22. Romneycare vs. Obamacare

Let’s face it—there are a lot of similarities between Romneycare in
Massachussetts and Obamacare: they both use state exchanges to administer
government and private insurance; they both expand Medicaid to cover the
uninsured; they both require that all citizens have “minimum” health insurance
or else they have to pay a fine; and they each require insurance companies to
issue policies to anyone at any time, regardless of pre-existing conditions. We’ll
discuss all of these points in time, but let’s suffice it to say that Romneycare in
Massachusetts isn’t exactly a model of healthcare success. Thankfully, Gov.
Romney doesn’t plan to institute Romneycare on a national level!! In fact, his
ideas for healthcare reform for America are totally different---they’re market-
based and I fully support them, but we’ll talk about all that later.

So, how is Obamacare different than Romneycare? Well, since Romneycare
hasn’t been very good at controlling healthcare costs in Massachusetts,
Obamacare plans to control costs through a combination of healthcare rationing,
and increasing taxes. We’ll talk about the new taxes in Obamacare later in more
detail, but there are roughly 22 new taxes in the law. And that doesn’t include
the Supreme Court decision that established the Individual Mandate as a massive
new tax that will affect primarily the poor and middle classes—one of the largest
in American history!

Obamacare will limit patient’s choices regarding their diagnostic tests and
treatments in basically 5 ways: we’ve already discussed the Independent
Payment advisory board, the $716 Billion dollars in Medicare cuts, and
Comparative Effectiveness. The other 2 ways are through the US Preventive
Services Task Force guidelines; and through Accountable Care Organizations.
We’ll discuss these last 2 in more detail starting next week.

So Obamacare forces us to participate in a system that will increase our taxes
AND decrease our freedom as patients to make our own healthcare decisions.
That’s how it differs from Romneycare.

(Note: This commentary is by Dr. Jill Vecchio.)