Thursday, September 27, 2012
The Democratic and Republican presidential candidates' positions on healthcare and visions for the future of American Healthcare have just been printed in the New England Journal of Medicine. The journal's editors invited President Obama and former Governor Romney to submit their essays, which were published late last night online. The essays are addressed to NEJM's physician audience. President Obama described and defended the Affordable Care Act and explained why it should make physicians' jobs easier by protecting their patients. Focusing on policies particularly of interest to physicians, the President wrote:
If I am elected for a second term, I will follow through on all the work we have started together to implement the Affordable Care Act. I have also been clear that additional steps are needed. We need a permanent fix to Medicare's flawed payment formula that threatens physicians' reimbursement, rather than the temporary measures that Congress continues to send to my desk. I support medical malpractice reform to prevent needless lawsuits without placing arbitrary caps that do nothing to lower the cost of care. I also know we must continue to support life-sciences research and ensure that our regulatory system helps bring new treatments and tools to pharmacies, doctors' offices, and hospitals across the country. I will keep Medicare and Medicaid strong, working to make the programs more efficient without undermining the fundamental guarantees.
My opponent in this election, Mitt Romney, has a radically different vision for the future of our health care system — even if it means running from his past as the architect of health reform in Massachusetts.
This, of course, highlights the most mystifying aspect of Former Governor Romney's position in his campaign, because he denies the legacy he left in Massachusetts in order to attack what he calls ObamaCare. Writing to the physician audience, Romney wrote:
A strengthened system must also be one where America continues to lead the world in innovation and where we continue to attract the best and the brightest, both from our own towns and from around the world, to the practice of medicine. Doctors should spend more time treating patients and less time practicing defensive medicine or processing paperwork. Innovators should increase their investments in new cures, and those cures should reach the market faster. Achieving these goals requires medical malpractice reform, a streamlined regulatory framework to support the interoperability of information technology, and strong Food and Drug Administration leadership committed to a practical and predictable approval process that appropriately evaluates risk.
Finally, for our health care system to work for all Americans, we must have government programs that effectively serve our senior citizens and people in need without breaking the bank. In other words, we need genuine entitlement reform.
The comments to these unsurprising essays range quite a bit, but a few ask the very question I had: why did NEJM bother to make the invitation? Neither candidate offers insights, both supply now familiar soundbites. Seems like a wasted opportunity.