Romney, Obama Hammer Each Other on Medicare in Debate


October 03, 2012

October 3, 2012 — President Barack Obama and Republican challenger Mitt Romney hammered each other on the high-stakes issue of Medicare Wednesday night in the first of 3 presidential debates, with each candidate hitting his favorite hot buttons on the subject more than once.

For Romney, one hot button was the figure of $716 billion — the amount of savings that the Affordable Care Act (ACA) extracts from Medicare over 10 years by cutting payment to Medicare Advantage plans, hospitals, and other providers. That spells trouble for patient access, he said.

"Some 15% of hospitals and nursing homes say they won't take any more Medicare patients under that scenario," said Romney. "We also have 50% of doctors say they won't take any more patients."

The president's hot button was the phrase "at the mercy of insurance companies," the fate that he said future beneficiaries would experience under Romney's plan to turn Medicare into a premium support or "voucher" system. The plan gives seniors a choice between a private plan and traditional Medicare. However, Obama said traditional Medicare would collapse in the arrangement, leaving seniors stuck with private insurers that have higher administrative costs than the government program, as well as a profit motive.

"You're putting seniors at the mercy of those insurance companies," he told Romney. "This is the reason why the AARP says your plan would substantially weaken Medicare."

Healthcare was officially allotted 15 minutes in the 90-minute debate held at the University of Denver in Colorado, but the topic surfaced in other segments, all devoted to domestic policy. The 2 men in dark suits, the Democrat with the blue tie and the Republican with the red tie, smiled cordially, but also grimaced at times as their stances came under fire.

The candidates predictably sparred on the ACA. Romney described the law as another example of big government gone awry. Instead of making healthcare more affordable, he said, "Obamacare" would cost families $2500 more than traditional insurance.

"It's expensive," Romney said. "Expensive things hurt families."

He repeatedly criticized the ACA for establishing "an unelected board that tells patients what kind of treatment they can have." That entity, the Independent Payment Advisory Board (IPAB), is charged with finding Medicare savings. Romney described it as an infringement on physicians' practice of medicine. Obama countered that the IPAB (unpopular with organized medicine) is prohibited under law from dictating a patient's treatment. But it will, he said, promote the adoption of best practices found at high-quality, low-cost healthcare organizations such as the Cleveland Clinic.

For his part, Obama touted the ACA's benefits, such as preventing private insurers from denying coverage based on a preexisting condition. Taking the offensive, the president said the ACA was modeled after Romney's own reform plan that he instituted in Massachusetts when he was governor there. "He said it could be a model for the nation," Obama said.

Obama also challenged Romney on his vow to repeal the ACA. "He can't detail how it will be replaced," the president said. Romney's own proposal to provide coverage of preexisting conditions, he noted, merely duplicates current law, which guarantees coverage only within the first 90 days of someone's loss of insurance.

Romney and Obama will square off a second time on October 16 at Hofstra University in Hempstead, New York, addressing both domestic and foreign policy in a town-hall format. They meet for a last time in a foreign-policy debate on October 22 at Lynn University in Boca Raton, Florida.

Vice President Joe Biden and Republican nominee Paul Ryan (R-WI) will meet for their one and only debate on October 11 at Centre College in Danville, Kentucky.