The health of our nation can be improved by extending health insurance to all Americans, not through a government program or new taxes, but through market reforms.

Governor Romney: "We can't have as a nation 40 million people-or, in my state, half a million-saying, ‘I don't have insurance, and if I get sick, I want someone else to pay."
(USA Today, July 5, 2005)

Governor Romney: "It's a conservative idea," says Romney, "insisting that individuals have responsibility for their own health care. I think it appeals to people on both sides of the aisle: insurance for everyone without a tax increase."
(USA Today, July 5, 2005)

Our healthcare system will thrive with increased consumer choice, consumer control and real competition. I believe it is important that we have price transparency within our health care system. This offers consumers, who are either enrolled in high deductible health plans or who pay out-of-pocket, the ability to shop around for the best prices and plan for health care expenditures. Also, the existing health insurance market forces consumers to pay for extra benefits in their premiums, such as aromatherapy and acupuncture, which tends to increase the cost of coverage. Instead, consumers should be able to choose the from health care coverage plans that are tailored to fit their families' needs and values. Accordingly, individuals should be allowed to purchase health insurance across state lines. Finally, I believe that consumers should have control over the use of their personal health records. I have a proposal that would offer consumers a means to create a lifetime electronic medical record, while, at the same time, ensuring that the privacy of their personal health information is secured and protected.

Over time, the socialized medicine model has shown to deprive consumers of access to life-saving treatments and is downright inconsistent with the spirit of the American people to be free from unwanted government intervention. I will continue to work at the forefront to create a consumer-centered, not government-centered, healthcare model that offer both affordable coverage choices and put the consumer in the driver's seat.

Governor Thompson believes America must strengthen its health care system if it is to remain the best in the world. He would accomplish this by 1. moving the focus to preventive from curative care; 2. accelerating the adoption of health information technology to save money and lives; 3. placing the uninsured in state-by-state insurable pools, allowing private insurers to bid on their coverage; 4. strengthening the nation's long-term care system that robs too many Americans of their life savings; and 5. strengthening the Medicare and Medicaid programs to ensure the programs are there in the future for the millions of Americans who depend on them. Details on his proposal can be found here.

First, the impacts of preventive medicine are often overstated. It's not that cleaning up the air or putting everyone on a gym regimen would greatly improve health-but people don't follow gym regimens, and business doesn't let you clean air. Furthermore, not all interventions are created equal. Better parenting might be beneficial, but it's unlikely to be more effective-either on economic or biological grounds-than the use of statins, or hypertensive drugs, or daily tablets of aspirin. There are a lot of highly effective medical interventions which are very, very cheap. But our system is very poor at incentivizing their use.

Meanwhile, the reason doctors are constantly prescribing statins along with admonitions to exercise and eat better is because using public policy to change diet and exercise habits is really, really, hard, unless you're prepared to be very heavy-handed (i.e, outlawing trans fats in restaurants, setting portion limits, etc). Indeed, part of the problem with preventive health measures is that, rather often, they don't work very well. Like with traditional health care, some things really succeed (stripping lead out of gasoline, giving people antibiotics), and lots of things...don't. And that's to sidestep the weird reality that what drives health care politics is concern over money which, in fact, is quite rational: Folks don't want to go bankrupt, and smart politicians don't want the government to lose all space for spending on other priorities.

Democratic presidential candidate Barack Obama (news, bio, voting record) on Tuesday offered a sweeping health care plan that would provide every citizen a means for coverage and calls on government, businesses and consumers to share the costs of the program.

Obama said his plan could save the average consumer $2,500 a year and bring health care to all. Campaign aides estimated the cost of the program at $50 billion to $65 billion a year, financed largely by eliminating tax cuts for the wealthy that are scheduled to expire. President Bush wants to make those cuts permanent.

"The time has come for universal, affordable health care in America," Obama said in a speech in Iowa City, at the University of Iowa's medical school.

Obama's plan retains the private insurance system but injects additional money to pay for expanding coverage. It would also create a National Health Insurance Exchange to monitor insurance companies in offering the coverage.

Those who can't afford coverage would get a subsidy on a sliding scale depending on their income, and virtually all businesses would have to share in the cost of coverage for their workers. The plan is similar to the one covering members of Congress.

Obama's package would prohibit insurance companies from refusing coverage because of pre-existing conditions...

My plan begins by covering every American. If you already have health insurance, the only thing that will change for you under this plan is that the amount of money you will spend on premiums will be less," Obama said. "If you are one of 45 million Americans who don't have health insurance, you will after this plan becomes law."

Obama also called for a series of steps to overhaul the current health care system. He would spend more money boosting technology in the health industry such as electronic record-keeping, put in place better management for chronic diseases and create a reinsurance pool for catastrophic illnesses to take the burden of their costs off of other premium payers.

His plan also envisions savings from ending the expensive care for the uninsured when they get sick. That care now is often provided at emergency rooms. The plan also would put a heavy focus on preventing disease through lifestyle changes.

Obama conceded that the overall cost of the program would be high.

"To help pay for this, we will ask all but the smallest businesses who don't make a meaningful contribution to the health coverage of their workers to do so to support this plan," said Obama. "And we also will repeal the temporary Bush tax cut for the wealthiest taxpayers."

So instead of really doing something which would actually make insurance more affordable and easier to get - like removing it from being provided by business and letting a real insurance market (a private insurance market) develop, Obama plans on keeping these plans under employers and making all of them share the cost. Additionally, not a word about all the mandates by various state governments on minimum coverage. And all of this will somehow make insurance cheaper.

Secondly, why not, if the purpose is simply to ensure that all uninsured have access to insurance, why not fix that problem and leave everyone else alone? Instead he wants to mess with the insurance 300 million vs. the 40 or so million purported not to have insurance. Taking care of the 40 million actually might make insurance for the remaining 260 million cheaper.

Again, having government "overhaul" anything is fraught with problems, the primary being cost and efficiency. It doesn't have a good track record with either. And someone is going to pay for this overhaul. Additionally you're looking at a mandate when you see things like "better management for chronic illnesses" and a cost increase (despite the promise of a cost decrease) when talking about government managing a "reinsurance pool for catastrophic illness", because again, someone has to pay for that pool.