This op-ed was originally published in the USA Today
by Mitt Romney
May 11, 2011
Health care is more than just one-sixth of the American economy. It is a source of well-being for individuals and families. We are blessed with much that is good in American health care. But we have taken a turn for the worse with ObamaCare, with its high taxes and vastly expanded federal control over our lives. I believe the better course is to empower the states to determine their own health care futures.
First, the good news: Health care in the United States has made remarkable advances in our lifetimes. Dramatic improvements in medical technology have expanded both the length and quality of life. And the U.S. health care system continues to provide consumers with many choices.
But our health care system has several well-known problems: high and rising costs, significant numbers of Americans without insurance, and glaring gaps in quality and efficiency.
We can fix these problems. Unfortunately, with the passage of ObamaCare last year, the president and the Congress took a wrong turn. ObamaCare will lead to more spending, greater federal involvement in health care and negative effects on U.S. economic activity. The president definitely forgot the admonition to “do no harm.”
My plan is to harness the power of markets to drive positive change in health insurance and health care. And we can do so with state flexibility (unlike ObamaCare’s top-down federal approach), no new taxes (as opposed to hundreds of billions of dollars of new taxes under ObamaCare), and better consumer choice (as opposed to bureaucratic, government choice under ObamaCare). This change of direction offers our best hope of preserving both innovation and value.
If I am elected president, I will issue on my first day in office an executive order paving the way for waivers from ObamaCare for all 50 states. Subsequently, I will call on Congress to fully repeal ObamaCare.
The reforms that I propose, which are based on the same philosophical tenets as the reforms I offered during my last presidential campaign in 2008, return power to the states, improve access by slowing health care cost increases, and make health insurance portable and flexible for today’s economy.
Step 1: Give states the responsibility, flexibility and resources to care for citizens who are poor, uninsured or chronically ill. This reform speaks to the central advantage of our federalist system — that different states will experiment with and settle on the solutions that suit their residents best. Some states might pass a plan like the one we did in Massachusetts, while others will choose an altogether different route. We can empower states to expand health care access to low-income Americans by block-granting funds for Medicaid and the uninsured. My reforms also offer the states resources to help the chronically ill — both to improve their access to care and to improve the functioning of insurance markets for others.
Step 2: Reform the tax code to promote the individual ownership of health insurance. The tax code offers open-ended subsidies for the purchase of insurance through employers. This subsidy is unfair — as it doesn’t apply to insurance purchased on one’s own. I propose to give individuals a choice between the current system and a tax deduction to buy insurance on their own. This simple change creates the best of both worlds. Absolutely nothing will change for those who like their current coverage. And individuals who don’t get coverage through their employers will have portable, lower-cost options.
Step 3: Focus federal regulation of health care on making markets work. This means both correcting common failures in insurance markets as well as eliminating counterproductive federal rules. For example, individuals who are continuously covered for a specified period of time may not be denied access to insurance because of pre-existing conditions. And individuals should be allowed to purchase insurance across state lines, free from costly state benefit requirements. Finally, individuals and small businesses should be allowed to form purchasing pools to lower insurance costs and improve choice.
Step 4: Reform medical liability. We should cap non-economic damages in medical malpractice litigation. The federal government would also provide innovation grants to states for reforms, such as alternative dispute resolution or health care courts.
Step 5: Make health care more like a consumer market and less like a government program. This can be done by strengthening health savings accounts that help consumers save for health expenses and choose cost-effective insurance. For example, we should eliminate the minimum deductible requirement for HSAs. The market reforms I am proposing will drive down costs, better inform consumers and improve the quality of health care in our nation.
These five steps are positive change. They will reduce health care costs, improve access and enhance value for the money. My reforms put quality, choiceand innovation — not Washington — in charge.