The Denver Medicare Debate: Substance vs. Style

File photo dated 25/05/11 of a stethoscope around a person's neck as thousands of hospital deaths could be prevented if d
File photo dated 25/05/11 of a stethoscope around a person's neck as thousands of hospital deaths could be prevented if doctors and nurses used a standardised bed chart, the Royal College of Physicians (RCP) said.

On Wednesday night, Governor Mitt Romney and President Barack Obama squared off in the first presidential debate. And while many pundits are commenting on who won or lost based on style, what's really important isn't who sounded smoother.

No, what matters most to American families is the substance of what the candidates said. And when it comes to health care, Governor Romney and President Obama offer a clear choice for consumers.

Let's take a quick look at five points from last night that sum up the Mitt Romney-Paul Ryan health care plan.

Medicare's Future: Voucher-Care

Governor Romney made it clear that he supports changing Medicare into Voucher-care. What's that? Well, under this plan, seniors would receive a government voucher to cover a portion of private insurance premiums.

Unfortunately, the value of that voucher would be limited and, as premium costs increase, it would shrink over time. That means seniors will be forced to use their retirement savings to pay for any remaining health care costs, which could have a potentially devastating impact on their finances.

What's more, this plan would fundamentally change Medicare, so that rather than having a clear set of benefits that our parents and grandparents can depend on, they'd be left to the mercy of insurance companies just when they are most vulnerable and in need of care.

Destabilizing Medicare

One perhaps funny comment from Governor Romney last night was that he has five boys, and so, despite his sons' best efforts, he "knows" that repeating something over and over again to try and convince folks doesn't make it true.

For some reason, Governor Romney didn't appreciate it when his sons tried that in their youth, but he has no problem doing the same thing when it comes to ObamaCare.

Over and over, Governor Romney made the false claim that ObamaCare cuts $716 billion from Medicare. Well, just because you say it over and over again doesn't make it true.

Obamacare stabilizes the Medicare program by adding eight years to the Medicare hospital trust fund. And rather than cutting benefits that seniors and people with disabilities need, it protects those benefits by reducing wasteful spending by insurance and pharmaceutical companies.

The real threat to Medicare comes from Governor Romney's plan to repeal ObamaCare. If that happens, the measures ObamaCare took to strengthen the Medicare hospital trust fund disappear, putting the future of Medicare in doubt.

Impact on Current Medicare Beneficiaries

When talking about Medicare, Governor Romney told 60-year-olds to "stop listening" because his plan wouldn't affect them at all. To anyone out there who is approaching their golden years or who has a loved one nearing retirement, my message is simple: "listen up!"

The cornerstone of the Romney-Ryan health care plan is a full repeal of ObamaCare. That might make for a good sound bite that appeals to the extreme right, but the real-world impact it would have would be devastating.

By repealing ObamaCare, Governor Romney's plan would cut existing prescription drug benefits for seniors and people with disabilities who have high medicine costs, and it would slap out-of-pocket fees on preventive services like check-ups, mammograms, and colonoscopies that are free thanks to ObamaCare. Already, 25.7 million Medicare beneficiaries have received free preventive services to keep them healthy, but Governor Romney's plan to repeal ObamaCare would mean beneficiaries would again face out-of-pocket costs for those services. If that's not an impact on current Medicare consumers, I don't know what is.

Turning Medicaid into a Block Grant

Despite what Republican leaders, including Governor Romney, might want you to think of Medicaid, it's an absolutely critical program that helps seniors afford long-term care, ensures that women and children have access to basic health services, and helps people with disabilities afford health coverage.

Governor Romney claims he would "improve" the program by turning it into a block grant. Block-granting Medicaid would mean massive cuts of federal funds from the program-by nearly 33 percent at the end of the next 10 years-which would mean millions of people would lose access to health coverage. I fail to see how gutting Medicaid's budget and taking health care away from millions of seniors, women, and children improves the program.

INCREASING the Number of Uninsured Americans

One final point: Governor Romney made the false claim that 20 million people will lose health insurance under Obamacare. The nonpartisan Congressional Budget Office has found that Obamacare actually expands coverage to 30 million more Americans.

Governor Romney's plan to repeal ObamaCare, coupled with his Medicaid cuts, would take coverage away, resulting in 78 million Americans being uninsured at the end of the decade.

The Bottom Line

As I said, style aside, Governor Romney and President Obama showed that the choice Americans will face next month about the future of health care in this country is clear. We can either continue down our current path and support ObamaCare, a program that is protecting consumers, expanding coverage, and putting people before insurance company profits, or we can go with the Romney-Ryan plan that slashes Medicare; takes health care protections away from seniors, women, and children; and leaves people at the mercy of insurance companies.

When you think about it that way, who "won" or "lost" based on style doesn't really matter, does it?