Don’t Repeal Obamacare: ‘Fix’ It!

An OPEN LETTER to House Republican Leadership:
Should you try to repeal Obamacare? No, for three reasons: 1) The President has already promised that he will veto any repeal; 2) There are a few (minor) good things, such as elimination of pre-existing condition exclusion and extension of Medicaid age eligibility; and 3) There are better ways to deal with this flawed Act than another bitter partisan floor fight.

The new Congress should do what the previous Democrat Congress did not do: their homework on H.R. 3590, what business calls its ‘due diligence.’

No one outside the Beltway would urge their company CEO to spend lots of corporate dollars without first doing a detailed cost/benefit analysis to prove that the gain is worth the outlay. The President says we should trust him: Obamacare will be good for us. The American people have said we don’t and it won’t!

I say, let the evidence speak. Don’t let bombast, bias, and scotoma prevail over hard data.

To fix Obamacare, first create a non-partisan Commission (HAC, or Healthcare Allocations Commission) staffed with a majority of practicing nurses and doctors, leavened by economists and management experts. This Commission will be tasked with advising the House Ways and Means Committee on which provisions of HR 3590 should be funded and which should not.

Next require all Directors tasked with implementing Obamacare – there are at least six new agencies –to submit to the HAC within six months a cost/benefit analysis based on evidence of their Agency, the new regulations, or any other activity embodied in the Healthcare ‘Reform’ Bill that will impact patients or our national bottom line.

Each analysis must include hard evidence in two parts: Costs and Patient/National Benefits.
* COSTS include money – immediate, long-term, and avoided costs – as well as other resources such as personnel, physical plant, capital equipment, disposables, and consumables.
* BENEFITS must list outcomes patients that patients such as increased lifespan; rapid, quantified restoration of health when sick; and national gains in productivity. [If they say that they cannot prove these real benefits, ask yourself why should we pay them with real dollars?]

We all know that the previous Congress should have done this BEFORE they imposed Obamacare on us. So let’s demand that the Obamacare bureaucracy do its homework…or else. I will be fascinated to see how anyone can argue against requiring evidence-based cost/benefit analysis before adding $2.7 trillion to an already unsupportable national deficit.

Talking heads on both the right and the left, and every national poll agree that the national deficit and job creation should have been and should be Washington’s top priorities. To increase jobs, Government must unshackle American business, not add new taxes, penalties and more costs as included in Obamacare.

The Deficit Reduction Commission will be reporting to the President and to Congress shortly. It seems obvious to everyone except the President that the U.S. should NOT spend $2.7 trillion (dollars that we do not have) on a new entitlement UNLESS that entitlement can prove it has a positive cost/benefit ratio?

Both President Obama and Republican leadership are now starting to talk about reducing government waste. You and I and every person who wants to solve problems more than live by partisan allegiances, we all know that new bureaucracies and associated regulatory compliance cost huge sums of our money. If cost/benefit analysis is negative, is that not the definition of “government waste?”

Republicans now in the majority:
Fix Obamacare and stop increasing government waste by creating a HAC.

System MD

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#1 George Hartzman on 11.07.10 at 7:06 pm

If “Obamacare” was dependent on the cuts to be “deficit reducing,”
could negating the cuts betray the electorate?

“The Centers for Medicare and Medicaid Services
has released the 2011 Medicare Physician Fee Schedule Final Rule,
which includes a 23 percent cut to Medicare physician fees…

…Congress delayed a scheduled pay cut of around 20 percent in June.

Rachel Fields
Beckers Hosptial Review, November 04, 2010
Did the delay of the June pay cut alter the “affordability”
of the Patient Protection and Affordable Care Act (PPACA),
and if so, who voted for both the initial legislation
and also voted to reverse the cuts making the law “affordable”?
“…The report from Medicare’s Office of the Actuary
…acknowledged that some of the cost-control measures in the [PPACA] bill
Medicare cuts, a tax on high-cost insurance
…could help reduce the rate of cost increases beyond 2020.

…the longer-term viability of the Medicare . . . reductions is doubtful.”
wrote Richard Foster, Medicare’s chief actuary”

Associated Press
Have the American people been lied to,
if the government passed a law that said X,
and those who voted for it did Y,
that made the “affordability” non-viable?
“…Neither the [the Patient Protection and Affordable Care Act (PPACA)] bill
…nor the accompanying reconciliation…
…addresses the flawed formula that dictates physician payments under Medicare

…a bill passed by the House in November would scrap the SGR altogether,
replacing it with a formula designed to ensure that doctors’ Medicare payments
reflect the true cost of delivering care.

Pricetag: $210 billion.

…it was that cost that caused Democrats,
who’d vowed both to keep their reform package below $1 trillion and to offset the entire tab
to strip the doc fix from the larger reform bills.”

The issue has left Democrats in a pickle:
…with voters already weary of deficit spending,
[and/or borrowing] another $210 billion to fund a permanent fix.”

Mike Lillis
Washington Independent
If Medicare Cuts
are what makes the recently passed Healthcare Legislation “deficit reducing”
and the 23% cut is not enacted in December,
how could those who voted for the legislation be considered
not guilty of misleeding the electorate?
From an email from some supporting the elimination of the cut:

“Is the new healthcare law accounting dependent on the 23% payment reduction?

If the can is kicked down the road,
does the math in the healthcare legislation become not operable?”

George Hartzman

The answer:

“That is how the administration officials explained it to us…

…Their numbers are based on the law as it stands,
and it currently stands that the cuts will occur.

I think you know the answer to your last question.”

Lee Beadling
Managing Editor, Orthopedics Today

#2 deanewaldman on 11.08.10 at 8:22 pm

My goodness! Someone who offers data instead of personal vitriolic opinion. Mr. (Dr?) Hartzman cannot work for the government.

Those who ‘do well’ in the current system, meaning the bureaucracy, have a strong vested interest not to change it, and particularly not to simplify it. If someone with an MD, an MBA, and 35+ years in the system [me] does not understand what in blazes they are doing with their so-called “reform,” it is because the “reform” is intentionally obfuscated, confusing and contradictory.

Examples that continue the themes by Hartzman.
1) Will Medicare payments to physicians be cut or not? Answer: yes, Congress approved a 20% this summer. The government is very careful not to say what that means for patients. They leave the impression that the cuts will reduce the excessive payments to those rich, greedy doctors. The Government does not report that the new Medicare payment schedule will be less than the fixed costs for a private physician and therefore, to accept Medicare patients means to go out of business. In other wards, cutting Medicare payments CUTS SERVICES to patients.

2) Are illegal residents covered or not covered by H.R. 3590? The answer is…there is no way to tell. No supporter of the Act, up to and including the President and Ms. Pelosi, will give a straight answer – yes or no. GAO statistics (January 2010) show that 12-15 million of the 45 million uninsured Americans are illegals. What will happen when they come to an ER needing care. You and I know, and so does the Government. The doctors and hospitals will provide care, get paid nothing and have to cost-shift, meaning over-charging other (paying) patients. If they do not do that, they will go broke.
Three years ago, the cost of uncompensated care at my Institution was almost 20% of the total hospital budget. What business can sustain a repeated 20% annual loss and stay in business? Answer: only the Federal Government, certainly not any U.S. hospital.

3) If we doctors practiced medicine the way the government did, we would all be guilty of malpractice. We don’t ignore evidence and substitute logic. We treat causes of illness: we do not symptoms. They (the government) does not even KNOW the root causes of sickness in our healthcare system.
Actually, maybe they do. The #1 symptom of our “broken” healthcare system bruited by the President was the unsupportable cost. So,
A. How does adding at least $1 trillion [minimum cost of HR 3590] to the national deficit help that unsupportable cost??
B. Which of the following is the #1 recipient of healthcare dollars: doctors; hospitals; pharmaceutical companies; other suppliers; insurance companies? Answer: none of the above. Almost 40% of all healthcare dollars expended are NOT repeat NOT paid to all of the above: they go to the government!

I could go on, but what is the point? The people who should be listening are not. The people who should be angry and are – the patients – feel powerless. I urge the latter to read “Uproot U.S. Healthcare” to become knowledgeable and empowered.

System MD

To continue

#3 Donald Karch on 11.19.10 at 5:56 pm

On behalf of seniors and their physicians, the AMA is urging Congress to act before a Medicare meltdown begins on December 1. Congressional action this month is the only way to stop the Medicare cut. Congress needs to keep Medicare strong for our senior patients and ensure that baby boomers will have access to physicians when they begin receiving their Medicare cards for the first time this January.

#4 Amada Normington on 11.29.10 at 8:02 pm

this American health related Association tendencies Congress to preserve clinical for baby boomers by blocking a substantial Medicare slice to clinical professionals. If absolutely nothing is done by means of December 1, doctors might be receiving 25% less from medicare, which would have negative repercussions for any elderly medical, the AMA (American healthcare Association) reported today.

#5 Motoki on 01.23.13 at 2:42 pm

As a Canadian/American, I agree we do need health care refrom in the US. However, I’ve read Obama’s bill. It scares me. It’s weird. I don’t want it. I’d love to see the US get a system of healthcare like Canada’s but trust me, hon, this is not it! I loved Canadian healthcare.In Obama’s plan there’s a section about real time access to your bank records, there are limits to the number of doc’s you can see and the services they can provide (this DOES NOT happen in Canadian healthcare). And there’s some odd stuff about asking people how they’d like to die. There are things in Obama’s plan that don’t need to be there and the fact that they are means something. It doesn’t mean something good.I’m glad you want healthcare like Canada’s, but Obama’s plan is NOT like Canadian healthcare.

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