Post-midterm Obamacare prognosis: Hold the champagne

healthcareConservatives and citizens concerned with the direction of the country under Democrat rule turned out in sufficiently large numbers on Election Day to return the Senate to Republican control.  Surfing the wave, Republicans increased their majority in the House, and dominated in State elections across the country.  But if you think this marks the beginning of the end of Obamacare, think again.

Within days of being assured of taking over as Senate Majority Leader, Mitch McConnell gave assurances there would be no government shutdown, citing concerns over defaulting on our national debt.  As Mark Levin (@marklevinshow) points out, there is no connection between a government shutdown and payments on our debt, which continue automatically, and for which there is adequate cash flow.  He cites 18 instances of the government shutting down going back to the Ford administration—none led to default on debt payments.

Last year, Republicans Ted Cruz and Mike Lee spearheaded a move to deny funding for the implementation of Obamacare; House Republicans were dragged along and the government shut down for 16 days.  RINO Republicans in the Senate, who in effect caved and sabotaged the effort, hammered Cruz and Lee, and pundits such as karl rove bemoaned the damage to the “Republican brand.” Well, the electorate sure didn’t seem to mind!  You could even make the case that the shutdown helped the Republican cause, as they at least attempted to stop Obamacare, the rollout of which was and continues to be a disaster.

By ruling out a shutdown, Congress preemptively surrenders its constitutional power of the purse to defund Obamacare (and the coming immigration diktat, for that matter).  What’s left in their arsenal to stop Obamacare, and to reign in a dictatorial chief executive?  Impeachment? Boehner and McConnell?  Don’t make me laugh!

No, sad to say, Obamacare, though every bit the nightmare we predicted it would be, is not going anywhere.  Far from being undeterred or humbled by the election results, Obama is pushing forward at breakneck speed to “fundamentally transform” the country in his remaining two years in office.   And the Republican leadership is too beholden to the special interests behind Obamacare to do anything serious to repeal it.  Remember, (Jonathan Gruber’s boasts notwithstanding) Obamacare was cobbled together and promoted by the insurance industry, the hospital industry, the pharmaceutical industry, the informatics industry, and even the pitiful AMA, and all are reaping the fruits of their lobbying.  These groups also give lots of money to Republicans.

The Federal/Corporate takeover of American healthcare continues unabated.  Insurance premiums, and deductibles, are going straight up.  Win-win for the industry.  Hospitals in states that expanded Medicaid are seeing a boost in earnings.  Doctors are increasingly becoming hospital employees and are being herded like sheep into using electronic health records that are a barrier between patient and physician.  These EHRs guide doctors to prescribe ever-greater amounts of virtually useless pills to ever-greater numbers of the healthy population through embedded practice guidelines or payment for performance.

What can citizens do?  They can of course pressure their (in some cases newly elected) representatives to fulfill their promises to repeal Obamacare.  They can push for common sense reforms that even some Democrats could support:

Expansion and deregulation of Health Savings Accounts would go a long way towards restoring the individual’s power to make their own health care decisions.  Enabling very large HSAs, as has been proposed by Michael Cannon (@mfcannon) and Todd Keefer (@freemktmonkey), would almost make Obamacare redundant.

Transferring the tax deduction for health insurance from the employer to the individual could revitalize the individual insurance market.  Employer-purchased health insurance, while entrenched, is bizarre and market distorting, and should disappear.

HHS should be stripped of power to decide which insurance plans are acceptable.  All existing plans should be allowed to continue as written.

Finally, individuals should seek out and retain private physicians who will care for them in exchange for a reasonable fee.  This is the best protection against the one-size-fits all approach that is part and parcel of Obamacare.

Richard Amerling, MD (New York City) is an Associate Professor of Clinical Medicine and an academic nephrologist at Mount Sinai Beth Israel in New York. Dr. Amerling received an MD from the Catholic University of Louvain in 1981. He completed a medical residency at the New York Hospital Queens and a nephrology fellowship at the Hospital of the University of Pennsylvania. He has written and lectured extensively on health care issues and is President-elect of the Association of American Physicians and Surgeons. Dr. Amerling is the author of the Physicians’ Declaration of Independence and is a seasoned speaker and on-air contributor. More online at www.aapsonline.org.


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