RomneyCare vs. RomneyReform

Sorry for the tome, but this comes from watching Romney’s speech on Romneycare and Romney’s Reform plan.  Soren Dayton listed several good questions earlier today for Romney’s health care speech. Romney did not answer all of them, but I compiled those that he appeared to answer with some additional points I was able to glean from the speech.  [My opinions are in brackets]:
  1. If you were to run for and be elected Governor of Massachusetts would your first act be a repeal of Romneycare?
    • No.  Massachusetts’s healthcare reform was created to solve a free rider problem which was mandated by the Hippocratic oath and state law that all non-insured individuals get free health care from hospitals.  Most states have this problem.  He acknowledges that mandates have become a political liability, but it was their way of experimenting in Massachusetts in trying to end 500,000 people free riding on tax dollars
  2.  Which parts of Romneycare do you still like?
    • The state decided what it wanted, not the federal government. He claims that no taxes were raised and that less than 1% of the state’s budget goes to that plan. If he had his way, 0% of the state’s budget would go to the plan.  Over 400,000 people are now newly insured due to Romneycare and less than 100,000 now pay the opt out fee ($140?).
  3. For which states do you think Romneycare would be a good model? What is different about those states?
    • Romneycare is only for Massachusetts
  4. When did you change your mind and begin opposing federal individual mandates, considering that you like mandates and believe they work?
    • If a state wants a mandate, then that is for the state to use in its own experiment. If voters can direct the politicians to experiment as they want. [Romney said in 2008 that he liked mandates, but he said in 2008 that Massachusetts’s healthcare was not for the nation.  Romney acknowledged that mandates are not what people want now and their states are free to use what they think is best]
  5. Why did you change your mind on a federal mandate?
    • Not answered.
  6. Why did you sign a bill that covers abortions?
    • Not answered
  7. Why did you sign a bill that would explode government costs without doing a single thing to offset them?
    • Romneycare is currently less than 1% of Massachusetts budget. The U.S. government was already sending Massachusetts money and they leveraged that along with insurance from all participants.  He would change several things about Massachusetts’s healthcare and he voted them, but was overridden by state’s congress.
  8. Why did you completely eliminate competition in the health care marketplace by limiting the number of insurance plans?
    • Not answered.  Romney’s Reform would focus on expanding individual insurance plans across state lines and from job to job.  This would create competition across the U.S.
  9. Why did you think that government was best positioned to negotiate rates with insurance companies instead of letting the market work?
    • Not answered for Massachusetts. This is not part of Romney’s Reform for 2012.  Individual consumers can take moneys their employers would put into an HR insurance plan and purchase any insurance plan offered across state lines or within their state. 
  10. What would you say to small business owners who now have 6 more pages of rules and regulations on their tax forms thanks to Romneycare?
    • Not answered. Romney’s Reform would turn insurance over to the individual and those insurance plans would be portable from job to job. Romney wants to take insurance choice out of the HR departments in companies and allow the employee to pick from any national plan from any state. The employee can then keep that insurance as long as they want from job to job. Company funds to any HR endorsed insurance plan can be used by the choice of the employee.
  11. Do you still think that Romneycare is a model for the nation?
    • No.
  12. When did you change your mind about any of the above questions? Was it about the same time that it became politically convenient for you to do so?
    • Romney acknowledged that his political strength in 2008 has become a liability.  He said it would be easy for him to distance himself from Romneycare, but chooses to stick with the overall plan of state driven solutions by local politicians.

Other notes:

Romney’s Reform plan focuses on lowering costs by increasing national competition for insurance policies. He wants to change policies from restricted to company only offerings to individual chosen policies from any in the nation which are all portable from job to job.  He wants to reform medical liabilities and cap medical malpractice payouts.  He wants to remove taxes from innovators in equipment and pharmaceuticals, unlike Obamacare.

Romney wants to restore to the states the care for their poor by block granting all federal funds to the states with no federal interference.  He wants to take away the open checkbook that is Medicade by using these block grants. He wants to make sure no pre-existing conditions can be denied for those who have had insurance.  He wants to promote health savings accounts and customer preventative incentives through co-insurance.  His plan is to incentivize consumers by having them participate in the cost and quality of their care.  He wants to promote a Consumer Reports-like listing for insurance policies across the nation.

Romney wants to debate Obama on how his plan is not only different, but how it is what Americans want from their insurance and healthcare providers.