Don't Repeal ObamaCare, 'Fix' It!

Most Americans want ObamaCare repealed and the Republicans have said they would do so. Should they try?

My response is no, for three reasons:

1) The President has already promised he will veto any repeal;

2) There are a few (minor) good things, such as elimination of pre-existing condition exclusion and extension of Medicaid age eligibility; and

3) There are ways to deal with this flawed Act other than another partisan floor battle. 

The new Congress should do what the previous Congress did not do: their homework on H.R. 3590, what business calls its ‘due diligence.'

No one outside the Beltway would urge their company CEO to spend lots of corporate dollars without first having a detailed cost/benefit analysis to prove that the gain is worth the outlay. The President says we should trust him: ObamaCare will be good for us. The American people have said we don't and it won't!

I say, let the evidence speak. Don't let bombast, bias, and scotoma prevail over hard data.

To fix ObamaCare, Congress should first create a non-partisan Commission (HAC, or Healthcare Allocations Commission) staffed with a majority of practicing nurses and doctors, leavened by economists and management experts. This Commission will be tasked with advising the House Ways and Means Committee on which provisions of H.R. 3590 should be funded and which should not.

Next require all Directors tasked with implementing ObamaCare -- there are at least six new agencies -- to submit to the HAC within six months a cost/benefit analysis based on evidence of their Agency, the new regulations, or any other activity embodied in the Healthcare ‘Reform' Bill that will impact patients or our national bottom line. 

Each analysis must include hard evidence in two parts: Costs and Patient/National Benefits.

  • COSTS include money -- immediate, long-term, and avoided costs -- as well as other resources such as personnel, physical plant, capital equipment, disposables, and consumables.
  • BENEFITS must list outcomes that benefit patients such as increased lifespan; rapid, quantified restoration of health when sick; and national gains in productivity. [If they say that they cannot prove these real benefits, ask yourself why should we pay them with real dollars?]

We all know that the Democratic Congress should have done this before they imposed ObamaCare on us.  So let's demand that the ObamaCare bureaucracy does its homework...or else. I will be fascinated to see how anyone can argue against requiring evidence-based cost/benefit analysis before adding $2.7 trillion to an already unsupportable national deficit.

Talking heads on both the right and the left, and every national poll agree that the national deficit and job creation should have been and should now be Washington's top priorities. To increase jobs, Government must unshackle American business, not add new taxes, penalties and more costs as included in ObamaCare.

The Deficit Reduction Commission will be reporting to the President and to Congress shortly. It seems obvious to everyone except the President that the U.S. should not spend $2.7 trillion -- dollars that we do not have -- on a new entitlement unless that entitlement can prove it has a positive cost/benefit ratio.

Both President Obama and Republican leadership are now starting to talk about reducing government waste. You and I and every American who wants to solve problems more than live by partisan allegiances, we all know that new bureaucracies and associated regulatory compliance cost huge sums of our money. If their cost/benefit analysis is negative, is this not the very definition of "government waste?"

Fix ObamaCare and stop increasing government waste by creating a HAC.

Deane Waldman MD MBA is author of "Uproot U.S. Healthcare" and Adjunct Scholar at the Rio Grande Foundation in New Mexico.