Ten Questions for Obama on Health Reform

It’s better to know some of the questions than all the answers.

James Thurber (1894-1961), Saying

February 9, 2013

Mr. President,  I have some questions for you about the Accountable Care Act.  I ask them not only for myself but for America’s patients.   At the onset, let me be clear.  I do not question your integrity, your intentions, your philosophy of government. I’m sure you have answers to all of these questions, and I hope you will answer some of them in your State of the Union address next week.

Question One -  What precisely is government’s role  in health reform?

Question Two – Is government’s role to contain costs,  improve quality, or expand coverage ?

Question Three -  It is now nearly three years after the Affordable Care Act passed.  Why have costs not come down? Indeed, some have doubled in private markets?  Are health plans to blame?  And why has access to care decreased for employees?

Question Four -  Why is the Congressional Budget Office projecting employers will drop health care coverage for 7 million workers?

Question Five -  Why is the doctor shortage growing, and why is so hard for me to find a primary care doctor?

Question Six -  What good is universal coverage if, in the end, there are no doctors to deliver the promised services?

Question Seven -  Do you honestly think government mandates will  control 1.4 billion health care transactions  without compromising  freedoms of doctors, patients, and religious organizations, to choose what care they want,  without rationing care?

Question Eight -  Does the free market  or consumer choice or physician and hospital competition have any role to play in your scheme of things?  Or are health care capitalism, and private care organizations,  kaput?

Question Nine -   I know you and your CMS colleagues believe data derived from EHRs and outcome comparisons are key to improving care and deciding what to pay for.  Do you have any evidence so far to support this line of reasoning?

Question Ten -  I do not  mean to be disrespectful, and I do not  mean to pin you down, but what changes need to be made, and what spending needs to be curtailed,  to prevent the relentless march towards Medicare bankruptcy and control of the national debt? Please be speficic.

Mr.President,  it is time to talk  truth and consequences.