Monday, June 1, 2015

ObamaCare Blogumentary

Over the past 2 years, I have composed 1700 blogs on ObamaCare. ObamaCare passed more than 5 years in March of 2010. I have been struggling how to put these blogs into a readable form and have settled on the idea of an E- ObamaCare tetralogy under the umbrella title, The Rise and Fall of ObamaCare. The first book is entitled The Road to Hell Is Paved with Good Intentions; second, There Is No Such Thing as a Free Launch; the third, The Party’s Over; and the fourth, to be issued after the June Supreme Court ruling on federal health exchange subsidies, It’s Barely Alive But Still Kicking.

The 4 books will comment on 10 truths I’ve learned along the way.

One, President Obama is a gifted political strategist, a charismatic progressive ideologue, and a powerful and persuasive speaker. He is cool, cerebral, and inspirational, but weak on delivering on his promises, and sometimes inept at governing and compromising.

Two, Obama’s greatest political mistake may have been isolation and arrogance – passing a national program effecting every American without compromising or even consulting with the opposing political party, thereby embittering Republicans and those displaced and disrupted by the health law.

Three, the U.S. has, in effect, a single, big payer system with government setting the rules and the rates of payment for the private and public sectors, covering 150 million Americans in Medicare, Medicaid, the VA, and health exchanges and paying half the health bills.

Four, Obama’s major liabilities are one, a slow growing economy, two, a foreign policy in disarray, and a health law that has failed to deliver on its promises of keeping your doctor and health plan, lowering costs, and improving quality.

Five, the health system’s major problems, are rising costs of premiums and deductibles, narrowing choices of doctors and health plans, a growing physician shortage, and complex rules of entry beyond any mortal’s comprehension.

Six, in the process of implementing ObamaCare, the administration has alienated physicians and small businesses owners, hobbled innovation with regulations, and burdened and undercut the middle class with the costs and inconveniences of health care redistribution.

Seven, the greatest unintended impact of ObamaCare has been to accelerate the corporate consolidation of hospitals and physicians into organizations large enough to monopolize care and negotiate higher prices from the government and insurers. These organizations have the capacity to mobilize technologies, recruit specialists, market their services, raise prices, and deal with bureaucracies.

Eight, Obama’s greatest political accomplishment has been to create a large enough coalition of the young, the liberal elite, young women, and minorities to win election and to use online tools to maintain that coalition.

Obama has misjudged and misread the fundamental nature of the American culture as an innovative, entrepreneurial, individualistic, freedom-seeking society with opportunities for upward mobility.

Ten, many ObamaCare “innovations” – bundled care, primary care initiatives, using metadata to judge and reward performance, and accountable care organizations – are not innovations but coercive attempts to force physicians into organizations in which they can be controlled.

Eleven, the Internet and iphone and the ability to collect metadata has changed rules of engagement between consumers and doctors and doctors and payers by empowering patients, making remote app monitoring possible, and by ushering in new age of telemedicine.

the 2016 elections will be a referendum on big government v. small government, high taxes v. lower taxes, heavy regulations v. reduced innovations, social justice v. individual freedoms.

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