Healthcare Business News

Referendum on reform

America has begun voting, with the future of healthcare policy a top-tier issue

By David May
Posted: January 9, 2012 - 12:01 am ET

The starting gun has sounded. The first votes have been cast and counted in the 2012 race for the White House. We now have an official Republican front-runner.

That margin of victory in last week's Iowa caucuses by former Massachusetts Gov. Mitt Romney was a resounding … eight votes.


Former Pennsylvania Sen. Rick Santorum was closing fast at the end, coming oh-so-close to pulling off his upset; it was essentially a tie, but there can be only one winner. Now it's on to New Hampshire and a rapid-fire series of primary contests building up to this year's “Super Tuesday” crescendo March 6.

This week's outcome in the Granite State seems much more pre-ordained for Romney, at least as of this writing. But then who knows what a few million dollars of negative advertising spend could do.

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Since it is still relatively early in the process, it's an opportune time to review some common healthcare planks in the platforms of the GOP pack.

The constant drumbeat, of course, is the universal vow, pledge, oath to scrap “Obamacare,” the sweeping reform law we know formally as the Patient Protection and Affordable Care Act. What do they say is wrong with the law? Take this multiple-choice quiz: It's a) socialized medicine; b) unconstitutional; c) a jobs-killer because of its regulatory chokehold; d) all of the above and much more.

The war cry is that Congress needs to “repeal and replace” the law. Now. Replace it with what? Good question. The most favored approach is a “market-based,” “competitive” model.

That's an excellent choice of words, but what any replacement cannot be is a return to a time when healthcare costs always far outpaced general inflation; pre-existing conditions meant inadequate coverage or precluded any coverage at all; the seriously ill were at risk for being rescinded from their health plans; and there wasn't a clear path to health insurance for 30 million more Americans.

Romney is one of the candidates barking the loudest for repeal of the ACA. Yet, as we all know, the plan he signed into law as governor uses essentially the same approach, employing an individual mandate. It has achieved remarkable success in getting patients covered in that state. While Romney might not be an official architect of the Affordable Care Act, he helped create the blueprints.

Santorum's healthcare ideas will also sound familiar: Allow patients to buy insurance across state lines; employ patient-driven approaches such as health savings accounts; and reform medical liability laws. Unfortunately, those provisions don't solve the access and affordability issues, especially when patients don't have any money to fund an HSA.

President Barack Obama and the Democrats who constructed the reform law cannot escape criticism. The law holds little promise of serious cost-control, especially in the short term. Cost is also the ding against “Romneycare” in Massachusetts, and getting it under control is the only thing that will make our healthcare system sustainable.

There's no magic bullet to slay the healthcare inflation beast. One place to start would be a New Year's resolution by all parties in all branches of government to amend and improve the Affordable Care Act through some grand compromise.

In speech after speech when the outcome in the Iowa caucuses became clear, several of the GOP candidates invoked the name of Ronald Reagan. He's essentially been deified in the party. But let's remember one thing about that man: He was, at times, willing to compromise. He sought common ground. He even raised taxes. During a recession.

Let's find a way to fix what still ails our healthcare system. Do it for the Gipper.

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