As pri­mary sea­son of­fi­cially starts, health­care stays a top-tier is­sue

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

Modern Healthcare - - EDITORIAL MODERN HEALTHCARE -

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. Thud. 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.

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 pa­tient­driven 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.

DAVID MAY As­sis­tant Man­ag­ing

Editor/fea­tures

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