ObamaCare is not “fixable.” Anyone who says it is has not read the law or embraces the concept of single payer socialized medicine, the Independent Payment Advisory Board deciding who gets what treatment and when, and a fundamental transformation of the ethos of our country via the capture and control of the allocation of medical resources. This 2,700 page monstrosity has metastatic bureaucratic tentacles into almost every aspect of American life, from school based complete care clinics, employer run personalized health improvement plans, what foods your kids can eat at school, and ultimately loss of privacy with electronic medical record intrusion into the privacy and sanctity of the doctor-patient relationship. Trying to “fix” ObamaCare is like “Whac-a-Mole,”- get rid of one section and two other inter-related regulations pop up.
Two of the laws authors, Drs. Ezekiel Emmanuel and Donald Berwick, have publicly acknowledged that they are enamored by the British model of rationed health care. What does this mean? It means that government bureaucrats, not you, your family, and your doctor, decide what treatment options are available to you based on arbitrary considerations such as age, previous diagnosis, and resources you have already used. The recent IRS scandal suggests political affiliation as another potential arbiter of favor. Real life examples from the U.K. are the current investigation of approximately 1300 deaths that occurred in government hospitals from neglect, starvation, and squalor over a six year period, and my son’s experience as an orthopedic spine surgeon in New York with an emergent airlift transfer from Canada of a robust 80 year old with a life threatening neck fracture whose family was told he was too old for repair. Where does that leave us now?
Realize that ObamaCare is not here to stay, because it is not “here.” What we have is a law that has been unlawfully changed at least 28 times to delay provisions that have been deemed politically harmful to the current administration. Translated, these delays are further efforts to hoodwink the American citizen by delaying the pain until after the 2014 and 2016 elections. However, the Weekly Standard, April 14, 2014 issue, reports the majority of American citizens reject ObamaCare according to the most recent WSJ/NBC poll (40 % approving, 54% disapproving). The heartening news is that this is a Main Street majority. Of those making under $40,000 per year, repeal and replace (important distinction to just repeal) was favored by 60% to 31%, and of those making more than $40,000 the margin was 60% to 33%. This is huge.
What does this mean for conservative candidates and Congressional members? The studies clearly showed that repeal alone was not a winner, but repeal and a clear idea of a replacement plan were overwhelming winners. The physicians involved with Rebel.MD and many other grass roots organizations, (AmericanDoctors4Truth.org, Docs4PatientCare.org, AAPS.org) have been working to inform our patients and the public at large about the coming destruction of our American healthcare system and what real reform looks like if we can repeal this law. Many in Congress have our plans. Some basic ideas are separation of the employer and the employee in the purchase of health care with defined contributions for individually held, portable, and non-job specific plans. Promotion of health savings accounts for preventive care and true indemnity insurance for catastrophic events would contain cost. Moving towards a totally transparent pricing systems for drugs, hospital services, medical devices, and physician charges would make all healthcare resource users better stewards of healthcare dollars. Keep the parts of ObamaCare that are beneficial- allowing children 26 and under to stay on their parent’s policy, creating provisions for pre-existing, and having subsidies for the working poor. Finally, tax parity – whoever buys health insurance can use pre-tax dollars. We already have a safety net which needs reform, not expansion. How do we get there?
We must flip the Senate in 2014 and then immediately delay the individual mandate. This would make ObamaCare and the role we want government to take in our everyday lives the central issues in the 2016 election. ObamaCare is not just about healthcare. It is the poster child for Central Planners, the takeover of 1/6th of the private sector economy, and a fundamental transformation of the relationship of the individual to the State. Most of us are disgusted with politicians in Washington. However, we have to change the mix and realize that it is through legislation that we can prevent the looming disaster for our country. We can then utilize the relationships we have worked to forge, with our patients, physician colleagues, and members of Congress, to forward our ideals of patient centered, physician guided, free market driven principles to reform our system. ObamaCare may be the best thing that ever happened to America and our healthcare system- if we can stop it and utilize the energy and attention it has engendered to do it right this time.
Photo by Stephen D. Melkisethian