Fundamental Differences Between RomneyCare And ObamaCare?

[MannyGoldstein]

I keep reading that they're different but I don't see how, except around the edges. They both are essentially:

1. we are forced to pay private insurers for health care
2. big increase in government subsidies to private insurers to cover more people, essentially and expansion of Medicaid.

Even Obama's pointed out "When you actually look at the bill itself, it incorporates all sorts of Republican ideas. I mean a lot of commentators have said this is sort of similar to the bill that Mitt Romney, the Republican Governor and now presidential candidate, passed in Massachusetts.", and Obama did not say that these commentators are wrong.

What are the substantial differences?

[Tailormyst]

1. In Mass low income can buy into mass health if they dont qualify for 100%

Up to 300% of the poverty level. And I believe the subsidies are actual subsidies rather then tax credits, which frankly, are useless to the working poor.

[MannyGoldstein]

3. So RomneyCare Is to the Left of ObamaCare?

And RomneyCare controls costs better by providing more coverage through the state's health insurance program rather than through private insurance companies?

[Tailormyst]

9. I think in some ways it is and in other ways it is not.

You would really need a spreadsheet to compare it all. It's extremely complicated.

[frazzled]

2. MA care had no cost controls

Though now, under Governor Patrick, they're starting to address that.

[MannyGoldstein]

4. What Cost Controls Does ObamaCare Have?

The only one that I know of is the so-called "Cadillac Tax" that hits many in the Middle Class.

[kenny blankenship]

5. Arraying differences of philosophy, party, impact side by side, the main thing that sticks out

is that one plan was advanced by a President, the other by a Governor who wanted to be President. That is to say, if you were a Massachusetts resident and you didn't like extortionate Romneycare, you could take your money out of the bank, get in your car and drive across the border to New Hampshire, or Vermont, or Rhode Island or Connecticut.

However, now, if you live in any of those states you will have to emigrate to escape the extortion of Romneycare. The good news is that almost anywhere you might escape to, like Canada or Britain or the Eurozone or even Mexico or Costa Rica, will have better, non-extortionate health care systems, in which people pay less and live longer. Nearly any country you can imagine where your 1st world job skills might earn you a living has a healthcare system where ALL your health care money goes actually goes to your care, and none of it is extorted from you by the armed force of the government and given to corporate parasites who do nothing to make sick people well, but merely suck their life blood.

The bad news is, it's a lot harder to get into those countries than it is to get into this one. Traps usually are a lot easier to get into than to get out of.

[Cali_Democrat]

6. Switzerland still uses private insurers

They seem to be doing pretty good.

[vaberella]

7. So does France and England. n/t

[Lydia Leftcoast]

19. France has public and private insurance (as does Japan), but England's system is mostly public

In Britain, every legal resident is eligible to use the National Health Service, which runs the majority of the hospitals and clinics in the country and employs most of the doctors and other medical personnel.

What Britain has is a "private option." That is, you are automatically eligible for the NHS, but you may choose to buy private insurance and/or see a doctor in private practice. When I asked about this in the UK Forum here on DU, the British DUers said that competition with the NHS keeps both private insurance and private medical care low priced.

[vaberella]

20. Yes, I'm aware.

I lived in England and I'm currently living in France. However, both have private insurance companies still functioning.

[kenny blankenship]

10. And those insurers MUST BY LAW offer non-profit basic policies. They are not allowed to make money

on delivery of basic, essential health care - about 70% of the medical market.

Do you folks ever tire of misrepresenting Switzerland's "private" health insurance system?

[frazzled]

11. BY LAW, at least one of the plans on the exchanges must be a non-profit entity

Know your Affordable Care Act

The Act requires states to establish the American Health Benefit Exchanges and Small Business Health Options Program (“SHOP”) Exchanges (collectively, “Exchanges”) designed to assist individuals and qualified employers in purchasing coverage. Exchanges are required to:

1. Be a governmental agency or nonprofit entity established by a state;
2. Only offer qualified health plans;
3. Establish procedures for certification of health plans as qualified health plans; and
4. Require health plans seeking certification to submit a justification of any premium increase prior to implementation of such increase.

Additional information to know about the Exchanges:

* Exchanges will be required to keep an accurate accounting of all activities, receipts, and expenditures and annually submit a report concerning such accountings.
* The Exchanges will permit an employer to select a level of coverage for its employees. Employees can then choose to enroll in any qualified health plan that offers that level of coverage. Initially, only individuals and employers with 100 or less employees will be eligible to participate in the Exchanges. Employers with 100 or more employees may join an Exchange after January 1, 2017.
* The Office of Personnel Management (which administers the Federal Employees Health Benefit Program) will be required to offer at least two multi-state plans in each Exchange. At least one plan must be provided through a non-profit entity and one plan must not provide coverage for abortions except as permitted by federal law.
* Through the Exchanges, the Act will also provide funding for the Consumer Operated and Oriented Plan (CO-OP) program, a program to create non-profit, member-run health insurance companies that will offer qualified health plans.

http://www.pharmqd.com/pharmacy-news/overview-landmark-healthcare-reform-legislation

[kenny blankenship]

12. Like Blue Cross - the insurance Doctors actually say they're sorry to hear you have.

Yep, I got to give you guys this much: you know the value of having the Washington Generals around.

When you create a Potemkin Village "reform" you leave no detail out.

[backscatter712]

13. Good to know.

The non-profit option did make it into the final bill, even though the government-run public option did not. There's also Kent Conrad's co-ops, though I doubt they'll come to anything.

[Lydia Leftcoast]

17. But the private insurers are HEAVILY regulated

REALLY heavily regulated.

[ChicagoSuz219]

8. Ironically...

Romneycare does cover abortions.

[Name removed]

14. Deleted message

Message removed by moderator. Click here to review the message board rules.

[HughMoran]

15. .

[Lord Helmet]

16. Lawrence O'Donnell: "The real secret is that there is no individual mandate."

LINK

[jeanpalmer]

21. O'Donnell implies there is no enforcement mechanism

but that doesn't mean there is no mandate or penalty. The mandate in most instances will be deducted from a person's tax refund. The only thing the government can't do is prosecute or place a lien against property, but they'll have their ways to get the money.

Regarding the IRS, the CBO estimates the IRS will require between $5 and $10 billion in new funding to enforce the Health Care law between 2014 and 2020. At $5 billion, it's about $830 million a year. Assuming 70% of the $830 million was used to fund personnel, personnel expense for HCR would be $581 million a year. That would imply the hiring of 16,220 people at a $50,000 annual salary per hiree. So this is about the number of new employees Republicans are saying the IRS would have to hire.

If new funding for the IRS is $10 billion instead of $5 billion, double the number of new IRS hirees to 32,440. :shrug: WTH, looks like the Republicans are conservative in their estimates.

O'Donnell needs to do some homework.

[area51]

22. +1

"O'Donnell needs to do some homework."

Plus, O'Donnell and Rahm need to stop lying.

[Lord Helmet]

23. Re: the enforcement provision in the bill -- there is no consequence

"In the case of any failure by a tax payer to timely pay any penalty imposed by this section such tax payer shall NOT be subject to any criminal prosecution or penalty with respect to such failure."

Yes, the bill imposes a tax on you if you don't have health insurance, BUT if you don't pay the tax there is no consequence. Therefore, nothing will happen if you do not get health insurance and you do not pay the tax for not having it.

In other words, the penalty for failing to pay the tax if you fail to have health insurance is NOTHING.

As an aside, current IRS employees: 93,000.

[quakerboy]

30. No criminal consequence

I could me mistaken, but that sure seems to leave garnishment and suchlike well within the realm of the likely.

[berni_mccoy]

39. Nope. You can not pay the penalty and there is explicit language in the bill that says

you will not be punished for not paying the penalty.

[Bleacher Creature]

18. Maybe I'm being too sensitive, but can we cut the "ObamaCare" crap please.

Not questioning for a moment that this is his bill, his policy and his legacy. That said, it's such a ridiculously juvenile term, coined by the wingnuts and to me carries a pretty negative implication.

[Hekate]

24. I've been meaning to ask if "Obamacare" isn't a RW term for the reform bill. Isn't it?

Personally I think it is, and I also think President Obama is laying a verbal trap for Romney in his run for POTUS.

Hekate

[johnaries]

25. It is a RW term. It was associated with a photoshop of Obama's

head on a witch doctor and photoshops of Obama as the Joker. It is not appropriate here on DU.

[ClarkUSA]

26. And it is against DU rules to use the same memes as those of Republicans.

Hint, hint. ;)

"Highly inflammatory or divisive attacks that echo the tone or substance of our political opponents are not welcome here."
http://www.democraticunderground.com/forums/rules_detailed.html

[Hekate]

31. Well that makes 3 of us

What to do next, what to do... :eyes:

[Honeycombe8]

27. Romney's take: It's different mainly because Romney's was state level, and

Obama's is at the federal level (which, as we all know, is the basis for all the lawsuits....federal govt can't tell the states to buy something).

The federal health care act is WAY larger, WAY more complicated, and covers WAY more things than Romneycare.

So the basics of the main parts...they seem the same to me. But the federal plan is much larger and encompasses more things.

For example: The fed. bill will cut Medicare Advantage payments to care providers.; the federal bill puts more funding into community health centers across the country; the federal bill involves something about schools or education (I forget what that is). Things like that.

[Honeycombe8]

28. The federal bill has those death panels. (Don't forget to hide Grandma.)

(just kidding!)

[ProudDad]

29. You've posed an irrelevant question...

The real question is: what is the difference between USAmerican the "Health Insurance Corporation and Big PhRMA Stimulus Act of 2010" and the way the entire civilized world has done health care?

1) The civilized world has decided that Health Care is a human right and acted accordingly...even NON-CITIZENS and "Illegals" are cared for when they need care. The idea that the Health Care you receive is a function of your net worth is an obscene and insane concept.

2) The civilized world has taken the profit out of health care financing for comprehensive basic care and as a result pays MUCH less for much better outcomes.

3) The civilized world has determined that the drug companies are leeches and negotiate for the lowest drug prices possible. They believe that human life is not a commodity to be traded on the open market.

By contrast in the greedy, selfish, self-centered, ubber-capitalist USAmerikan Empire:

1) In USAmerika, Health care is a commodity...if you can't afford it, you can't have it at all or you get a truncated version of it after a hell of a long wait...the more money you have, the better the care.

2) In USAmerika, most Health Care provision is for-profit...if you can't satisfy Wall St., you're not doing your bit for the Korporate Kapitalist Kleptocracy.

3) In USAmerika, the corporate capitalist is king -- the drug companies are encouraged to make obscene profits from human misery...in fact, they are required to by the banksters and stock market to do so.

-------------------------------------------------
There's a basic flaw in the USAmerican "character" that allows this travesty to occur...as I outlined in my Letter to the Editor printed on 3/18/2010 in the home town newspaper:
-------------------------------------------------

I'm not surprised that all reasonable solutions to the only profit-driven system of sick care are "off the table."

As the industrialized world has realized, you must remove the profit motive from health care to succeed.

But this country suffers from a deep sickness that impedes any consideration of strengthening community.

That sickness, brought by the rapacious European white men who stole this country from people living here gently on the Earth, is the deviant notion that each man is an autonomous self-serving pirate whose task is to grab all he can using any means necessary.

The tax structure, anti-democratic political system and the "education" system are all designed to promote that deviant idea.

It's no wonder Congress can't find a way to provide universal health care, say "enhanced and improved Medicare for all."

[boppers]

32. Meh. I'll throw five out.

I'll give you 5, because, well, that should be enough to point out to any scientist that their theory is complete tripe. YMMV, you may not be a scientist.

5 WAYS THE TWO THINGS ARE DIFFERENT:
1. One is a single state, the other is Federal. This totally changes the legal landscape for claims, standards, norms, and regulations.
2. One establishes national clinics, the other does not.
3. One establishes national doctor training, the other does not.
4. One sets up per-state public option optional systems, the other does not.
5. One taxes Republican tanning beds, the other does not. (This was to point out the absurdities.)

Basically, the error in logic is not comparing apples and oranges, but it's comparing amantia muscaria to a cantharellus cibarius. They're both mushrooms, so why differentiate between the two?

Hm...

Put another way, the error in logic is complaining that both "RomneyCare And ObamaCare", as apples and oranges, are both fruit, that come from trees, therefore they must be the *exact* same thing.

[Hekate]

33. ~*~

:thumbsup:

[cornermouse]

34. Meh. I'll throw one out here.

States are frequently the testing lab for federal projects. That would knock #1, #2, #3, and #4 arguments out of serious consideration for anyone but dedicated political contortionists.

[ClarkUSA]

35. That's a supposition without any factual substance.

"That would knock out" your "argument out of serious consideration for anyone but dedicated political contortionists."

[cornermouse]

36. Well, since apparently the Clark that I had some respect for

is long gone, I see no more need to reply to you. Bye.

[ClarkUSA]

37. I am the same "Clark" I was years ago, only now we are on opposing sides. n/t

[boppers]

38. Seriously? If Nevada decided on a flat earth policy, it should be adopted?

Maybe you should write Texas schoolbooks.

Science does not work that way. Nobody cares about the lab.