Thursday, September 13, 2012

Romney’s Health Reform Plan

The chess board is the world..the rules of the game are what we call the laws of nature.  The player on the other side is hidden from us...He never overlooks a mistake, or makes the smallest allowance for ignorance.

Thomas Huxley (1825-1895), A Liberal Education (1868)
September 13, 2012 -   What are the details of Romney’s health reform plan?  Is it Romneycare revisited?  Is it a more conservative, more broadly-based competitive model?  
 It’s hard to know for sure. Presidential campaigns are like chess.  One does not let your opponent know your next move in advance. You might be checkmated. And you might make a mistake.

In any event, yesterday in The Health Care Blog, a widely read blog among policy wonks, Robert Laszeswki  gave us an inkling of the Romney strategy.  Laszewski is President of Health Policy and Strategy Associates in Alexandria, Virginia.

Here are a few Laszewski nsights, summarized.

  • “Kill Obamacare” – There seems to be no chance Romney would try to fix the Affordable Care Act––he would repeal all of it.
  • No new federal health insurance reform law – There is no indication from his policy outline that he would try to replace the health care reform law for those under age-65 (“Obamacare”) with a new federal law–his emphasis would be on making it easier for the states to tackle the issue as he did in Massachusetts.
  • Small incremental steps – His approach for health insurance reform for those under age-65 relies on relatively small incremental market ideas when compared to the Democrats big Affordable Care Act–tort reform, association purchasing pools, insurance portability, more information technology, greater tax deductibility of insurance, purchasing insurance across state lines, more HSA flexibility.
  • Getting the federal government out of the Medicaid program – He would fundamentally change Medicaid by putting the states entirely in control of it and capping the annual federal contribution–”block-granting.”
  • Big changes for Medicare – Romney offers a fundamental reform for Medicare beginning for those who retire in ten years by creating a more robust private Medicare market and giving seniors a defined contribution premium support to pay for it.
As for the uninsured,  Romney would call for a number of steps to cover more of the uninsured.
  • Limiting federal standards and requirements on both private insurance and Medicaid coverage
  • Ensuring flexibility to help the uninsured, including public-private partnerships, exchanges, and subsidies
  • Ensuring flexibility to help the chronically ill, including high-risk pools, reinsurance, and risk adjustment
  • Offering innovation grants to explore non-litigation alternatives to dispute resolution
Other Fundamental Romney Beliefs
“Competition drives improvements in efficiency and effectiveness, offering consumers higher quality goods and services at lower cost. It can have the same effect in the health care system, if given the chance to work.”
Non-economic damages in medical malpractice lawsuits need to be capped.
Health care costs are out of control. Consumers are divorced from its real costs. They have no consequences for unlimited and unbudgeted care. The solution is defined contribution health care—you get a fixed amount of money to go shop in a more robust and competitive marketplace where health plans must now compete for your business.
Tweet:  Romney’s health reform plan stresses defined contributions,  private competition, state management of Medicaid, and malpractice reform.

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