Obamacare Divides Obama Against Himself

John Ransom
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Posted: Sep 20, 2013 12:01 AM
Obamacare Divides Obama Against Himself

I have one message for the Senate, the House and Obama himself: It’s not too late to remove this malignant tumor on the body of healthcare.

No one is ready for this “reform,” not even the Obama administration itself.

While the nation uneasily prepares for the October 1 deadline for implementation of Obamacare, a potentially fatal rift has materialized in the most unlikely place – inside the Obama Administration itself, demonstrating once again how unready the country is for this law.

When liberals collide on issues it’s easy to just sit back and laugh it off.Their “movement” is so full of special interest, special pleaders and special causes that the biggest problem the administration has is keeping every special interest happy.

Unions, for example, are upset because Obamacare is having intended “unintended” consequences for their membership.

Union leadership, including Jimmy Hoffa, Jr. sent a highly publicized letter to Harry Reid and Nancy Pelosi “demanding” changes to the healthcare law.

Surprisingly, the unions were rebuffed by the White House on labor’s demands.

So, despite an enormous investment in political and financial capital to build public support for Obamacare, liberals just can’t be of one mind on how to implement it.

If it’s true that the healthcare scheme was one of the most poorly thought out pieces of legislation, the implementation is likely to be sloppier still.

For example, the administration’s Federal Trade Commission and Justice Department are suing to block mergers among many of the nation’s hospitals-- hospitals that are only trying to accommodate the changes the law promises to bring. In short they just want to stay in business under the changed environment of Obamacare.

This requires some industry consolidation.

Yet, the Obama FTC is jamming on the brakes to prevent the industry from achieving this critical mass required for hospitals to run efficiently under Obamacare.

Ironically, the FTC is talking about making sure we have enough hospitals to maintain competitiveness, even as the Obamacare design is inevitably leading to fewer hospitals, doctors, pharmacies and labs.

As was intended, even if it was not admitted when Obamacare was under consideration.

A big program like Obamacare can only truly create cost efficiencies for healthcare providers if they are able to manage data- and thereby outcomes- by consolidating data, rather than leaving data segregated in various locales.

Obama himself is no doubt aware of this. After all, massive data management is how he won his reelection campaign.

While big city hospitals have the critical mass in many cases to implement Obamacare without much cavil, rural or small city hospitals will find tougher sledding.

St. Luke’s Hospital in Boise, Idaho presents perhaps the best case in point.

For several years, the St. Like’s hospital system has been growing both organically and through acquisitions of smaller healthcare centers and physician practices. Its growth has consolidated care throughout the region and extended services to remote communities, improving quality of care in smaller communities that previously were under served.

But when a physicians group in nearby Nampa sought to consolidate with St. Luke’s to afford better care and service to its patients, a nearby hospital sued, claiming that St. Luke’s was “buying up” physician practices in order to hold more patients “captive” to its system.

The Federal Trade Commission was quick to join the lawsuit, buying into the premise that if hospitals and physicians groups were consolidating, they must be colluding to squeeze out the competition, ignoring completely for the moment that Obamacare defines “the market” not the competition.

The case goes to trial in mid-September.

In fact, St. Luke’s was merely moving strategically to prepare for the new economic realities it sees coming with Obamacare.

The Nampa physicians see it too.

They know they must be part of a larger-scale enterprise if they are going to achieve the level of efficiency demanded by the new law while still ensuring that smaller, rural communities have access to the same choices and quality care they get in the larger markets.

It is not just St. Lukes, either. Phoebe Putney Health System in Georgia, ProMedica health system in Ohio, Reading Health System in Pennsylvania, Renown Health in Nevada, are also victims of the FTC - punishing those who are trying to get in front of the situation.

Hospitals and doctors groups that want to survive under the changed conditions of Obamacare must consolidate to keep those costs down. Keeping cost down is, after all, the basic premise that Obama sold the country on when the healthcare pact was passed.

“The law helps you by bringing down healthcare costs and making sure your healthcare dollars are spent wisely,” trumpeted the White House at the Obamacare signing ceremony in 2010.

Yes, but the “wisely” part will be instituted by hospitals and doctors, not the Justice Department, the Federal Trade Commission or the White House.

The St. Luke’s antitrust case, which goes to trial September 23 before the federal court in southern Idaho, is a referendum on the whether the administration is serious about a move from an old model built on paying for services to a new model built on paying for value.

The alternative is government run hospitals…only.

And that’ll be really competitive, right?