More CSM - Obama v Romney on Health Care Reform

Here's a little summary of the differences between the candidates on health care reform. It's worth it to read the underlying article and more for yourself.

My biggest concern is in the area of pre-existing conditions and denial of coverage. I was shocked a few years ago when a healthy self-employed friend who moved to another state found herself unable to purchase insurance at any price because of a minor pre-existing condition. Personally, I'd rather pay a little higher premium and have everyone covered.

• Patient Protection and Affordable Care Act of 2010 (ACA)
  • Obama - will continue to implement. Has offered to work with either party to improve the law.
    • Coverage is guaranteed, regardless of pre-existing conditions.
    • Insurance premiums are allowed to vary based only on a few factors and then to a limited extent (self vs. family enrollment, geography, age, and tobacco use).
  • Romney - pledges to immediately grant state waivers & work with Congress to repeal and replace (retaining GOP majority in the House and gaining majority in the Senate is required to deliver on this).
    • Guarantees coverage only for those who have maintained insurance; otherwise gives states responsibility for dealing with the uninsured.
    • Insurance premiums can be be priced on any factors, including health conditions, age and gender.
• Source of Health Coverage
  • Obama - no change for those who get coverage through their employer. Those who purchase independently will be able to shop at an online exchange. Middle/low income people who don't qualify for Medicaid may be eligible for federal subsidies.
  • Romney - tax break for people who purchase insurance independantly (not clear how he offsets this cost).
• Controlling Costs
  • Obama -
    • Establishes an Independent Payment Advisory Board (IPAB) to institute cost-saving measures for Medicare
    • Provides financial incentives to provide quality care while keeping costs down
    • Hospital reimbursements to be based on quality of care as well as amount of care
    • Introduces excise tax on high-end health plans.
  • Romney - Believes state-driven solutions and allowing purchase of insurance across state lines introduces competition that will drive down costs.
• Medicare
  • Obama - addresses unsustainable growth by slowing payment growth via the IPAB; benefits are not cut back
  • Romney - fundamental overhaul of Medicare. Recipients to be given a fixed amount of money with which to buy insurance, one option being to purchase traditional Medicare (although premiums may rise). Competition among plans to hold down costs.
• Medicaid
  • Obama - expands Medicaid insurance for low-income and disabled people, although states are allowed to opt out.
  • Romney - turns federal funding into block grants to states, with annual increase in funding capped at inflation + 1% (US health care expenditure growth in 2010 was inflation + 2%; for the previous 20yrs it was inflation + 5%)
• Malpractice Reform
  • Obama - does not address
  • Romney - calls for reform; would cap noneconomic damages in litigation and provide innovation grants to state to try other reforms