Not Your Typical Presidential Debate Forum For Obama, Romney

By Peggy Girshman of Kaiser Health News

There’s nothing unusual about the way The New England Journal of Medicine displays the “Perspective” section this week: In dueling columns, under an original article on a “novel androgen-receptor blocker” for prostate cancer. But the authors of two of the perspectives are far from typical: B. Obama and M. Romney.

The introduction to both is basic:

The editors asked the Democratic and Republican presidential nominees, President Barack Obama and former Massachusetts Governor Mitt Romney, to describe their health care platforms and their visions for the future of American health care. Their statements follow.

And though the audience is far different from those at typical campaign stops, both candidates brought out familiar points.

Mitt Romney promises to repeal the health law and to replace it:

In the health care system that I envision, costs will be brought under control not because a board of bureaucrats decrees it but because everyone – providers, insurers, and patients – has incentives to do it. Families will have the option of keeping their employer-sponsored coverage, but they will also be empowered to enjoy the greater choice, portability, and security of purchasing their own insurance plans. As a result, they will be price-sensitive, quality-conscious, and able to seek out the features they want. Insurers will have to compete for their business. And providers will find themselves operating in a context where cost and price finally matter. Competition among providers and choice among consumers has always been the formula for better quality at lower cost, and it can succeed in health care as well.

Romney says he would make no changes to Medicare for today’s beneficiaries or those enrolled for the next 10 years and he advocates for Medicaid block grants to the states.

Obama promotes the features of the health law that have already proved popular, such as beginning to close the Medicare prescription drug doughnut hole and coverage for young adults on their parents’ insurance plans. And he promises:

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.

Obama and Romney both provided the standard NEJM disclosure form, a typical way scientific journals ensure that readers know about any funding source or conflicts of interest.