May ‘11
16
Romneycare/Obamacare….Who Cares?
When Mitt Romney was the Republican governor of Massachusetts, he took on a Democratic legislature in an effort to reduce health care costs by expanding access, improving quality, reducing excess utilization and reforming health insurance and health care payment policy. The conservative administrators of President Bush’s Medicaid program encouraged him to make the deal with a big commitment of federal dollars. Conservative Washington think tankers helped seal the deal and applauded Romney’s resolve.
Today many of Governor Romney’s signature accomplishments have become national health policy goals in a new law Romney and all Republicans have sworn to “replace and repeal” – the Affordable Care Act of 2010. Every elected Republican in America, Rupert Murdoch and the Wall Street Journal and Roger Ailes and Murdoch’s Fox News radio and TV, are ripping Obamacare and Romneycare. The conservative think tankers who cheered for Romneycare are today fodder-feeding “replace and repeal.” Why are they able?
First, because the agreement on the Massachusetts law was premised on the fact the medical industrial complex which is the state and especially the Boston medical megalopolis has fiercely resisted changing all their bad habits. Because they say it’s too costly to do so at what public and private insurers are willing to pay them for better behavior. It’s these docs who are driving 80 plus percent of the MA health care costs through their largely academic health systems.
Second, because Republican dogma today has been made clear to legislators at every level. Markets work. They haven’t been tried because they haven’t been trusted by the liberals who love one-size fits all health care. Medicare and Medicaid are driving health care costs up and reimbursement for private providers down. Both need to be converted to private insurance programs ASAP. The tax spending on these programs need to be converted to “premium subsidies” set by legislatures and Congress and as much as possible of the actual costs of health care must be shifted to consumers of private health insurance and private health services.
At the University of Michigan last week, candidate Romney did what former MN Governor Tim Pawlenty did in South Carolina last week. He admitted his mistakes and begged for forgiveness in GOP primaries and caucuses next year. Romney committed to send your federal taxes to the 50 states in the form of block grants to be spent by state legislators on experimental designs with new health care payment. But without assurance of access or coverage for the 28% of Americans who today rarely or never have health insurance.
Romney promised each of us our choice of tax subsidies for our insurance depending on whether we buy coverage from our employers or from insurance agents. He promised insurance companies and agents they would not have to assume much risk in the individual insurance market and that he would encourage states to compete for your insurance business by keeping their regulation of insurance markets as weak as possible. And of course he supports caps on malpractice awards by juries and health savings accounts for everyone.
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