generated by the conservative Heritage Foundation, which thought “Romneycare” was just dandy until a Democratic President borrowed its provisions for his own legislation.
Since then, Mr. Romney and the Heritage folks have raged against their own ideas and painted the ACA as the worst thing that’s happened to America since the British invasion of 1812. And since Romney has repudiated his own record in Massachusetts — in spite of the fact that his health care law is popular there — we can’t go by his record on health care to know what he might do as president.
Politicians of both parties will paint their opposition as dangerous radicals whose ideas will hurt America. It’s important for voters to look at the details of what candidates propose and decide for themselves whose ideas are more radical. This is especially true for those with life-threatening conditions such as mesothelioma, because health care policies can be life or death for them.
In the Los Angeles Times, Noam N. Levey writes that Mr. Romney could replace the ACA with something much more revolutionary. “Mitt Romney has turned to proposals that could alter the way hundreds of millions of Americans get their medical insurance,” Levey writes.
The centerpiece of Romney’s plan, Levey says, is to eliminate health insurance as an employment benefit. Instead, he would give Americans who buy their own insurance a tax break to help pay for it. If most Americans are buying their own insurance on the private market, the theory goes, competition will drive down prices and give people more choices.
Without a mandate for people to buy insurance, however, those insurance companies can’t be forced to take people with pre-existing conditions. So Romney’s approach would also be riskier and could possibly leave even more Americans without health insurance than is true now.
By contrast, the Massachusetts plan that Romney repudiated has reduced the number of Massachusetts citizens without health insurance. It worked, in other words. And when the Affordable Care Act goes into more effect in 2014, it is believed at least 30 million Americans will be able to obtain insurance who don’t have it now.
The fact is, there is no place on Planet Earth in which most people are getting health care paid for by individual policies purchased from for-profit, private insurance companies. Most industrialized countries have some kind of taxpayer-funded program that provides most health care for citizens. In a few countries private insurance companies are required to sell a basic insurance package at cost; insurers can make a profit only on supplemental insurance products. Only in the United States are private, for-profit insurance companies paying for most health care.
Further, Romney has proposed privatizing Medicare. He also wants to scrap Medicaid in favor of giving block grants to states to provide health care for the very poor. Many experts warn that this could result in seniors paying a lot more out-of-pocket for the health care, and the very poor getting even less health care than they are now.
We should get more details as the campaign progresses. It’s important for all of us to be paying attention.