Repeal-and-replace key to spurring innovation: GOP

The innovation in care delivery that is needed throughout the healthcare system will occur only under the GOP's repeal-and-replace approach, according to conservatives who challenged Democratic criticisms unleashed this week at the Democratic National Convention regarding Republican plans to overhaul Medicare.

During a Wednesday call with reporters, conservative health policy experts sought to boost the plans by Republican presidential candidate Mitt Romney to repeal the Patient Protection and Affordable Care Act and replace it with a variety of health policy changes, including controversial plans to add a subsidized private insurance option to Medicare.

“A lot of people say, 'How are we going to have more Intermountain Healthcares or Geisinger Health Plans and other group health arrangements and something that will incent them nationwide?'” said James Capretta, a scholar at the American Enterprise Institute.

“Frankly, you need something like a premium support system that rewards them with marketshare and beneficiaries who will sign up with their plans because they are offering a lower premium and a high-value option.”

Conversely, the healthcare innovation approach used by the 2010 law created a federal office that authorizes pilot programs to test new approaches and then spread them nationwide.

The shortcomings of such a government-led approach, according to conservative health policy experts, are that it is both slow and overly standardized, without accounting for regional differences that present unique challenges and opportunities for providers.

“The question is, where does the innovation come from and where do the fine-tuning adjustments that make or break these ideas come from? They don't come from Baltimore,” Joseph Antos, a scholar at the American Enterprise Institute and a former assistant director at the Congressional Budget Office, said in a reference to the CMS.

Robert Moffit, a scholar at the Heritage Foundation and a former deputy assistant secretary at HHS, said he supports the law's goal of driving innovation by changing the payment incentives. However, the sustainability of those innovations is unknown unless they are “tested in the crucible of real experience.”

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