By Nancy Thorner and Ed Ingold -
President Obama in the past has frequently tagged his speeches with a reference to Mitt Romney's Massachusetts health insurance reforms as the basis for his Obamacare. This same claim has not unexpectedly been picked up and used as ammunition against Mitt Romney by the only too willing mainstream media.
Obama care is a very complicated piece of legislation. Although it was passed over two years ago with the admonition from Speaker Pelosi that "We have to pass it before we can understand it," very few people have read it, much less understood its ramifications.
The original 2700 pages (depending on the font size) have expanded ten-fold as fleshed out in regulations. As reported in an editorial in The Orange County Register on July 9, 2012:
"The Human Services Department was given a billion dollars of implementation money. That money is gone already on additional bureaucrats and IT programs, computerization for the implementation. There's already 13,000 pages of regulations, and they're not even done yet. These pages are in addition to the 2,700 pages of the law itself, as enacted in 2010."
Mitt Romney's Massachusetts health insurance plan legislated when governor of MA became a sore spot for Romney during the individual state Republican primary elections when running to claim the top presidential spot. Romney had difficulty explaining how his healthcare legislation was not a mirror image of the Obamacare legislation in a coherent way even when debating his fellow Republican candidate opponents.
But does Romney's Massachusetts health insurance really mirror Obamacare which the Supremes recently proclaimed as health care reform legislation that meets constitutional standards, and which now stands as the orchestrated Democrat partisanship endeavor destined to bring radical changes to the practice of and the application of health care available to the American people once fully implemented in 2014?
To Mitt Romney's credit, in the aftermath of the Supreme Court's 5-4 decision that the penalty imposed in Obamacare was a tax and that Obamacare was therefore constitutional to go forward, Romney, after much denial, did admit that the penalty imposed in his own Massachusetts legislation also constituted a tax.
RomneyCare was the first significant healthcare reform to happen in the U.S. for decades. "The primary goal of Romneycare was to provide all citizens in MA with access to affordable health insurance and to eliminate the 'free riders' who expected the government or taxpayers to pay for their health care."
It is often stated that Romneycare is the same as Obamacare, but this simply is not true. While there are similarities, there are also key differences. It must be remembered that the state of Massachusetts opposed Obamacare so much so that they elected Senator Scott Brown (R) in 2010 to be the deciding vote against Obamacare after Senator Ted Kennedy's death.
Like any other huge "problem", it is necessary to break down the Obamacare legislation into specific headed categories so that the individual parts can be compared to what was mandated by the Romneycare legislation in Massachusetts.
UNFUNDED MANDATES (OBAMACARE AND ROMNEYCARE)
The parts of Obamacare which, according to the President, people like and want to keep include extended coverage for dependents, coverage for pre-existing conditions and "free" wellness care. These are basically unfunded mandates. In other words, the Government demands that insurance companies provide for these benefits, but government does not pay for them. You, the consumer, foot the bill.
A study by the Kaiser Family Foundation of September 28, 2011 shows that the average annual premium for family coverage increased by 9% in the first year under Obamacare. Many small businesses and families have already been warned higher healthcare payments are on the way.
Romneycare, predated in the regulation of insurance companies in every state of the union, to some degree or another. If people like these features, and continue to pay for them, why not keep them? It doesn't cost the taxpayers a dime.
PARTIALLY-FUNDED MANDATES (OBAMACARE AND ROMNEYCARE)
The second part of Obamacare also has a parallel in Massachusetts - providing insurance to those who can't afford it to some degree.
This provision provides the justification for both Massachusetts and Obamacare - universal coverage. Massachusetts has a state run exchange program similar to that proposed on a national level by Obamacare. In order to distribute the cost of "free" insurance, both Massachusetts and Obamacare demand that all individuals purchase insurance or pay a penalty (tax, it doesn't matter what you call it).
Obamacare, however, delegates this coverage to Medicaid programs, run by each state. The federal government proposes to pay for most of this at first, but shifting most of the burden to state taxpayers beyond four years. To this extent, it can be called a partially-funded mandate of Obamacare.
While the Supreme Court upheld the "individual mandate", it struck down the imposition of this responsibility on state Medicaid programs. In other words, the pillar of Obamacare has been shattered. Consequently, the Federal burden shifts to the establishment of insurance exchanges. Ideally, this would be done on a nationwide basis, so that New York residents could shop for insurance from North Carolina companies (or some other state).
Unfortunately, the exchange feature in Obamacare has been nullified through Presidential waivers to states which feel they know best - mainly states which voted for Obama.
Not good for the Obama administration is that many states are not jumping the gun on the mandates to set up a state insurance exchange or to expand Medicaid in accordance with the Patient Protection and Affordable Care Act.
Governor Perry of Texas said "that adding more than a million adults to the state's Medicaid rolls would create a financial burden costing billions." Louisiana, Mississippi, Florida, Iowas and South Caroline have also announced their opposition to Medicaid expansion, and other states are expected to do so.
BIG TAX AND POWER GRAB (NO PARALLEL BETWEEN OBAMACARE AND ROMNEYCARE)
The third part of Obamacare has no parallel in Massachusetts - a huge block of new taxes and penalties, many of which bear no relationship to health care. A list of 20 new taxes imposed by Obamacare is detailed here.
It is this part, the financial cliff (the death knoll aspect) which threatens our economy and future. Obamacare will impose taxes on health insurance, health service, medical devices, tanning parlors, benefit programs, investments ... the list is endless. On top of this are new regulations and reporting requirements that threaten free enterprise. These taxes and regulations threaten the continued availability of health care benefit packages and even private insurance for as many as 80% of those who now have them. Many appear to be retribution for opposing Obamacare during its debate.
In addition, Obamacare promises to cut Medicare benefits by $500B and payments to physicians by 37%. This can't improve service, but will reduce availability and coverage - all in the name of "reducing" costs. The only practical way to accomplish this is by rationing care, and several committees and boards have been set up to do just that.
By established law, taxes cannot be earmarked for particular services, regardless of oral promises to this effect, and in many cases, no attempt to justify the tax or regulation is made at all. The Democratic Congress used this bill to dig into the couch cushions to fund their spending spree.
For a more detailed summary of how Romneycare measures up against Obamacare check the following links:
Obamacare is far too complex and invasive to repair. It must be repealed in its entirety, replaced with new, bi-partisan legislation. This cannot happen with a Senate leader who blocks legislation before it can be debated, and a President who promises to veto anything which might slip through this trap. It should be clear that the only way to avoid the disaster is to elect Mitt Romney and a Republican majority in both houses of Congress.
It is also clear that Republicans must keep in mind that there is a humane way to retain the few good parts in Obamacare while eliminating the bad, but not before the the entire monstrosity of the bill is repealed.
The physicians of Docs 4 Patient Care "present a prescription for health care reform that addresses the root causes of the problems that have developed in our health care system over the last 50 years. These reforms relieve the federal government of its role as a health insurance provider, prevent the intrusion of the government in the health care free market, and place patients in control of their own health care decisions."
Hopefully Republicans will heed the eight points set forth by Docs 4 Patient Care physicians.
Obamacare is definitely the wrong prescription for healthcare. In contrast, the Docs 4 Patient Care prescription is a sound and workable one that could serve as a framework on which responsible health legislation could be constructed for all Americans.