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Four Steps to Better Health: Read (& Buy) this Book, Reveal that Law, Fix What’s Broken, Let Us Choose What Works. Tom Miller American Enterprise Institute “Why ObamaCare Is Wrong for America” Book Forum on the Hill March 29, 2011. Book ‘ Em , Danno (the most serious charges):

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Four Steps to Better Health:Read (& Buy) this Book, Reveal that Law, Fix What’s Broken, Let Us Choose What Works

Tom Miller

American Enterprise Institute

“Why ObamaCare Is Wrong for America”

Book Forum on the Hill

March 29, 2011

obamacare oh no

Book ‘Em, Danno (the most serious charges):

Latest unaffordable entitlement (higher costs, more dependency)

Financed by higher taxes, more borrowing, coercive mandates

Unaccountable, unpredictable, unworkable regulation

Centralization , politicization, & regulatory chokeholds

Real-time redistribution? PoliticalPriceline.com

Doubling down on past policy mistakes

Disincentives (work less, hire fewer, grow slower, pay lower)

Promises are made to be broken

Time-release toxins, dampen disruption ‘til reality bites later

Made in Washington, unsold in America

ObamaCare Oh-No
what we know

Numbers don’t add up

Wires can’t connect

Stress test, overloaded circuits

Inside job: co-opt, consolidate, comply

Outside job: distort, (re)distribute, distract, demonize, delay

Winning ugly … keeps looking coyote ugly later

This party’s over, before it started

Don’t expect future answers from past failures

What We Know
what we don t know

When it ends (how many more unhappy anniversaries)

What is left (we know what’s right)

Where the meltdown fallout zone reaches

(beyond the containment chamber)

How much it will cost

Why we let it get this far

What real choice and competition in HC markets looks like (yet)

What We Don’t Know
where we need to go

More market signals on the margin

Stop chasing runaway trains with slower growing tax dollars

Bypass third parties, empower & enable patients

Information & incentives, choice & competition

Retarget subsidies (risk & income)

Accountability, responsibility, sustainability

Promise less, perform more

Work, save, invest, inform, choose, assist

Where We Need to Go
a short policy shopping list

Defined contribution (all taxpayer subsidies)

Continuous coverage incentives (pre-ex, portability)

Protect the most vulnerable (HRPs)

Break down artificial barriers (competitive federalism)

Decentralized, customized, dynamic solutions

Somewhere to go, something to know, someone to trust

Get beyond insurance financing and coverage (health, delivery)

Respect limits and differences

Search for value (all-in costs vs. outcomes)

Don’t look for many answers here

A Short Policy Shopping List