Replacing Obamacare with Real Health Care Reform

[DreamGypsy]

Got your attention, did I?

Earlier today, pinto posted Securing the Future of American Health Care in the Good Reads forum capturing the response President Obama gave to the New England Journal of Medicine:

The editors asked the Democratic and Republican presidential nominees, President Barack Obama and former Massachusetts Governor Mitt Romney, to describe their health care platforms and their visions for the future of American health care.

At the time of pinto's post, the Romney response was not available. When I was poking around later, it was available: Replacing Obamacare with Real Health Care Reform. I attached a link and a few comments to pinto's post.

During the late afternoon and early evening, as I contemplated what I had read I felt a need for discussion on what the Romney 'vision' outlined in the response really means. This post could have gone a lot of places: Good Reads, Politics, Humor, etc., but I decided on Health. I hope this is the correct place.

I'll seed the discussion with a few excerpts from the Romney/Romney campaign statement of their platform and vision, and my reactions to that statement.

The first four paragraphs of the statement are IMHO (im)pure political/electioneering rhetoric. Then we get something interesting:

In the health care system that I envision, costs will be brought under control not because a board of bureaucrats decrees it but because everyone — providers, insurers, and patients — has incentives to do it. Families will have the option of keeping their employer-sponsored coverage, but they will also be empowered to enjoy the greater choice, portability, and security of purchasing their own insurance plans. As a result, they will be price-sensitive, quality-conscious, and able to seek out the features they want. Insurers will have to compete for their business. And providers will find themselves operating in a context where cost and price finally matter. Competition among providers and choice among consumers has always been the formula for better quality at lower cost, and it can succeed in health care as well.

This description seems, to me, a flight of fantasy. Waving some magic wand will create incentives to reduce costs -but that's not the way health care currently works - some provider offers a cut-rate colonoscopy at and the provider next door introduces the new, improved colonoscopy at twice the price. Families can keep employer coverage, as long as they're employed, or can purchase their own plans...if they can afford them. Insurers don't really compete for business - if they financially able, they drive competitors out of business and then raise prices. Maybe cost and price will matter in the context in which health care providers operate ... fifty years from now, but that's not the current business model. Ok, rant off. What do you think?

To achieve this aim, we must end tax discrimination against persons purchasing insurance, we must strengthen and expand health savings accounts, and we must establish strong consumer protections. The result will be patients who can confidently choose the coverage that is right for them, who know and care what health care costs, and who reward providers that deliver effectively. For this choice to be meaningful, insurance market reforms must promote competition by eliminating onerous mandates, facilitating purchasing pools, and opening up an interstate market. Regulation must prevent insurers from discriminating against people with preexisting conditions who maintain continuous coverage.

Uh, this tax discrimination thing...so now health insurance, whatever you or your blind trust decides to spend, that's deductible? Or am I missing some nuance? Health savings accounts if you don't need food and don't plan to retire? Then, the mantra of deregulation...except the hot bullet of preexisting conditions if you don't ever miss a payment...otherwise, coffin fodder. Your thoughts?

Finally, for our health care system to work for all Americans, we must have government programs that effectively serve our senior citizens and people in need without breaking the bank. In other words, we need genuine entitlement reform.

Ok, cuts to medicare, medicaid, and other assistance programs coming soon...but not so soon as to jeopardize my candidacy.

A couple more paragraphs of campaign rhetoric.

Good night. Hope to hear from you tomorrow.