ObamaCare Decline and Fall?

Self-Evident Issues

1. Cultural – America is a vast middleclass center-right culture that believes the majority, not the minority, rules and in equal opportunity, not equal results, for all. One size does not fit all. When this equation changes, decline and fall of health reform law may follow.



2. Economic Growth - In retrospect, as a nation, perhaps President Obama should have focused more on economic growth and prosperity, rather than on regulations and social justice. At 2% growth over last 6 years, recovery from recession is slowest since World War II.



3. Politics - In a bipartisan nation, one does not pass social legislation affecting every American without a single vote from opposition party. Unilateral power breed intense bitterness, lingering partisanship, and gridlock.



4. Constitution - Our governing document, the Constitution, was designed to give checks and balances and equity to three branches of government – executive, legislative, and judicial. When that balance is altered, or the Constitution is thought to be violated, rules for governing may descend into chaos.



5. Consumers - America is a consumer-driven nation, and any health law should be consumer-friendly and consumer-centered, rather than bureaucratic and government-controlled.



6. Doctors – For any health reform system to be effective, practical, and workable, it must have enough doctors to care for patients generated by that reform. If the system causes doctor shortages and relies on foreign-trained physicians to fill gap, it presages reform decline.



7. Simplicity - Health reform that remains unpopular, that incomprehensibly raises premiums and deductibles and leads to loss of health plans, and whose mandates produce uncertainties, confusions, and penalties is in trouble.

8. Computers - In a humanistic enterprise like health care, overreliance on online technologies to judge providers, to measure outcomes, and to improve quality has its pitfalls.

9. Costs - Present costs of healthcare.gov ($2 billion) and projected 10 year costs of ACA ($1.7 trillion), long-term costs of $6 trillion, and unsustainable costs of Medicare and Medicaid and other entitlements make reform of health reform and alternative approaches inevitable.


What's to become of ObamaCare? Will it be repealed in the next session of Congress? Will it prevail and be irreplaceable? Will it be like Prohibition, repealed after 14 years because of unworkability and public rejection? Or will we behave as Pogo said, " We have met the enemy, and he is us."?