Repeal And Replace The “ACA”: Administrative Change at Anderson

Repeal And Replace The “ACA”: Administrative Change at Anderson


Leonard Zwelling

The Affordable Care Act or ACA is under attack from both ends of Pennsylvania Avenue.

One of the essential deliverables of the Trump Presidency will be a new health care law that “covers everyone” and is less expensive than ObamaCare. Sixteen blocks away, the GOP-led Congress is itching to repeal and replace the ACA. We just don’t know with what.

I never knew how ObamaCare would cost less than the health care system of 2009 and I surely don’t know how you gather the rest of the uninsured in the United States under some kind of insurance plan and save money. That never made any sense to me, more care for less money.

The major problem is the skeletons of GOP plans are starting to emerge and they will be less effective than ObamaCare at covering the currently uninsured as they rely on mechanisms that will only save premium dollars for the rich and the well. A health savings account won’t save you any money if there is nothing in the account. High deductible plans will break the budget of most people who make under $100,000 per year when a family member is seriously ill. Selling insurance across state lines may be helpful, but expanding insurance under ObamaCare has actually led to a down sizing of the players in many insurance markets. Many counties have exactly one provider of insurance within their borders. That’s not choice. That’s a monopoly being played with real money.

Once one recalls that the principles governing the ACA derived from 1989 ideas emanating for the Heritage Foundation and ObamaCare’s first iteration was RomneyCare in Massachusetts in 2006, you get the sense that ObamaCare is more Republican than it is Democratic in ideology even if it was passed with Democratic votes only.

ObamaCare was never meant to be more than a start toward the only system that makes any sense, a single payer system that covers everyone that is funded with tax dollars and administered by the private sector. You know, like we buy fighter jets.

That’s that for that ACA.

I want to talk about the new ACA—Administrative Change at Anderson. Now there’s an ACA we can all agree on.

I personally have seen enough inept management with regard to the electronic medical record and the operations of the hospital and clinics to know exactly why there is a huge shortfall in the Anderson budget. I also have seen nothing emerge from Dr. DePinho’s moon shots or IACS that will help a patient let alone the bottom line. I have seen layoffs with the prospect of more to come and deficit spending despite the purported $2.8B set aside in a basement somewhere. Guess what? With regard to this rainy day money—it’s raining on Holcombe.

On every quantifiable measure of excellence, Anderson is regressing to the mean. It is time to change horses.

As a further example of the management problem, the Chancellor has run into strong criticism from Governor Abbot’s new Regental appointees for purchasing land to expand UT in Houston. My guess is that this idea needed a lot more planning and more clever political execution to get done. Primarily the entire Houston legislative delegation should have been made aware of the Chancellor’s plan before it was executed. Anyone who knows anything about Texas politics would know to do that because there would be massive pushback from the rest of the Legislature about spending all that money in Houston and a lot of upset people at U of H. But our good Chancellor pushed ahead without doing the necessary political spade work. Thus the current outcry.

You have to be impressed with the absence of skill on the part of the leadership of both the University of Texas and its flagship cancer center. Not only is it ACA on Holcombe, time for Administrative Change at Anderson. But it’s probably time for ACA, Administrative Change in Austin, for allowing 1515 Holcombe to fall apart.

It’s not too late. Regents! Repeal and replace the Texas version of the ACA. Administrative Change All around.

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