WASHINGTON – Republican presidential nominee Mitt Romney has a prescription for controlling soaring costs within the $2.8 trillion US healthcare system, partly by making consumers pay more of their own medical bills.
Romney’s vow to repeal and replace President Barack Obama’s health care overhaul has played prominently in the campaign, even as Romney has offered few details about his alternative.
But as he prepares to face Obama in their first presidential debate on Wednesday, Romney is giving a few hints.
The former Massachusetts governor’s advisers say he would accelerate the use of high-deductible insurance plans that offer lower premiums but require beneficiaries to pay thousands of dollars more in out-of-pocket expenses than they would face under conventional coverage.
Romney’s overriding aim is to create a much bigger retail market in health care, with transparency on pricing and services, more flexible insurance pools and interstate insurance markets.
That would allow consumers to choose up front what products and services to buy and from whom, according to the Romney campaign. But consumers would cover most routine medical expenses themselves, including annual check-ups, with assistance from health savings accounts and new tax breaks intended to align the private markets for group and individual insurance that cover more than 160 million people.
“The result,” Romney wrote in the New England Journal of Medicine, “will be patients who can confidently choose the coverage that is right for them, who know and care what health care costs.”
The Romney campaign says its series of changes differ dramatically from Obama’s 2010 Patient Protection and Affordable Care Act, which requires most Americans to buy health coverage and seeks to make it easier to do that by creating state-based insurance exchanges. Medicaid, the national programme for the poor, would be expanded to accommodate those with low incomes.
Romney’s approach is a political departure for him.
In Massachusetts, he oversaw the passage of comprehensive state health care changes that later became the model for “Obamacare,” the president’s federal programme.
Romney’s role in creating the Massachusetts plan made many conservatives wary of him, and in seeking the Republican nomination for president Romney made a point of rejecting Obama’s plan as an illegal over reach by the federal government.
Romney’s new incentive-based strategy also could hold pitfalls for consumers.
Analysts say the use of heath savings accounts favours the affluent, while statistics indicate that high-deductible plans can mean big out-of-pocket costs for people with lower wages and little disposable income. (Reuters)