I Am Not A Texas Governor Rick Perry Fan But….

Stanley Feld M.D.,FACP,MACE

http://www.nytimes.com/2010/07/28/health/policy/28texas.html?_r=2&th&emc=th

President Obama is ignoring the causes of the dysfunction in the healthcare system. The healthcare debate is supposed to be about setting up a healthcare system that delivers universal care of the highest quality at an affordable cost to consumers and the government.

I believe President Obama’s healthcare reform act is more about increasing government control over the people than it is about improving the delivery of healthcare.

My suggested solutions have been ignored by President Obama. Instead, he has created 160 new agencies and boards with regulatory power. Non-elected public officials appointed by the executive branch of government now have the power to make medical care policy.

The Department of Health and Human Services just published 864 pages of regulations to govern electronic medical records alone. There are many more regulations coming.

Does anyone think these bureaucracies are going to save money, make medical care affordable or universal? The greater the number of regulations the harder they are to execute and enforce. They will make criminals out of people who cannot comply with the maze of complex regulations.

The experts that President Obama has chosen are academicians. They live in the Ivory Tower. They do not live in the trenches and experience the problems of running a day to day medical practice. These experts (Dr. Don Berwick) believe central control of the healthcare system is essential. “The healthcare system is too complex for individuals to be responsible for their care and make intelligent decisions.”

I believe government has to make rules to level the playing field for all the stakeholders. Then it should let the stakeholders operate in the free market system. The central government should not control the stakeholders after the rules are made.

The healthcare debate is bizarre. Instead of fixing the defects in the healthcare system, like tort reform, the lack of individual responsibility for healthcare dollars, health, medical care, the lack of support to educate patients to self-management chronic diseases and lack of public service campaigns to combat obesity, the executive branch has taken total control of the dysfunctional healthcare payment system. The healthcare reform act does not have respect for individuals’ freedom to choose or their ability to be responsible for themselves.

The multiple bureaucracies are making it impossible for congress to have input into the healthcare law. What we central executive branch control without checks and balances.

The frightening thing about it is President Obama was able to force the healthcare reform bill through congress using all sorts of tricks and deals. It does not represent the will of the people. Nancy Pelosi and Harry Reid simply emasculated congress’ power.

I hope the American people realize what has happened. Americans still have the power to vote and demand the constitution be defended.

Texas Governor Rick Perry threatened to have Texas secede from the Union because the healthcare reform bill is unconstitutional. I hope he was a joking. He has vigorously opposed the healthcare law. He is concerned about the devastating effect it will have on the Texas economy, the citizens of Texas and the ability of the state to attract new industry and job growth.

Texas is America’s Top State for Business, according to a CNBC study that scored each state based on 40 different measures of competitiveness. The reason is Texas has maintained a free market economy in a fiscally responsible way. We do not have a state tax yet and our property taxes have been reasonable.

Governor Rick Perry has been vocal about what is being imposed on Texas by the federal government. I applaud him. I have included some of his recent statements

“This designation reinforces the fact that the Lone Star State is the best state in the nation to live, work and raise a family thanks to our low taxes, reasonable and predictable regulations and skilled workforce,” Gov. Perry said. “These policies have helped keep our economy comparatively strong through the national economic downturn, and will continue to make us globally competitive in the future.”

The federal government is going to change that by imposing a huge burden on the state to fund Medicaid for many new required recipients .

There are more uninsured residents of Texas — 6.1 million and counting — than there are people in 33 states. The state’s elected officials might be expected, therefore, to cheer a federal health care law that is likely to deliver billions of dollars from Washington to Austin and cover millions of low-income Texans.

“But leaders in Austin are focused on the fiscal threat it poses, which they estimate could cost the state $27 billion in the 10 years beginning in 2014.”

Governor Perry said it all in a few paragraphs. However, he did not mention that some favored states will receive a higher federal subsidy for Medicaid that others. This fact is demonstrated in the figure below.

The figure reflects increase in Medicaid eligible population and the relative difference in subsidies of various states reflecting the deals President Obama made with various State’s Senators to vote for his bill. “click to enlarge”

"Unfortunately, the health care vote had more to do with expanding socialism on American soil than it does fixing our health care finance and delivery systems. The Obama health care bill undermines patient choice, personal responsibility, medical innovation, and fiscal responsibility in America.”

"As passed by the U.S. House, the bill will cost Texas taxpayers billions more, and drive our nation much deeper into debt. Congress’s backroom deals and parliamentary maneuvers undermined the public trust and increased cynicism in our political process.”

I never thought Rick Perry was much of a leader. However, his recently demonstrated leadership might get him elected for a fourth term.

"Texas leaders will continue to do everything in our power to fight this federal excess and find ways to protect our families, taxpayers, and medical providers from this gross federal overreach."

Twenty one states are suing President Obama on the constitutionality of his healthcare law. One of the attorneys general said,

“You can say a chicken in every pot, a car in every garage and he
alth care for all, if taken in isolation,” said “But none of those are good things if it requires breaking the Constitution and breaking the bank to do it.”

I believe the bill will fail to achieve its goals. Massachusetts’ healthcare reform has failed. President Obama is making the same mistakes. He is not getting at the core of the problems causing the dysfunctional healthcare system. The healthcare reform law will make the healthcare system worse.

Hooray for Governor Rick Perry for defending Texas and the citizens of Texas.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.