By Jack Torry

The Columbus Dispatch Sunday October 14, 2012 7:15 AM

Thomas West gets a checkup at the University of Chicago Medicine Primary Care Clinic. The number of Medicare beneficiaries is projected to grow to more than 64 million by 2020.

WASHINGTON The signature achievement of President Barack Obamas term could be out the door if Republican challenger Mitt Romney wins in November, but the debate over the future of health care in America will continue and possibly dominate the next term no matter who gets elected.

The candidates competing visions could scarcely be more dissimilar, even though Obamas Affordable Care Act was closely modeled after the health-care plan that Romney signed into law while governor of Massachusetts.If Obama wins re-election, he can be expected to fully phase in the health-care law, which is designed to extend coverage to millions of Americans without insurance.

And he likely will retain the basic structures of Medicare and Medicaid, the Great Society programs that provide health coverage to the elderly and the poor, respectively.

Should Romney win the presidency, count on him to try to repeal the 2010 law which has earned the nickname Obamacare while launching a sweeping transformation of Medicare and Medicaid.

The competing ways to deal with the millions of Americans without health insurance while simultaneously trying to restrain the growth of federal health programs that eventually will devour much of the annual federal budget has been a dominant dispute in the testy presidential race.

During the first presidential debate in Denver, Obama complained that Romney wants to replace the health law but he hasnt described what exactly wed replace it with other than saying were going to leave it to the states.

By contrast, Romney says that the law has discouraged small companies from hiring. During the same debate, he assailed Obama for spending his energy and passion during his first two years in office fighting for Obamacare instead of fighting for jobs for the American people. It has killed jobs.

Read the rest here:

Health care: Will Americans go ahead with Obama or change direction with Romney?