Last week, Mitt Romney published an op-ed in the New England Journal of Medicine entitled, "Replacing Obamacare With Real Health Care Reform." In this report, Romney discusses certain details of his plan which, critics say, would leave 72 million people without health insurance by 2022.
Throughout the campaign, Romney has pointedly and repeatedly criticized Obama's health care policy, trying to distance himself from the infamous Massachusetts Plan—the comprehensive state healthcare program—that Romney oversaw while Governor and which became the model for "Obamacare."
Romney's overriding goal for health care is to create a greater retail market for insurers and patients with transparency on pricing and services, more flexible insurance pools and interstate insurance markets. This would, in theory, create a more market-based approach, allowing consumers to choose up front what products and service to buy and from whom.
"The result," Romney wrote, "will be patients who can confidently choose the coverage that is right for them, who know and care what healthcare costs."
However, most routine medical expenses—like annual check-ups—patients would now have to shoulder themselves. The plan places great emphasis on the use of health savings accounts and tax breaks, which, according to analysts, often favor the affluent.
"It remains a very significant tax shelter, and with all tax shelters, it means a lot to people in high (income) brackets," said Henry Aaron of the Brookings Institution.
"What he's really talking about is shifting more and more of the cost onto the individual," Obama campaign associate policy director Christen Linke Young told Reuters. "That's what he means when he says 'patient centered.' It's really troubling."
Additionally, high-deductible plans can mean big out-of-pocket costs for people with lower wages and little disposable income to put into health savings accounts. Critics also believe that this "patient-centered" approach of his does little to benefit the chronically ill, who often have limited options for coverage and can rarely forego any expenses.
Reuters reports: "Conservative analysts say plans with high deductibles make consumers more responsible because they eliminate co-payments and require the patient to see more of the bill." However, this can also have the unfortunate consequence of deterring individuals from practicing preventative health care, which Obama's 2010 Patient Protection and Affordable Care Act (ACA) sought to promote.
A new report published by The Commonwealth Fund—a New York based health care research foundation—found that under Romney's health care plan, the uninsured population would soar to 72 million by 2022, 12 million higher than if nothing had been done at all. The report compares this to ACA which, if fully implemented (including complete state participation in the voluntary Medicaid program), the number of uninsured would decrease from 47.9 million in 2011 to about 27.1 million people in 2022.