AGA Washington Insider

A policy blog for GIs

Republicans Set Their Health-Care Agenda in Tampa

During the Republican national convention, GOP presidential nominee Mitt Romney and vice presidential nominee Paul Ryan made their case to the American people as to why they deserve to be elected in November. A large part of the Republican’s argument has been their stance on health-care policy and what they would do differently than President Obama and the Democrats. The Republican Party formally adopted their platform on health care, which focuses on a few main themes: reforming Medicare and Medicaid, repealing and replacing the Patient Protection and Affordable Care Act (PPACA), and enacting tort reform to revamp our nation’s medical liability system.

Much discussion has occurred on the campaign trail on the Medicare program with both sides making accusations against the other regarding their plans. The Republican plan would transform the current Medicare system into one that gives beneficiaries premium support to purchase a plan of their choice. Under this proposal, traditional Medicare would compete with private plans and seniors could choose a plan. This proposal would not impact current beneficiaries, but would be put in place for future retirees since the current system is not sustainable. The goal of this proposal is to give seniors an array of health-care choices, including health savings accounts on which the private market would compete for their business. Other elements of the proposal include means-testing wealthier beneficiaries and increasing the eligibility age to reflect changes in life expectancy. Although the proposal does not specifically address the broken Medicare physician payment system and how it should be fixed, the party does support value-based payment models and believes that infusing more competition into the Medicare program will help stabilize Medicare payments.

The GOP also proposes reforming the Medicaid system by block granting the program, which would give states more flexibility in how they administer Medicaid. Again, the platform stresses infusing more competition to Medicaid and encourages states to give beneficiaries vouchers to purchase health insurance, giving patients more responsibility toward their health care.

Consistent with their ongoing position, the Republican platform expresses support for medical liability reform and specifically seeks legislation that would cap non-economic damages on liability cases. AGA is very supportive of medical liability reform and of caps,  but also recognizes the political realities and the fact that this proposal was hard to enact even when the Republicans controlled Congress and the White House in the last decade. The problem needs to be addressed, but we need to explore other ideas besides caps to finally get a federal reform bill passed.

Another important issue addressed in the Republican platform is the need to invest in biomedical research, which holds the key to improving the treatment and care for many diseases and ailments.

Last but certainly not least, the Republican platform supports repeal of “Obamacare,” which they believe limits patients’ choice of health care and imposes a huge regulatory burden to providers. The GOP has proposed repealing PPACA and replacing it with more market-based reforms. They also propose enacting insurance reforms to help patients with pre-existing conditions purchase insurance and equalizing the tax treatment of individual and group health plans. The proposal would restore the nearly $700 billion in Medicare cuts that were part of PPACA. Much has been made of the Medicare cuts contained in PPACA on the campaign trail since the Ryan budget also retained those cuts, which was changed in the platform. I am sure that we will continue to hear more about this point throughout the campaign.

The AGA will continue to analyze both candidates’ proposals and their impact on gastroenterology. Once the conventions are complete, Congress will return to Washington for a short stint until they adjourn for the year and continue with the campaign. Conventional wisdom says that most of the tough decisions will be made in the lame duck session after the election and everything will hinge on which party controls the White House and the Senate. Congress will need to address such major issues as the expiring Bush-era tax cuts, sequestration and the annual doc-fix among many other issues in the lame duck session.

Stay tuned for more updates on the AGA Washington Insider as the campaign season moves into high gear.

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