What would you ask President Obama and GOP nominee Mitt Romney about healthcare when they take to the national stage Wednesday night?
Patricia Salber, MD, and Joshua Archambault offered nine questions to clarify Obama’s and Romney’s stance on healthcare for voters.
Salber is an internist, author, consultant, founder and co-host of the blog “The Doctor Weighs In” and Archambault is director of healthcare policy at the Pioneer Institute, a free market think tank based in Massachusetts. Salber is pictured below right.
[See also: Obama, Romney give NEJM glimpses of healthcare visions.]
Here’s what they proposed the candidates address:
1. Governor Romney, Massachusetts has the lowest rate of uninsured in the country. Texas has one of the highest. Leaving health care to the states (at least some states) has increased the vulnerability of large numbers of residents. Please explain specifically how you will address high rates of uninsured in those parts of the country.
2. In some parts of the country, competition between hospital systems has led to overbedding of the community. Over-bedding can be associated with delivery of unnecessary care or in care being delivered in high cost settings when it could be provided in lower cost settings — thus contributing to the high overall cost of care. President Obama and Gov. Romney, the "free market" does not seem to be working well in those communities, how would you address this specifically?
3. President Obama, during the last campaign, you promised to not raise taxes on those in the middle-class making less than $250,000 a year. However, the so-called "Cadillac tax" on higher-cost insurance plans in Obamacare appears to break that pledge. Especially in high premium states — New England and New York for example — most workers, particularly those in a union and public employees, will pay tens of thousands of dollars in new taxes if healthcare costs continue to grow. Can these folks in the middle class expect to pay more in taxes starting in 2018 when the tax kicks in?
4. President Obama, you said in February 2008 at Ohio State University that “If you've got health insurance we're going to work with you to lower your premiums by $2,500 per family per year. But we will not wait 20 years from now to do it, or 10 years from now to do it, we will do it by the end of my first term as president." Instead premiums have gone up roughly $2,700 according to the Kaiser Family Foundation. Acknowledging that Obamacare is not the sole reason as higher health care costs are to blame as well, how do you explain this reversal to families?
5. President Obama, critics have pointed to the reduction in future Medicare payments under ObamaCare, to the tune of $716 billion, as unsustainable since that money will be used to pay for other spending. The Congressional Budget Office seems to agree with that concern and has said that the Medicare reductions in ObamaCare "will not enhance the ability of the government to pay for future Medicare benefits" from the Medicare program. And you even acknowledged in a 2010 interview with Fox News this fact: "You can't say that you are saving on Medicare and then spending the money twice." How do you square these seemingly contradictory statements?
[See also: Tweetchat recap on what HIT pros would ask during the debates, EHRs and upcoding, IT talent shortage, and more.]
6. Governor Romney, you have spent limited time on the campaign trail talking about the healthcare reforms you signed into law in Massachusetts. You have said you are proud of the law, but would have implemented it in a different manner. Can you spell this out for voters? What has your successor done that you disagree with? How should it look different?
7. Governor Romney, Massachusetts policymakers just passed a new cost containment law citing that your 2006 law did not tackle costs. Yet in the Wall Street Journal in 2006, when you signed that law, you said, "Every uninsured citizen in Massachusetts will soon have affordable health insurance and the costs of health care will be reduced." Did your 2006 law tackle costs?
8. Governor Romney, over the last two weeks, multiple reports have been released claiming to outline your healthcare plans and modeling its impact on the nation. The resulting headlines have not been favorable to you, as millions more will remain uninsured. What is your national health care plan? How many people will remain uninsured? What can we expect for the average family premium?
9. Can each of you provide three reasons why Obamacare should be implemented and three reasons why it should not?
What else would you ask? Comment below.
