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Paul Hsieh

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June 28, 2012 - 9:22 am

The Supreme Court has finally ruled on ObamaCare.  To the surprise of many, the court has essentially upheld ObamaCare, including the controversial “individual mandate” requiring Americans to purchase health insurance. (They ruled it could not be upheld under the Commerce Clause but could be upheld under Congress’ taxing power.)

What does this mean for Americans and what should we do now? There are three important take-home points:

1) American health care will be in deep trouble in just a few years.

Not only does the individual mandate stand, but also all the other provisions including various new taxes, new regulations on the insurance industry, and new payment and practice standards for physicians.

CNN recently reported that 17% of doctors in private practice might close shop within the next year due to a combination of factors, including “business expenses and administrative hassles, shrinking insurance reimbursements and costly malpractice insurance.” Under ObamaCare many will likely join large “Accountable Care Organizations” or become hospital employees, accelerating the government-driven collectivization of American medicine. Under new medical practice incentives, doctors will become increasingly beholden to their paymasters, rather than their patients.

Medicare patients will also face de facto rationing under the Independent Payment Advisory Board (IPAB) which will set physician reimbursements. Given that private insurance companies generally mirror Medicare coverage and payment decisions, this means these government restrictions will likely affect millions of Americans with nominally private insurance as well.

However, Chief Justice Roberts also noted that the Court “does not express any opinion on the wisdom of the Affordable Healthcare Act.” Rather, “That judgment is up to the people.”

In other words, if Americans want to repeal ObamaCare, we will have to do it ourselves.

2) There are plenty of good ideas for free market health care reform.

One silver lining that has come about from ObamaCare has been an outpouring of proposed free-market alternatives to the current law.

One small sampling of many such proposals includes the Docs4PatientCare, “Physician’s Prescription for Health Care Reform,” proposals from the American Association of Physicians and Surgeon (AAPS), and “The Pipes Plan: The Top Ten Ways to Dismantle and Replace Obamacare“ by Sally Pipes (Pacific Research).

Likewise, Dr. Milton Wolf, John Mackey (CEO of Whole Foods), and Andrew Bernstein (author of Capitalist Solutions) have also published free-market health care solutions.

Although proposals differ in various details, they share many common features and they would all move us in the direction of a fully free market in health care. These include fixing the tax code to put employer-provided health insurance and individually owned health insurance on a level playing field, repealing costly mandates specifying which benefits insurers must offer, allowing individuals to purchase health insurance across state lines, and eliminating monopolistic medical licensing requirements that prevent doctors from practicing across state lines.

Such reforms would uncouple insurance from employment, allowing consumers to keep their own policies when they change jobs. Furthermore in a free market, consumers could purchase riders while still healthy to guarantee future insurability in the event they develop later medical problems (so-called “health status insurance“).

Similarly, there are various proposals to restructure Medicare to allow patients more control over their health spending, as an interim step towards the eventual goal where, “Medicare as we know it is phased out and the transition to private health insurance is accomplished” (per Docs4PatientCare).

There’s certainly legitimate room for debate on specific points of these proposals. But whereas the debate in 2010 was on how best to create a government-run health system, the debate starting in 2012 should be over how best to replace ObamaCare with free market reforms.

3) ObamaCare must be defeated politically.

The American people will have one final chance to kill ObamaCare at the ballot box this November, by electing politicians committed to repealing it. If Americans value their lives, they must repudiate ObamaCare soundly at the ballot box. The elected officials who supported it two years ago should sent packing.

This must include holding Republicans’ feet to the fire. As Michelle Malkin notes, some GOP leaders are too willing to support elements of ObamaCare out of political expediency, even though that runs counter to core principles of economic freedom.

Ultimately, the political fight against ObamaCare must be part of a broader fight for limited government that respects our freedoms. The proper function of government is to protect individual rights, such as our rights to free speech, property, and contract. Only those who initiate physical force or fraud can violate our rights. A properly limited government protects us from criminals who steal, murder, etc., as well as from foreign aggressors. But it should otherwise leave honest people alone to live peacefully, not deprive us of our freedoms in the name of “universal health care.”

We can still reclaim our freedoms. Reversing our present course won’t be easy. We will have our work cut out for us, through November and afterwards. But the opportunity is ours for the taking — as long as we are willing to seize it.

Paul Hsieh, MD, is a member of the Colorado chapter of Docs4PatientCare (www.Docs4PatientCare.org) and co-founder of Freedom and Individual Rights in Medicine (www.WeStandFIRM.org).
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