According to their Wall Street Journal article, “How to Reform ObamaCare Starting Now, Scott Gottlieb, MD and Tom Miller, Esq., propose that “states should steer the mandated health-insurance exchanges in a pro-market direction and dare Washington to stop them.” Have we not been in a “pro-market direction” with the advent of managed care and health maintenance organizations for almost 20 years and experienced fiscal and professional havoc? It was the escalating cost of insurance premiums coupled with deals like United Health CEO Dr. William McGuire’s 1.5 billion golden parachute nearly pushed our healthcare system straight over the edge. Or what about the Columbia/HCA Medicare scandal that bilked our government out of $898 million dollars by submitting over-inflated Medicare and Medicaid bills for payment? Had it not been for conscientious whistle-blowers, the American people might never have known about such fiscal improprieties.
Gottlieb and Miller propose that the states “resist” the mandates to the Patient Protection and Affordable Care Act of 2010 (PPACA) and refuse to implement the health-care exchanges. What kind of physician and attorney (the occupations of Gottlieb and Miller) would advocate breaking the law? The warped thinking is that refusing to implement the health-care exchanges would “slow down federal implementation of Obamacare but fail to provide any alternative solution to insurance coverage problems.” First and foremost, the health-care exchange is not the Bogeyman. It is a government-administered marketplace where private or public insurance policies are sold. Policies offered there would be monitored by the government to make sure they meet minimum standards and that they are less expensive than those now sold on the open market. Unfortunately, history has taught us that people DON’T do the right thing when no one is looking and therefore they DO need to be regulated. The Silverado Savings and Loan Scandal of 1988 should have taught us something but it didn’t. Countrywide Loans; AIG; Merrill Lynch; Lehman Brothers; Bernie Madoff; Morgan Stanley; Bear Stearns; Citigroup; need I say more? A 2008 $750 billion dollar bail-out on the American people’s dime and we have yet to recover.
The assertions from Gottlieb and Miller that the PPACA would be a “regulatory dragnet to trap insurers into offering a single government-prescribed set of health benefits” is ludicrous and to proposed that state-designed exchanges could do better is asinine. If the Florida Medicaid system is an example of Gottlieb and Miller’s “state-designed exchanges,” Heaven help us.
Where have these brilliant scholars been for the past 15 years while our healthcare system was in shambles? As a physician who works on the frontline every day I have witnessed the havoc firsthand: the denied claims; the slow payors; the rejected services for patients based on decisions made by people who never stepped foot into a medical school.
By attempting to impede the PPACA law, Gottlieb, Miller and the rest of the anti-reform tribe will only cut off their noses to spite their faces but believe me, it won’t be a pretty sight.