Source: EverydayHealth.com
Walton Francis is an author and independent consultant with expertise in health markets and government regulation. He has worked for the Office of Management and Budget, the Office of the Secretary at the Department of Health and Human Services, and as a consultant to the Centers for Medicare and Medicaid Services on implementing the Medicare Advantage and Prescription Drug Plan programs
Devon Herrick, Ph.D. is a Senior Fellow for the National Center for Policy Analysis and a contributor to Townhall.com. He received a Ph.D. in Political Economy and a Master of Public Affairs from the University of Texas at Dallas.
EverydayHealth.com: In tonight’s presidential debate between President Obama and Governor Romney, what do you expect will be the focus of the healthcare segment?
Walton Francis: There will be two hot button topics: Whether the Affordable Care Act is worth its costs, and which candidate will best preserve Medicare.
Devon Herrick: Access and affordability.
EH: How important are the candidates’ stances on healthcare in terms of voter preferences? As important as the economy?
WF: Not as important as the economy, to the vast majority. But much more polarizing.
DH: The economy and jobs will always come before healthcare. However, most Americans get health coverage through their jobs so a bad economy impacts their healthcare.
EH: President Obama’s healthcare plan has been criticized because of its potentially massive long-term cost. The Republican side of the Senate Budget Committee predicted that Obama’s plan could cost $2.6 trillion over the next 10 years. How do you think Obama will sell his healthcare plan and explain costs in tonight’s debate?
WF: The President will explain his plan in terms of “you can now be sure you will have insurance for you and your family.” He will quote CBO [Congressional Budget Office] projections that his plan will cost only a few hundred billion dollars over the next decade. These estimates assume what is quite unlikely, that the Congress will allow massive cuts in Medicare physician and hospital payments to take place. CBO is required to assume that current law will be enforced. The Medicare Trustees have warned that this is unlikely.
DH: The President will not focus on the aggregate costs; although he may claim the PPACA [Patient Protection and Affordable Care Act] will reduce the deficit. Americans cannot comprehend such large numbers in terms of what they mean for job growth and the economy. Rather, the President will focus on the health insurance subsidies Americans can expect; the Medicaid benefits more Americans will qualify for; and the Medicare benefits (closing the donut hole) seniors are not entitled to. The President might even mention that Americans can expect new insurance will have new protections and enhanced benefits.
EH: Obama stresses that one way his plan will improve access to healthcare is through preventive services. Is that an important point for him to make in the debate? How do you thing he could most effectively “sell” this point?
WF: I don’t know that Web site. Regardless, under his program a general set of preventive benefits will be “free.” Of course, all “free” benefits show up in insurance premiums sooner or later. I think he will stress both free preventive care and the coverage of children up to age 26, both very popular.
DH: Preventive service is little more than a sound bite. He’s more likely to tout “affordable health coverage” and how Americans cannot be turned away or charged more because they are sick.
EH: A new study from The Commonwealth Fund estimated that Romney’s healthcare plan could leave 72 million Americans uninsured by 2022. How do you think Romney will overcome this and other possible negative perceptions of his health plan in the debate?
WF: Romney will deny that the study has any validity. Since he has not put forth a detailed health plan (so far as I know), he will focus on “repeal Obamacare” as his main policy. He may also mention the current tax discrimination against self-employed and unemployed Americans, who don’t get the massive tax subsidy from employer-sponsored insurance.
DH: The Commonwealth Fund is hardly non-partisan. The President’s health plan will leave 30 million people uninsured. Romney may emphasize how his plan will give these 30 million people more options.
EH: Can Romney use his successful background in business to convince Americans that his health plan will save money and provide the best care?
DH: Romney’s background will resonate with Republican voters; but less so with Democrat voters. Who Romney and Obama really need to convince is the moderate independent voters.
EH: What do you think voters want to hear from each side on healthcare?
WF: Voters don’t have a uniform view, to say the least. Each candidate will make points he thinks most attractive to uncommitted voters, e.g. “repeal Obamacare” or “everyone has a right to health insurance.”
DH:Voters mostly want to hear what each candidate’s proposal means to them. Will they have access to healthcare they can afford? Will they have access to a doctor when they need it? Will the proposals actually slow runaway spending that threatens future pay raises?
EH: How can each presidential candidate reassure the public that they have the most effective health plan?
DH: Obama will tout better access to affordable coverage/care. Romney will need to emphasize empowering consumers by letting them control more of their healthcare dollars.
EH: Who do you think will emerge as the debate winner in terms of healthcare? Why?
WF: Each will win with core, committed voters of his party.
DH: The President is a good speaker and probably has an advantage because his message is simple and easier to understand. Although I prefer Romney’s free market approach, it’s harder to convey the mechanism by which market forces will encourage competition and increase control.