Back to the Future for Meaningful Healthcare Reform


In the months between George W. Bush’s first Inauguration in January of 2001 and the terrorist attacks of 9/11, Republicans in both Houses of Congress were busily patting themselves on the back for retaining control of Capitol Hill and gaining the White House.

The conservative public policy community and its health care scholars were delighted that after years of economic and practical analysis, market-based, patient-centered reforms that expand choice, increase access to care and stabilize costs would be achieved.

After 9/11, our leaders focused on keeping our nation safe – and rightfully so. The domestic policy agenda was largely ignored and little attention paid to passing meaningful health care reform. When Democrats re-captured majorities in the House and Senate in 2006, contributing to their success was anger and disappointment by voters who felt the GOP squandered its chance to pass health care and entitlement reform.

Democrats, however, did not make the same mistake.

From the moment Barack Obama became president, they pushed for big government health care and passed ObamaCare over the objections of the American public. Many aspects of ObamaCare were presented dishonestly, with several line items removed after proponents claimed they weren’t there in the first place.

“Here,” said ObamaCare supporters, “is your long awaited health care reform.”

ObamaCare is not health care reform. It is a massive tax increase of at least $500B to be paid by Americans over the next ten years. It is expected to increase federal spending by one trillion dollars in its first decade and nearly three trillion when fully implemented – adding to America’s already mind-numbing debt. It adds a myriad of regulation and new bureaucracies to an already bloated system that will result in yet another unsustainable government entitlement program for taxpayers while limiting health care choices for patients at a personal, private and painful level.

Despite assurances by ObamaCare supporters, patients and providers are already seeing increases in costs and limits on services. ObamaCare gives no flexibility to consumers in its mandate that all Americans purchase health insurance and imposes significant monetary penalties to individuals and businesses if they do not comply with that mandate.

Seniors in particular will be negatively impacted by ObamaCare, which is already cutting reimbursements to doctors and other health care providers, leading many to drop Medicare patients. ObamaCare cuts over one trillion from Medicare in the next ten years while doing nothing to provide seniors with more choice or flexibility.

ObamaCare dictates coverage requirements in Medicaid, the federal health care program for low-income Americans implemented by the states. States will be struggling for find $100B (from taxpayers) to pay for the massive increase in enrollees mandated by ObamaCare.

The program includes regulatory and tax changes that negatively impact the ability of our nation’s medical innovators — who have led the world in new technologies and treatments — to invest in new ideas and products.

Ultimately, ObamaCare will harm America’s patients by limiting their ability to make decisions about their health or medical treatments. This government-run health care program will eventually lead to barriers to treatment, an overall reduction in the quality of American health care, and devastating outcomes for patients who face rationed care.

It is nearly assured that ObamaCare will face repeal by legislative, judicial or executive hand — or some combination thereof — before full implementation in 2014. We must not repeat the sins of the past that lead us to this lurch toward socialized medicine. Now is the time to prepare for passing good, healthy, patient-centered reforms. They need to be in the pipeline, ready to flow at the first possible legislative moment.

Reforms that benefit patients and truly reform the system — without breaking it — must apply elements of choice, competition, accountability and responsibility to patients, providers and insurers alike.

The quality and primacy of the patient-doctor relationship must always be protected, and policy changes that make the patient the priority will improve affordability of coverage and expand access to care while providing flexibility, portability and coverage choices for the uninsured.

Market-based reforms that meet these criteria already exist and have been analyzed and scrutinized at length. These include allowing individuals to deduct premium from their taxes as businesses do, permitting insurers to sell policies in a competitive state-to-state market, tax and regulatory changes that create a stable environment for investment in medical treatments and products, and entitlement reform that increases choice for enrollees while giving states flexibility in program management and funding. Medical malpractice, which costs $56B a year, must be addressed through tort reform.

Americans are smart enough to do two things at once – repeal ObamaCare and prepare reforms to replace it. Let’s put patient-centered health care back on the table of national discussion and look beyond repeal in a meaningful and substantive way.

Kerri Toloczko is the Director of Beyond Repeal (, a project of the Independent Women’s Forum that advocates for market-based, patient-centered health care reform.


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