After Repeal, Then What?

By Richard E. Kelly & Mark A. Evans

So what happens if the 2010 Health Care Law is repealed? If the health care system in the U.S. is not broke, why fix it? Right?

The engine that drives U.S. health care is health insurance, which will be an unregulated industry if the law is repealed. Unlike bankers and Wall Street, this industry will then be able to police itself, with no government regulations to get in the way of keeping Americans healthy, at least for those who can afford health insurance.

Unfortunately, there are a few doomsayers. Warren Buffet, for one, warns, “If we repeal the current law and do nothing, everyone’s health care will be in jeopardy. The way we are going, within a decade we’ll spend one dollar out of every five we earn on health care – and we’ll keep getting less for our money. Fixing what’s wrong is a necessity we cannot postpone.

“The high costs paid by U.S. companies for employee health care puts them at a competitive disadvantage internationally. That kind of cost, compared with the rest of the world, is like a tapeworm eating at our economic body.” And feeding his warning are the following facts:

  • Health care premiums have doubled in the last eight years at a rate 3.7 times faster than wages have increased.
  • The U.S. spends 17% of GDP on health care while the rest of the world spends 9% and it has fewer doctors and nurses per person.
  • The average cost per person/year for health care is $6,714 for U.S.; $3,678 for Canada; $3,449 for France; and $2,760 for the UK.
  • Half of all bankruptcies are caused by medical bills.
  • 25% of all medical spending goes to admin/overhead costs.
  • Antiquated paper-based record keeping and information systems needlessly increase health care costs.
  • Only four cents on every health care dollar spent is on prevention.
  • Many businesses cannot provide health care coverage to its employees as it’s too expensive.
  • The constantly rising costs of Medicare and Medicaid could lead to fiscal meltdown in the near future.
  • Inefficient and poor quality health care costs the US somewhere between 50 to 100 billion dollars a year.
  • Millions of dollars are lost each year due to profiteering, resulting in people paying more without receiving better care in return.
  • The number of uninsured is growing at an alarming rate. Today it’s 51 million, up from 46 million 9 months ago. If it balloons to 100 million, could that trigger a U.S. health care crash?
  • $2.3 trillion plus was spent on health care in 2008.

One knowledgeable insurance executive checked the facts here cited and said, “To the best of my knowledge, this paper is factually accurate.”

“The case that your paper doesn’t make—and as far as I can tell no one has made—is that the proposed health care reform actually addresses the issues that your paper highlights. I understand that this would require a massive explanation. Personally, it troubles me that the government has not attempted to explain its analysis of the problems you’ve outlined or demonstrate how HCR solves those problems.

“Yes, one can imagine how some of the proposed elements of HCR will help, but it would benefit the American public immensely if the government would thoroughly and explicitly describe the problem, explain all of their root cause analysis, describe the potential solutions they explored, justify the solutions they chose, and connect all the dots between problem and solution elements.”

Okay, so what does one expert know? Once the law is repealed, we’d suggest setting the following two goals to improve health care in America:

  1. Cut National Health Care Spending by 2 Trillion Dollars in 10 Years
    • This includes Medicare and Medicaid
  2. Provide Quality, Affordable Health Care for all Americans
    • Protect families from bankruptcy or debt because of HC costs
    • Guarantee choice of doctors and health plans
    • Invest in prevention and wellness
    • Maintain coverage when a person changes/loses their job
    • End barriers to coverage for people with pre-existing conditions

P.S. Oops! I think those were the goals President Obama and his team set for the current 2010 Health Care Reform Law. So why doesn’t the President just explain the damn law so the average American can understand it?



  1. John Hoyle says:


    You and Mark have made the issues with health care reform quite clear. But there are a few other things to consider.

    Most European nations provide health care services as simply another daily requirement for their citizens AND the tourists who come to their country. You get sick or injured and you go to hospital and get fixed. In most cases you pay very little. If you have insurance in the USA, they will bill your insurance for those things over and above the basics. Europeans, Canadians, and many Central and South Americans look at the USA and wonder why such a rich and powerful country can not provide basic health care for its citizens? They can and do it fairly inexpensively.

    Why do we have local police forces and county sheriffs? To protect our citizens and to save lives. They also provide emergency services. How do we pay for these things? Through our local taxes.

    We have public schools and require all of our children to complete at least the 8th grade (some states even higher levels). We require that because we know that it is important that our children be able to read and write and do basic math – in order to survive in our modern world. How do we pay for those things? Through our local and state taxes.

    We pay for building inspections, fire protection services, emergency rooms in hospitals, road paving, and government buildings. Why? Because we know these are basic requirements for our modern society.

    But health care? Health care is a matter of life and death to all of us. Not just some of us – but each and every single one of us. It’s a matter of life and death whether we are rich or poor, working or unemployed, old or young, black or white or brown, male or female, child or adult. It matters not a lick what country our ancestors came from or what our primary language might be – it’s a matter of life and death. Having health care is every bit as important as being able to call the fire department or to wave down a police officer. Isn’t paying for health care more important than paying for criminal court cases that cost millions and go on for several months? Isn’t being alive more important than having a post-graduate degree from a state funded university or college?

    The saddest thing is watching those lower income and middle-class Americans labeling health care reform as “a socialist takeover” while the health insurance industry is pricing them out of the ability to actually buy insurance.

    The political far right has done so much to set this country back by at least 50 years. They are closely related to the religious right that basically says, “don’t confuse us with the facts. We believe what we believe and we don’t care about logic. We don’t even care about what’s good for us personally or for our families. If Obama is for it – we’re against it. We’d much rather go without medical insurance than have to pay a lower rate than what insurance companies are charging now. We want our liver transplants denied! We don’t want heart bypass surgery if we can’t afford it! If we get in a horrible car accident and need emergency surgery, then we should only get it if we can afford it! We’d rather see our babies die than take away the freedom of huge health insurance companies to make massive and growing profits! If we can’t pay for health insurance – THEN WE DESERVE TO DIE!”

    Hopefully you got my point.


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