Medicare & Aging
- Spoke out early in the campaign season against the Medicare voucher plan advanced by House Budget Committee Chairman Paul Ryan, R-Wis., calling it “a big jump” and “radical” for Americans. His May 15 appearance on NBC’s Meet the Press drew a lot of media attention.
- In December commended Ryan for backing off his earlier plan and teaming with Sen. Ron Wyden, D-Ore., on an altered premium support proposal that would allow seniors to stay in traditional fee-for-service Medicare.
- Supports making structural changes to Medicare that would give beneficiaries more options and less government control while seeing to it that seniors have more ‘skin-in-the-game.’
- Wants to “create more choices in Medicare,” allowing consumers to choose either the current structure of the program or a private option thereby creating “price competition to lower costs.” Health savings accounts would be among the options. Currently, Medicare beneficiaries are not allowed to sign up for HSAs.
- Supports restructuring Medicare’s reimbursement systems to reflect quality of care and give entitlement programs like Medicare “latitude to design benefits to encourage, incentivize, and reward healthy behaviors.”
- Describes himself as a strong advocate of strengthening Medicare, mentioning his efforts to push for the 2003 Medicare Modernization Act that created the Medicare Part D prescription drug program.
- Argues that Medicare and other entitlement programs create undesirable dependence on the government, worsening the nation’s financial woes.
- Views the Medicare’s Part D prescription drug program as an unwarranted expansion of the government’s role in health care and a “reminder that the GOP sometimes can’t resist the temptation of big government.”
- Didn’t take part in Medicare when he practiced medicine; offered low-cost or free care to those who couldn’t afford his services.
- Proposes redirecting resources from defense spending and foreign aid to fund Medicare for those already enrolled, while weaning younger people away from such assistance programs in favor of free market approaches.
“Why exactly should Americans be required, by force of taxation, to fund retirement or medical care for senior citizens, especially senior citizens who are comfortable financially? And if taxpayers provide retirement and health care benefits to some older Americans who are less well off, can’t we just call it welfare instead of maintaining the charade about ‘insurance’ and ‘trust funds’?” — Texas Straight Talk weekly address
, Nov. 2010
- Has supported various renditions of the premium support model for Medicare that would give seniors a set amount to purchase insurance coverage. Most recently embraced proposals that would allow seniors to use that money to remain in fee-for-service Medicare.
- Unveiled his own premium support plan last November that would retain the option of fee-for-service Medicare. All plans would have to offer coverage at least comparable to what Medicare provides today. He offered few details, however, and critics say that capping the government’s contribution would likely mean that beneficiaries pay more for the same benefits. He embraced a similar proposal by Rep. Paul Ryan, R-Wis. and Sen. Ron Wyden, D-Ore., in December.
- Last spring, Romney supported a premium support plan that Ryan wrote and the House approved in its budget resolution, which would have ended fee-for-service Medicare. At the time, Romney said he would have signed it as president, but that he preferred to create his own proposal.
- Supports the notion that wealthier seniors should pay more towards their health coverage.
- Wants to publish federal yearly balance sheet to help people understand the impact of entitlement spending on the budget and economy.
- Promises he won’t slice benefits for current seniors or jeopardize their retirement security.
Supports the Medicare changes advanced by House Budget Committee Chairman Paul Ryan, R-Wis., including replacing the current program with a voucher system.
- Considers his 2003 vote for the Medicare prescription drug program to be a “mistake” because it is “universal” in nature when only about 15 percent of seniors had trouble with drug coverage, though he likes the private-market structure of the program..
- Supports tort reform to decrease unnecessary and costly law suits.
- Promotes a 21st-century personalized intelligent health system that would empower patients to access accurate and timely knowledge about their health and treatment options through the use of information technology.
- Believes market competition allows consumers to make better health choices at lower prices and that patients and consumers should have access to information to make more informed choices.
- Believes in several insurance reforms including giving people the choice of a generous tax credit or the ability to deduct a certain amount of the value of their health insurance, allowing the purchase of insurance across state lines and strengthening laws that prohibit insurers from cancelling or increasing rate increases to those who become sick while insured.
- Supports expanding Health Savings Accounts (HSAs) throughout the health care system. Was an early, strong proponent of tax-preferred medical savings accounts, which preceded health savings accounts. Successfully advocated for Congress to create the first demonstration project for MSAs in 1996.
- Advocates rewarding health and wellness by giving health plans, employers, Medicare, and Medicaid more flexibility to encourage healthy behaviors.
- Proposes encouraging medical breakthroughs to patients by reforming the Food and Drug Administration.
- Wants to invest in research for health solutions that are urgent national priorities, such as brain conditions that are costly for the system including Alzheimer’s, autism and mental health.
“The lesson of nearly four hundred years of entrepreneurial, technology and science-based free market capitalism is very clear. You should expect to get more choices of higher quality at falling prices. This is the opposite of the rationing mentality of some left-wing politicians and the scarcity mentality of too many bureaucrats. We need to bring these concepts into health and health care. We must insist that doctors, hospitals, medical technologies, and drugs have both quality and cost information available on-line so people can make informed decisions.” — “Winning The Future
Introduced legislation in 2009 to allow patients and physicians to opt out of the electronic medical records system set up by the federal government, to refuse to have those records shared with a third party and to repeal a federal program establishing a “unique health identifier” for each patient.
- Supports creating tax credits and deductions for all medical expenses, exempting terminally ill people from paying the employee portion of payroll taxes, providing a payroll deduction to workers who are caring for a spouse, parent or child with a terminal illness.
- Opposes caps on awards in medical liability cases.
- Endorses a new tax credit for “negative outcomes” insurance bought by patients before medical treatment so they can be compensated for medical mistakes. Says it would reduce “the burden of costly malpractice litigation.”
- Supports allowing insurers to sell across state lines, as well as association health plans.
- Wants to expand high-deductible health savings accounts.
- Wants to “strengthen” high-deductible health savings accounts by allowing consumers to use them to pay insurance premiums.
- Seeks to cap non-economic damage awards in medical malpractices law suits and favors giving states grants to fund other ways to deal with the liability issue, such as health care courts.
- Urges restricting federal regulation of health care insurance, although he supports limited rules to bar insurers from denying coverage to those with preexisting conditions when they have had coverage for a specified period of time.
- Says insurers should be allowed to sell their products across state lines.
- Supports creating a tax deduction for people who obtain health insurance on their own.
- Favors allowing individuals and small businesses to join together to buy insurance.
- Supports individual control over their health coverage – meaning peole should own their insurance and be able to continue to keep it during the course of their lives. Romney’s explanation of this position during a campaign stop in New Hampshire drew criticism because, in the context of insurance companies, he said he likes “being able to fire people.”
“I want people to be able to own their own insurance, if they wish to. And to buy it for themselves and perhaps keep it the rest of their lives and to choose among different policies offered from companies across the nation,” he said. “That means the insurance company will have an incentive to keep you healthy. It also means, if you don’t like what they do, you can fire them.” – Nashua, New Hampshire, Jan. 9
Health Reform Philosophy
- Advocates for tax credits or deductions for purchasing insurance. For those who choose to remain uninsured, he has explored diverting the subsidy they could have gotten to safety net medical providers, who would deliver any needed care.
- Founded the Center for Health Transformation, a corporate for-profit organization focused on the health care industry. The Center, which has been the topic of coverage by news outlets including The Washington Post and The New York Times, advances a range of market-based reform concepts and has been a vocal opponent of the 2010 health law.
- Has worked on healthcare issues since 1974 and wrote a book called “Saving Lives & Saving Money” in 2002, which outlines proposals to “transform” the health care system by improving quality and reducing errors through increased transparency, better use of technology such as electronic medical records, and giving consumers greater ability to make decisions.
- Says in his “21st Century Contract with America” that repealing the 2010 health law will be the first task of his administration.
- Supports replacing the health law with proposals that include medical liability reform, insurance portability, improved price competition, and that emphasize electronic records and health savings accounts.
- Opposes the 2010 health law’s individual mandate, but has been criticized for his previous support of it. Gingrich advocated the concept, in collaboration with the Heritage Foundation, when he opposed Hillary Clinton’s health care reform efforts in the 1990s. Many credit the conservative think tank as the original source of the mandate idea.
- Calls for states to set up high risk pools to cover uninsured people who have become too sick to buy health insurance.
“As I carry the banner in fighting for the repeal of Obamacare, I will advocate for specific replacement health policies that will create a free market framework for healthcare, provide affordable, portable, and reliable healthcare coverage, and establish a healthcare safety net focused on those in need. This system will assure healthcare for all with no individual mandate or employer mandate of any kind.” — 21st Century Contract with America
- Outspoken opponent of the health law on policy, procedural and constitutional grounds.
- Believes the individual mandate is unconstitutional; introduced legislation to end the mandate
- Cites his experience as a physician to oppose the implementation of managed care: “We don’t have a right to medical care.”
- Introduced legislation to create a market-based system “that reflects consumer choices while rationally pricing services.”
“If medical care is provided by government, this can only be achieved by an authoritarian government unconcerned about the rights of the individual.” — Statement
, Sept. 23, 2009
- Known for working with Massachusetts Democrats to enact the precedent-setting 2006 state law requiring most residents to have insurance.
- Supported – as part of this law – the creation of an online marketplace called the Health Connector, through which individuals and businesses can purchase insurance.
- Argues that the federal law didn’t grow out of the Massachusetts law, saying the state reforms were tailored specifically to meet the needs of the state.
- Says, if elected, he’d allow states to opt out of the federal health law and encourage Congress to repeal it.
“Mr. President, if, in fact, you did look at what we did in Massachusetts, why didn’t you give me a call and ask what worked and what didn’t? … I would have told you, Mr. President, that what you’re doing will not work. It’s a huge power grab by the federal government. It’s going to be massively expensive, raising taxes, cutting Medicare.” — GOP candidate debate
, June 13, 2011
- Places high priority on repeal of the health law.
- During a speech at the 67th anniversary of D-Day, Santorum criticized the health care law and said that American soldiers stormed the beaches of Normandy and “risked everything to make sure you could make your own decisions on your healthcare plan.”
- Strongly opposes more federal funding for health coverage and involvement in health programs. Has said that Democrats love entitlement programs and are trying to get more people “hooked” on health care benefits.
- Supports giving states more freedom and flexibility to customize their Medicaid programs into block grants, a policy he pushed for unsuccessfully while speaker of the House in the mid-1990s.
- Believes Medicaid reforms must recognize three distinct populations: people with disabilities, the poor and the elderly poor.
- Supports adjusting Medicaid reimbursement models to reward quality of care and create incentives for beneficiaries to seek out facilities that deliver the best care at the lowest cost.
- Says Medicaid beneficiaries should be free to choose a health savings account as part of their coverage.
Voted for the creation of the Children’s Health Insurance Program as part of the Balanced Budget Act 1997 and supported an extension of the program 2007.
Did not support the 2009 stimulus package, which included increased federal funding to states for Medicaid.
- Voted against expanding CHIP in 2009 and 2007.
- Opposed stimulus package, which included a temporary enhanced federal Medicaid contribution and short-term extension of COBRA coverage.
- Opposes the health law’s expansion of Medicaid coverage to more than 30 million people.
- Backs block grants for Medicaid to allow states to use capped federal contributions to run Medicaid as they see fit.
“My view is get the federal government out of Medicaid, get it out of health care. Return it to the states.” – South Carolina GOP Primary Debate, Jan. 20.
- Supports dramatically overhauling Medicaid in order to reduce national spending.
- Cites the 1996 welfare reform law, which substantially reconstructed the nation’s welfare system and turned much of its administration over to the states, as a model for how Medicaid should be revamped. Santorum was a member of the Senate when that legislation was drafted.