Wednesday, June 26, 2013

E-Book,  Obamacare Implementation Trials and Troubles
It almost looks as if analysis were the third of those “impossible professions” in which one can be quite sure of unsatisfying results.  The other two, much older-established are the bringing up of children and the government of nations.
Sigmund Freud, MD (1856-1939)
I am engaged in composing an E-Book, soon to  available soon on, on the trials and troubles of Obamacare Implementation.  It is a hot subject right now because signups begin  in 100 days for Obamacare health exchanges and because it will be a central issue in the upcoming November 2014 elections.   The outcome of these events may determine whether the Affordable Care Act eventually succeeds or fails.
I will base my E-book on these previous Medinnovation blogs.

E-Book,  Obamacare Implementation,  Trials and Troubles

Medinnovation blog posts on Implementation of Accountable Care Act

1.       January 3, 2007,  In Final Analysis, It’s Implementation, Not Ideas, That Count

2.       August 10, 2010, Health Reforms Fans Messaging and Implementation Difficulties

3.       April 10, 2011,  $105 Billion for Implementation

4.       December 14, 2012,   An Uncommunicative Bureaucracy Causes Health Care Uncertainties

5.       April 3, 2013 Obamacare Implementation Blues

6.       April 13, 2013,  Obamacare and Important Media Sources

7.       April 29, Uncertain Physicians and Health Reform

8.       May 3, 2013. Caution! Obamacare Train Wreck Approaching

9.       May 24, 2013, Obamacare Implementation in Doubt

10.   10June 6, 2013, Selling America on Obamacar

11.   June 11, 2013, Can Obama Be Trusted?

12.   June 12, 2013, American Culture and the Obama Transformation

13.   June 13, 2013,  For New Doctors, The New Commencementarians

14.   June 14, 2013,  Is Congress Guilty of Hypocrisy over Obamacare

15.   June 17, 2013, The Obamacare Radar Detector

16.   June 18, 2013,  Second Thoughts by Physicians and Others over Obamacare

17.   June 19. 2013,  Obamacare May Fail to Sign Up Young and Healthy

18.   June 24, 2013, Obamacare Starts in 100 Days

19.   June 25, 2013, Selling Obamacare, Will It Ever Work?

For me, the central questions are: Will Obamacare survive, thrive, or improvise? 

I have a hunch it will survive but not thrive and will be full of improvisations, better known as compromises.  Some of these have already occurred, dropping of long term care provision, taxes on medical devices,  backing off of waivers for Obama allies, and the probable extinction of the Independent Payment Advisory Board.   

In my view,  Obamacare’s implantation troubles stem from:  its unipartisan,  arrogant, and clandestine  passage;  its writing of a 2700 page indecipherable bill because its compositon  by inside Beltway Congressional staff and lawyers;  its  expanding of Medicaid by sacrificing Medicare,   its deep cuts of hospitals and physicians,  its lack of clarity and obsessive secretiveness, its anti-small business and anti-physician attitudes,  its excessive bureaucratic regulations and costs,  its broken promises – lower costs, greater efficiencies, and better outcomes;   its over-reliance on data and EHRs as tools to make medical care more “scientific; ” its overlong four year introduction designed to mislead public on its costs;   its brazen attempt to completely and comprehensively restructure a system 70 years in he making rather than approaching it incrementally;  its one-size-fits-all  standardzation of all policies regardless of age, sex, and needs[ and  its contempt for market reforms such as health savings accounts.

Tweet:  I am working on a E-book, soon to be available on, which will detail trials and troubles of Obamacare implementation.



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