Policy

Why nearly all of Rick Santorum’s ideas on healthcare are bad policy

Unlike Mitt Romney and Newt Gingrich, Rick Santorum has never publicly declared support for the individual mandate — the portion of “ObamaCare” that requires Americans buy health insurance and sets conservatives’ blood boiling. (Or at least Santorum has never intentionally spoken in favor of the individual mandate.) That should be a big advantage for Santorum […]

Unlike Mitt Romney and Newt Gingrich, Rick Santorum has never publicly declared support for the individual mandate — the portion of “ObamaCare” that requires Americans buy health insurance and sets conservatives’ blood boiling.

(Or at least Santorum has never intentionally spoken in favor of the individual mandate.)

That should be a big advantage for Santorum with Republican voters who care about health policy, and it certainly isn’t lost on him. Santorum recently blasted Romney as “the same” on healthcare as President Obama. “We cannot put up a presidential candidate who is basically in the same place as Obama on government-run healthcare,” he said.

Like all the major Republican presidential candidates, Santorum advocates repeal of the controversial federal health reform law passed in 2010 that’s often derisively referred to as ObamaCare, or less derisively as the Affordable Care Act.

“One of the first things I’m going to do is repeal ObamaCare,” Santorum recently said in New Hampshire, the Hill reported. “I can repeal every ObamaCare regulation, every one of them. I’ll repeal them all so there’s no implementation of the bill; I can stop it right away.”

But those positions are no-brainers for any Republican who’s trailing Romney in the polls. What else might U.S. healthcare look like under a Santorum presidency? (Hint: Even worse than now.) Following is an examination of several of Santorum’s ideas and policies on healthcare issues — and a brief explanation of why nearly all those ideas are bad policy.

Santorum’s position: Replace Medicare with a voucher system. While campaigning in Iowa, Santorum expressed support for a healthcare plan floated by Rep. Paul Ryan, R-Wisconsin. Ryan’s plan involves  transforming Medicare into what he calls a “premium support plan” in which Americans would receive federal dollars to supplement the purchase of health insurance in a regulated private market.

Why it’s a bad idea: Not only would the private plans Ryan advocates be more expensive than Medicare, but the government’s contribution (the amount of the voucher) would grow more slowly than health costs. So, over time, more and more costs would be shifted to seniors. Under Ryan’s plan, seniors would end up paying almost twice as much out of their own pockets — or more than $12,510 a year, the nonpartisan Congressional Budget Office (CBO) estimated.

Santorum’s position: Allow consumers to buy health insurance across state lines. Santorum says this will allow consumers to shop from a wide variety of policies to find the one that fits their exact needs and doesn’t include any services they don’t need. Live in Ohio, but your local insurers don’t have any policies that you like? Maybe some in Indiana or Delaware will.

Why it’s a bad idea: We’ve seen this movie before with the credit card industry in South Dakota. The result? The industry offers up a bunch of political donations, gets one small, cash-strapped state to allow it to write blatantly pro-industry (and thus anti-consumer) legislation, and then all the companies in that industry locate in that state. So one (no doubt small, conservative and financially desperate) state is essentially allowed to dictate health insurance policy that was written by health insurance companies to the entire nation.

Santorum’s position: Enact “meaningful” tort reform. Reforming laws to reduce the maximum dollar amount for which patients are able to sue doctors would  reduce premiums doctors must pay for malpractice insurance, the thinking goes. Thus, tort reform would “increase access and reduce added costs and inefficiencies from defensive medicine,” Santorum’s website says.

Why it’s a bad idea: The amount of cost savings that would come from tort reform is way overblown. A 2004 CBO report found that medical malpractice contributes only about 2 percent of annual U.S. health costs. But, sure, those are real costs. The problem is that evidence from states that have enacted tort reform suggest that it doesn’t reduce health costs. Granted, there are plenty of problems with the U.S. malpractice system that are ripe for reform, but those reforms would do little to solve America’s No. 1 healthcare problem: runaway costs.

What isn’t a bad idea: In all fairness, Santorum’s advocacy of increased use of electronic health records seems like an obvious winner and obvious position to take, even if today’s EHR technology needs improvement. Plus, his position on allowing people who purchase their own health coverage — rather than getting health insurance through their employers — to do so with pre-tax dollars, and also giving them a refundable tax credit, would likely lead to a reduction in employer-based coverage. That could be a good or a bad thing, depending on your perspective, and a lot would depend on the size of the tax credit and whether and to what extent its growth would lag that of health costs.

 

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