Tuesday, January 6, 2015

Ten Fundamental ObamaCare Mistakes, Leading to Publication of The Road to Hell is Paved with Good Intentions: the Story of ObamaCare ($9.97, Kindle E-Book)

I beseech you, in the bowels of Christ, think it is possible you may be mistaken.

Oliver Cromwell (1599-1658), prior to his beheading

For the last 2 weeks, I have had an E-book on amazon. com. The Road to Hell is Paved with Good Intentions: the Story of ObamaCare.
The thought behind the title is this: President Obama and Democrats, who own the ObamaCare law because it passed without a single Republican vote, had good intentions: to create a law that covered the uninsured by offering them more access to more affordable care.

The law also had a less than noble intention – to seize and cement perpetual political power by making Americans dependent on government.

Along the way, ObamaCare went to hell politically because it could not deliver on its promises and because it made these mistakes.

Mistake #1 - The President and his party did not bother to consult or engage the GOP, who won the 2014 midterms by 60/40 margins, in writing a law that effected the entire population, not just Democrats. As a result, Obama and Democrats own the law lock-stock-and-barrel, and have nobody to blame but themselves for its shortcomings.

Mistake #2 – In passing the law, Obama and his followers showed a profound ignorance of and utter disdain for America’s center-right, free-enterprise culture, whose members are more interested in economic growth and prosperity than in health reform. Before the law passed, 85% said they were satisfied with their health plans. Today that percentage is down to 67%, according to Gallup.

Mistake #3 – A third fundamental mistake was thinking that Middle Class Americans, who comprise most American voters, would sit back and passively accept the notion that health and wealth redistribution with equality of outcomes was necessary in a free-enterprise culture where many have the dream and opportunity of becoming rich.

Mistake # 4 – A fourth mistake was making promises the architects of the law knew they could not keep - lowering premiums, keeping your doctor and your health plan- and by presenting and writing and delaying the law to obfuscate its contents so the average “stupid” American would not be aware of its ultimate consequences once it was fully implemented.

Mistake #5 – A fifth mistake was engaging in political warfare with the states, the majority controlled by Republican governors and legislatures, and in which, Medicaid was the number one, fastest growing budget item. Medicaid threatened to crowd out other state government programs. ObamaCare depended on the states to set up their own health exchanges, but only 13 did. Medicaid has added 9.7 million people in the last year, thanks to ObamaCare's health exchanges, an unsustainable growth rate.

Mistake #6 - A sixth mistake was honestly believing and grossly overestimating the ability of the top-down federal bureaucracy to manage transactions and clinical behaviors of bottom-up patient-physician relationships at the local point of care level. All of these relationships, like all politics, are local.

Mistake #7 – A seventh mistake was the notion that the federal government could standardize and homogenize individual care through uniform health plans administered through government by providing ten essential benefits for all plans, regardless if patients wanted or needed these benefits. All-for-one, one-for-all, and one-size-fits-all, is not a good fit for heterogeneous, freedom-seeking-and loving, and multicultural society.

Mistake #8 – An eighth mistake was trying to reform the health system without thinking through or paying attention to how the reform would lower costs or provide more benefits for the typical worker, how much he or she would have to pay out-of-pocket, and how their choices of plans and providers would be narrowed.

Mistake #9 - A ninth mistake was going to philosophical and ideological war with the small and medium-sized business community and start-up companies. Small businesses supplies 80% of the jobs in the U.S, and to make such statements as “You didn’t build that,” or “Anybody who thinks businesses or corporations create jobs is crazy,” is absurd and shows an anti-business bias.

Mistake #10 - A tenth mistake was the fantasy that reform would result in more coverage and more access even if the law was designed to drive more doctors out of business with burdensome regulations, complicated coding schemes, lower reimbursements, and monetary punishments for not installing dysfunctional, time-consuming e-records systems.

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