Sunday, April 10, 2011

Health Reform and the Budget Battle: Who Won?

When they say it is the principle, and not the money, it is the money


April 10, 2011 – In the extraordinary budget battle just concluded, who won on the health reform issue ? Obama supporters or opponents?

The consensus is that those who would repeal Obamacare won. At least that’s the opinion of Donald J. Palmisano, MD, JD, former president of the AMA,as expressed in his widely read blog, DJP Update. He and many others felt the main issue in the budget deal was cutting $38.5 billion from the budget, not ending social programs like NPR or Planned Parenthood.

Palmisano gives three reasons why the deal favors opponents of the health reform law.

One, because the deal supports the position of those who say the health reform law is failing as articulated in the new book Why Obamacare is Wrong for America.

Two, because the deal guarantees a Senate vote on repeal of the health care law, gives lawmakers new tools in the form of studies and hearings to demonstrate negative impacts of the law, and denies new funds to the IRS to enforce the law’s mandates.

Three, because the budget battle deal somehow will culminate in a Supreme Court 5-4 decision declaring the health law unconstitutional.

I do not know whether Dr. Palmisano is right or wrong, but I thought it might be worthwhile reprinting the details of the alternatives to Obamacare as set forth in Why Obamacare Is Wrong for America.

It is not sufficient to repeal the law. A reasonable alternative must be offered.

Private Insurance

• Offer people a health credit to purchaser coverage on their own, through an employer, or through other groups.

• Allow greater flexibility in health benefits: consumers, not regulators, should decide what their health plans cover and not be forced into one-size-fits-all, government determined standard plans.

• Provide portability of health insurance and greater competition by allowing cross-state purchase of health insurance.

• Allow states to develop market mechanisms to help consumer find and enroll in the insurance that best meets their needs.

• Ensure more secure renewal of health insurance this is guaranteed so people who have insurance can keep it, and others without it will encourage getting insurance and maintaining their coverage continuously.

• Provide greater financial assistance to the states to create more functional high risk pools or state risk-transfer pools that allow people with preexisting conditions to purchase more affordable health insurance.

• Reform the medical malpractice litigation process at the state level.

Public programs

• Puts the savings from Medicare reform into saving Medicare.

• Convert Medicare for new enrollees into a market-based, consumer-choice program in which the beneficiaries select the coverage that best suits their needs with fixed support from the government.

• Allow people to escape from Medicaid by giving them health credits that they could use to purchase private coverage.

• Provide more flexibility to the states in running Medicaid programs so that can get the best value for taxpayers’ dollars, including allow Medicaid beneficiaries to enroll in state-designed consumer-choice models.

• Provide more options for Medicaid recipients, Medicare beneficiaries, and others on public programs to escape the restrictions that inevitably come from price controls and government micromanagement.

Richard L. Reece, MD, has posted 1725 blogs at medinnovation blog over the last four years. His main themes concern health reform and innovation and how they impact physicians and American culture as a whole. He works closely with the Physicians Foundation but his opinions are his alone. He has written eleven books. His latest book, The Health Reform Maze, is now at the publishers and will be released in June. Doctor Reece’s website,, is now up and running He invites comments and questions on his blog trough his website and will respond to each comment or question on his blog or to him directly at 860-395-1501 or

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