The reason many childhood diseases have been eliminated from the United States is simple: All schools, public and private, require immunizations. Children can't attend school without them. As a result of mass immunizations, once feared childhood diseases have been eradicated. This is an example of great health policy - complete coverage for the protection of everyone at the lowest cost.
That is why Mitt Romney and Paul Ryan must be out of their minds when Romney says, "When I'm elected president, my first day in office, I will repeal ObamaCare." The key to great public health is to cover everyone. Over the long term, it produces a better result at less cost.
If a "cover everyone" system is cheaper and healthier, why hasn't it been adopted until now? Health care didn't start out as a national program in the same way that Social Security did. As a result, health insurance came to be regulated by the states instead of the federal government. While health insurance companies have grown into corporations that transact business across state lines, state insurance departments don't regulate across state lines. Without a national health care policy, companies have held states hostage by unilaterally setting rates, defining coverages, and if state insurance departments refuse to accept the terms, companies pull out. As costs have escalated out of control, health insurance companies have become effective lobbyists, political contributors and no president has had the political will to take on the health insurance industry and establish a national health care policy.
The Affordable Care Act (ObamaCare) is not a government take over of the health care system, but rather a coordination of health care policy that sets minimum standards for consumers and insurance companies across the country. It fills the coverage gaps that private insurers have failed to address. Republicans readily accept such national policy coordination over the entire spectrum of business and industry. With health care costs approaching 20% of the entire economy, isn't a national health care policy needed?
Medicaid and Medicare are also big parts of the health care system, but the G.O.P. doesn't like those improvements, either. Republicans claim the Obama administration would cut 716 billion dollars from the Medicare program. Nothing could be further from the truth. The Obama administration would slow the future growth in Medicare costs by 716 billion without any cut in services to beneficiaries. Romney claims controlling costs in Medicare would force hospitals to refuse to accept Medicare. Again, not true. Any hospital which has accepted any federal funds for any purpose whatsoever is required by law to accept Medicare. Romney claims doctors will stop accepting Medicare. Again, not true. Physicians are already free to accept or decline any health plan. The real problem is not the lack of doctors who accept Medicare, it's a basic shortage of primary care physicians. Many primary care practices are closed to new patients, no matter what insurance plan they have. That will be made worse by Romney, who plans cuts to the student loan program, something which is essential to pay medical school costs that are nearly $250,000 for every graduate.
While the Obama administration has used some of the savings created by the Affordable Care Act to increase coverage to low income seniors, children and the disabled through Medicaid payments, Republicans have fought the adjustments. Republican governors have declined to accept funding increases even though they are fully paid
for by the federal government through 2016 and 90% funded through
2020. Romney would actually cut the program in half by 2030. Quoting the Congressional Budge Office: "Because of the magnitude of the reduction in federal Medicaid spending
under the (Romney/Ryan) proposal... states would face significant challenges in
achieving sufficient cost savings through efficiencies to mitigate the
loss of federal funding. To maintain current service levels in the
Medicaid program, states would probably need to consider additional
changes, such as reducing their spending on other programs or raising
additional revenues."
The Obama administration has done what no other president has been able to accomplish: put the nation on a course toward a national health policy that reduces costs and increases care. I'm sure Governor Romney agrees since he helped pass a nearly identical plan as governor of Massachusetts. But, candidate Romney doesn't - he's running for president.
And, that is a view from Missouri.
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