Supreme Court Decision May Not Matter to ObamaCare Authors

TUCSON, Ariz., June 4, 2012 /PRNewswire-USNewswire/ — The late libertarian economist Murray Rothbard wrote that laws are generally passed to grant some privilege to those who advocate them. So we must always ask “Who benefits?” writes G. Keith Smith, M.D., founder of Surgery Center of Oklahoma(www.surgerycenterok.com), in the summer 2012 issue of the Journal of American Physicians and Surgeons, https://www.jpands.org/vol17no2/smith.pdf.

Smith believes that the main supporters of the Affordable Care Act (ACA or “ObamaCare”) have already achieved their main objectives, and so may be indifferent to whether the U.S. Supreme Court overturns it.

One huge beneficiary is the health information technology industry. Physicians and hospitals were presented with a carrot (subsidies to purchase government-approved systems) and a stick (progressive fee cuts If they fail to implement electronic medical records or EMRs). Billions of dollars have already been made, and since the subsidies were in the HITECH Act that preceded the ACA, overturning the ACA might have little effect.

Hospitals favored the costly EMR requirement. The additional overhead cost makes physicians more vulnerable to hospital takeover offers. And once physicians become employees, the EMR provides the hospital the tool it needs for remotely controlling their practices.

Central planners get most of what they need with the EMR, as they will be able to identify high-cost patients. Overturning just the individual mandate would not affect the “death panel” or rationing feature, as the enforcement tool — the EMR — would remain.

The medical loss ratio provision of the law, which requires insurers to pay out all but 10% to 15% of premiums in claims, will do the same thing to small insurers that the EMR requirement does to small hospitals — drive them out of business. For relief from competition, “big businesses are more than willing to pay big money,” Smith writes.

The political theater at the U.S. Supreme Court may serve mainly to divert attention from the real objectives of the biggest proponents of the ACA.