Hands down, the Patient Protection and Affordable Care Act has been one of the most controversial pieces of national legislation ever passed by Congress.
The nation was told that health care had become unaffordable. Too many Americans lacked access to affordable health care and, thus, either did without or went bankrupt when faced with significant medical expenses. Many Americans were also considered “uninsurable” due to pre-existing conditions. The solution, we were told, was to overhaul the way health care was paid for and to bring the entire operation under the wing of the all-knowing, all-seeing federal government.
Between the Senate and the House, every Republican in the U.S. Congress but one—Sen. Jim Brunning (R-KY)—voted against it. Considered the signature piece of legislation of President Obama’s first term, ObamaCare drove a deep wedge between conservatives and liberals and gave birth to the Tea Party Movement. In the months leading up to its passage, Rep. Nancy Pelosi (D-CA) famously said “We have to pass the bill so that you can find out what is in it, away from the fog of controversy.”
Today, three years after the bill was signed into law, and with several of its mandates already in place, many people are still trying to figure out what is in the bill which was supposed to go into effect on January 1, 2014. However, on the eve of the Fourth of July holiday last week, in a move that caught many off guard, the Obama Administration announced a one year delay in implementing a major portion of the bill—the employer mandate for companies with at least 50 employees—while maintaining that the individual mandate would move forward as scheduled.
If ObamaCare has had your head spinning faster than Regan’s head in The Exorcist, there are some books that may help you to decipher the 2,500 page bill. (Actually, if you want to read the entire act as passed and signed into law, you can download a 960 page PDF from the Government Printing Office, but to fully understand the law, you would also need to read all of the regulations, some 20,000 pages of them.) The only problem with the books, and with trying to write a book review column about these books, is that it appears ObamaCare may be in such flux that the information in them may—hopefully—be moot before too long. In the meantime, as we approach the deadline for at least the highly controversial individual mandate in less than 6 months, these books are worth a look.
Author Nick Tate is the Deputy Health Editor at NewsMax Media and his highly advertised book has been on the New York Times Bestsellers List in the advice category since February 3. Anyone familiar with the format of the Dummies books, will immediately see the similarity in this book’s layout and style. The text has been set in a slightly larger than normal font and the pages have lots of white space, pull quotes, and sidebars. This is not a deep, close reading of the law, but it is an introductory overview of its main parts organized into six parts and 16 chapters covering the “essentials,” insuring the uninsured, the costs, the details in the fine print, and how to “protect” yourself when the law is fully implemented. This primer should be read with a highlighter in one hand, a packet of mini Post-It-Notes in the other, and a Bromo-Seltzer cocktail at the ready.
Former Lt. Governor of New York Betsy McCaughey—and an occasional contributor to TIR—has written a brief summary of the PPACA that teases out the main structure of the law. Trying to distill the law, which McCaughey says is 2,572 pages, into 15 short chapters is no mean feat, but she delivers a Cliff Notes version that highlights key components into bullet points and insightful commentary. Two of the best features of the book are a glossary of ObamaCare terms—individual mandate, employer mandate, exchanges, free choice vouchers, medical loss ratio, public option—and a chapter on what ObamaCare should be replace with.
Dr. McCaughey was a guest this past week on Simon Conway’s show on WHO-Newradio 1040. She projected that the Obama Administration’s decision to delay the employer mandate of the “unaffordable” health care act will impact some 10 million full-time uninsured and under-insured people and add a net $60 billion to the cost of ObamaCare next year alone, almost as much as the annual cost of the Medicare Part D drug benefit.
While many people want ObamaCare repealed and replaced, McCaughey pointed out that the Constitution doesn’t give the President the authority to postpone pieces and parts of a law, and then to implement it after the 2014 mid-term elections when it would be more politically convenient. Even Iowa’s Democrat Senator Tom Harkin, who has been a staunch supporter of the President, has questioned the President authority to suspend the law.
One of the reasons the cost of ObamaCare is expected to rise so much is that the federal government will lose billions by not collecting employer penalties. Another is that people who enroll for ObamaCare through the exchanges will not be required to prove their financial eligibility to receive federal subsidies. According to McCaughey, the Obama Administration made this accommodation to business not to help them in dealing with the complexities of ObamaCare, but to drive uninsured workers into the health exchanges in an effort to create the single payer system all around.
McCaughey says conservatives can use the 2014 elections as a referendum on ObamaCare, and because it is unlikely that the law will be completely repealed in the near term, she advises people to talk with their doctor about ways to keep their medical records private and out of the larger computerized health care system. Because of the dysfunction of a government run health care system, McCaughey predicts many doctors will opt out and will go to a cash-for-service relationship with their patients.
As an antidote to the politics and headaches of ObamaCare, I recommend picking up Dr. Ben Carson’s book. Dr. Carson is a professor of neurosurgery, plastic surgery, oncology, and pediatrics, and the Director of Pediatric Neurosurgery at Johns Hopkins Medical Institutions. He is also the man who schooled President Obama for nearly 30 minutes at the National Prayer Breakfast earlier this year on the nation’s moral decay and the consequences of fiscal. In Chapter 10, Dr. Carson takes on the idea that health care is a right and challenges some the thinking that “health care should be available to everyone in our society, but rather how can we provide universal health care in an efficient and cost-effective way.” He proposes some pragmatic yet compassionate ways to address the problems of the costs of health care particularly during the last six months of life, of waste from fraud, of the need for tort reform and the need for portability of health insurance. Dr. Carson’s book is inspirational on many levels and offers practical solutions that foster self-reliance and personal responsibility.
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