Obamacare: The issue not discussed in last night's debate

I have lost count of how many times residents of Grand County have been asked to contribute to a family's medical costs when serious diseases or accidents strike. The usual reason: No insurance. We pass the hat, hold a benefit, and pray it is enough. That era is about to end if Pres. Obama is re-elected and Obamacare is implemented in 2014. If Mitt Romney is elected, it is back to the present, but worse.

Romney plans severe cuts in Medicaid care for disabled kids, child health care, and nursing home help for Grandma. If Romney repeals Obamacare , seniors will be stuck with the donut hole again, averaging $600 per year. Those measures will hurt current seniors and kids. For those future seniors not yet 55, Ryan/Romney voucher plan (the new revised edition) will cost them more, according to the independent, a non profit Kaiser Family Foundation in a report released Monday, Oct. 15, 2012.

Grand County has one of the largest uninsured populations in the state, over 20%. We have attempted to fill in the holes with 9 Health Fair that provides health screenings and P.A.I.N.S. , privately funded vouchers for adult non emergency doctor care. Nonetheless, the hat gets passed for emergency treatment and hospitalization.

There are others with insurance who still struggle with medical bills because the coverage they have is inadequate. The single largest cause of bankruptcy in the US is medical bills and most who go bankrupt have health insurance.

With Obamacare, if a family is uninsured now, they will be able to afford it because there will be a subsidy available based upon income level. In Colorado they will have a choice of many different private insurance plans that cover pre-existing conditions and adequately cover costs.

What would Romney do? For those who have pre-existing conditions, he would only require coverage for those who already have insurance with uninterrupted coverage. Tough luck if you lose insurance for even a day or never qualified.

Don't have insurance? Romney would send you to the emergency room.

Scott Pelley asked Mitt Romney on CBS' 60 Minutes, Sept. 23, 2012: “Does the government have a responsibility to provide health care to the 50 million Americans who don't have it today?”

MITT ROMNEY: “Well, we do provide care for people. If someone has a heart attack. We pick them up in an ambulance and take them to the hospital and give them care.”

Romney knows better. ER care is expensive. The insured and state governments ultimately pick up the unpaid bills and those high costs are passed onto the entire system, including Medicare and Medicaid. That's why he invented Romneycare in Massachusetts on which Obamacare was patterned. Would free market competition lower costs? Even in the Ryan plan, competition is tightly controlled and per the Congressional Budget Office, only 3 million more would get affordable insurance if cross state purchase would be allowed.

Romney plans to let states reform health care on their own dime, but it is fantasy to think cash strapped, Teaparty dominated state governments would adopt Romneycare, either.

Medicare would go broke by 2016 but keeping Oamacare extends it until 2024. Long term, Simpson Bowles Debt Reduction Commission has their own plan to save Medicare and concluded keeping Obamacare was essential because it brings down health care system costs. The Congressional Budget Office also concluded Obamacare would reduce the deficit; repealing it would increase it. Voucherizing Medicare is not the only plan on the table.

For those Mediscared by the GOP with Obamacare death panels, the law forbids any panel from recommending changes in patients' benefits. Would fewer doctors take Medicare and hospitals go out of business? It did not happen in Romney's Massachusetts and the “doc fix” law insures adequate doctor compensation.

This is my column appearing in the Sky Hi News today.