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Health reform, comparing Romney and Obama

There’s no question this election presents voters with a stark choice in candidates, and nowhere is that more obvious than health care.
Colleague Bob Laszewski has written an authoritative piece delineating the differences between Obama and Romney’s plans for health reform; here are a few excerpts. I encourage you to read the entire post, it is well worth careful consideration. (emphases added)
“On his first day in office, Mitt Romney will issue an executive order that paves the way for the federal government to issue Obamacare waivers to all fifty states. He will then work with Congress to repeal the full legislation as quickly as possible.”
The Affordable Care Act (ACA) does give the President power to issue states waivers from the Democratic health plan legislation. But, not before 2017 and only if the state can demonstrate that it can cover as many people as the Democratic health care law is covering in the state… If Romney tried this, I would have to believe advocates for the ACA would quickly be in federal court.”
“…it looks like their [Republicans’] health care priorities will be to pass their Medicare and Medicaid reforms and leave dealing with the uninsured to the states.”
Romney places a lot of trust in competition in the market for solutions…
Romney would empower individuals and small businesses to form purchasing pools. I have actually run such pools–association health plans. It is perfectly legal to start one today. In all of my years running these pools, I never saw them save money–actually they tended to cost more when compared to small group plans…”
Romney would allow consumers to purchase insurance across state lines. The problem he is trying to address is that states have lots of coverage mandates…I have no doubt that some states have fewer mandates and lower individual health insurance prices. However, I know of no state that has truly affordable health insurance. It is hard to see this as any real solution.
If this provision were ever to become law it could have a very negative impact on current state individual insurance markets. Many, and many in the health insurance business, believe this provision will take us back to the days of cherry picking in risk selection. Predatory insurance companies could use this provision to offer a stripped down policy in a state with more mandates. That policy would be cheaper and cover less–and therefore attract more healthy consumers. That would leave a sicker population in the existing state risk pool with rates having to ratchet up for those who need more coverage.”
Bob’s views, as always, are on point.
I’d add that the reason health reform is so complicated, and the bill so long, is to address these – and the myriad other issues that must all be considered if we are to ‘reform’ the health care and health insurance system(s).

Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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