2012 Presidential Candidates: How They Compare on Healthcare

October 17, 2012

It's almost Election Day. Here's how the two men vying for the Oval Office compare when it comes to issues facing today's physicians.

No matter who wins the White House on Election Day, the way you practice medicine today is destined for change.

In the wake of the Supreme Court's decision to uphold the Affordable Care Act (ACA), the Republican nominee for president, Mitt Romney, has said he'll work to repeal the law if elected. President Obama would, of course, press forward with the ACA. But observers argue that the outcome of the election may matter only to the scope and pace of change in healthcare, not to the fact of change itself or its general direction.

Robert B. Doherty, senior vice president for governmental affairs and public policy for the American College of Physicians, says, "the pressures on small practices, the rising cost, the pressure on payers to deliver care more efficiently, the pressures of EHRs - those all will still be there with or without the law."

"Healthcare in this country is in crisis mode and regardless of what happens in November, our system in this country still needs overhaul, well beyond what the Affordable Care Act does," says Gregory Moore, who chairs the international health group for the Washington, D.C.-based law firm Clark Hill.

Here's a breakdown of where each candidate stands on various issues facing today's physicians:

 

ObamaÂRomney
• Fully implement all provisions of the Affordable Care ActHEALTHCARE REFORM

• Repeal ACA

• Restore state-based healthcare leadership vs. federal oversight

• ACA establishes several pilot programs, including Comprehesive Primary Care Initiative and accountable care organizationsFEE-FOR-SERVICE ALTERNATIVES• "Promote" alternatives; no further specifics
• Several pilot programs, promotion of health IT initiatives, featured in the ACA. EHR adoption incentives, included in the stimulus of 2009, already underway.HEALTH IT PROMOTION• "Facilitate IT interoperability"; no further details provided
• "Individual manadate" begins in 2014, expanding insurance options and penalizing those who do not purchase insuranceREDUCE UNINSURED ROLLS• Promote state-based initiatives, including private-public partnerships, exchanges, and subsidies
• Expand program to low income individuals with incomes at or below 133 percent of the federal poverty levelMEDICAID EXPANSION• Block grants to states to fund program and aid uninsured
• ACA has established annual wellness visits, "doughnut hole" protections. Obama opposes making Medicare a definded contribution program.MEDICARE REFORM• Supports Paul Ryan plan to restructure Medicare by capping amount for either Medicare or private plan payments
• Does not support caps on non-economic damages; initial support for health courts and other initiativesTORT REFORM• Cap non-economic damages in medical malpractice lawsuits
• Expressed support for repealing SGRREFORM MEDICARE SGR FORMULA• Has not made formal proposal/statement on issue
   

Sources: Mitt Romney for President; Obama for America; American College of Physicians Candidate Position papers

This article originally appeared in the October 2012 issue of Physicians Practice.