Monday, March 16, 2015

ObamaCare Alternatives

I am contemplating writing another book on ObamaCare, tentatively titled ObamaCare Alternatives.

Why another book on ObamaCare? In my case, the answer is simple. In the course of writing 2000 blogs on health reform over the last 5 years, I have noted a growing number of ObamaCare alternatives. In part, these alternatives are due to deep unpopularity of the health law and its failure to deliver on its promises. Alternatives include retail clinics, urgicare clinics, free-standing emergency rooms, direct cash practices, alternative medicine, self-care at home, self-pay, care outside the U.S., care from faith-based organizations, and going without insurance.

What is driving these alternatives?

Desire for more choice and more balance between private and government care.

Evidence that market-driven alternatives are often more efficient, less costly, and more personal.

Perception that ObamaCare is a poor fit for America’s decentralized capitalistic culture.

Polls indicating Americans prefer economic growth and opportunities to social equities and redistribution policies.

Growing physician shortages in part due to government cost-cutting and loss of clinical autonomy.

Inability and intrusiveness of government in managing billions of patient-physician-hospital transactions on ground.

Failure to recognize human beings will always seek to obtain best of care and latest technologies .

Over-reliance on information technologies and social media to inform patients and reform system.

Distrust of government in wake of dashed promises to keep doctors and health plans and to lower personal costs.

Fears of loss of personal privacy and over-surveillance secondary to individual and employer mandates.

Growing recognition that ObamaCare has winners (the uninsured, hospitals, Medicaid) and losers (the young, middleclass, and taxpayers) and that being a patient, physician, and employer is no piece of cake.

Resistance to individual, employer, and religious mandates and penalties as un-American.

Conclusion: In America, there is always room for more efficient, innovative private alternatives to government care.

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