Serious options are welcome 
for making Obamacare changes

By Michael J. Pramenko

Once or twice a week, Daily Sentinel editorial page readers are treated to ongoing criticisms of the Affordable Care Act. Columnists Kathleen Parker and Charles Krauthammer are the usual authors of these columns.

Recently, Parker waxed unpoetically about how the Affordable Care Act will likely reduce the workforce.

Yes, Ms. Parker, some families might actually be able to keep one parent at home to help raise their children because health insurance will be more affordable.

In addition, Parker points out the millions of Americans still left without insurance under Obamacare. Her criticism on this sad reality rings utterly hollow.

For nearly four years we have heard endless criticisms of Obamacare without any bonafide alternative that comes anywhere close to covering as many Americans as the current law. So when Ms. Parker opines about the lack of coverage for many Americans without offering a better alternative, we know her critiques of Obamacare are more about her politics than they are about real policy.

In fact, Obamacare includes a provision that allows states to avoid the major controversial elements of the current law. You read that correctly. Section 1332 of the Affordable Care Act allows for states to try something different. The same law that critics describe as a “federal takeover” allows for states to innovate and prove that they can do it better. 

As long as a state develops a plan that covers at least as many people in that state as the ACA, provides similar protections regarding coverage, and doesn’t increase the federal expenditure on health care, the state is free to move in its own direction.

Will the duo of Parker and Krauthammer ever provide their perspective on Section 1332 of Obamacare? Unlikely. Educating their readers on these aspects of Obamacare doesn’t fit the conservative mantra and messaging on health reform. They are betting on misinformation. They are betting on failure. 

Does anyone really believe that critics of the Affordable Care Act care about the millions of Americans still left without insurance under the current law? After all, current replacement policy under consideration by Senate Republicans would leave far more millions of Americans without health insurance.

Where’s the beef? Put up or shut up. Show me the money. Pick any phrase you want to describe the lack of substantive alternatives to current health reform efforts.

Section 1332 remains a true opportunity on health reform for conservatives and liberals alike. It represents a door left wide open by Obamacare that would allow states to develop an innovative plan that works better for the American people.

The state of Vermont is choosing this route as it continues designs on a homegrown single-payer plan.

Right here in Colorado, state Sen. Irene Aguilar believes we can do much better than Obamacare. She is traveling the state, outlining her plan that would create a member-run cooperative that would operate a universal health plan right here at home. You can read about her plan at

Back in the 1990s, legitimate conservative alternatives to the Clinton health reform plan sprang from opposition to the president’s proposals. Those ideas are now part of Obamacare. Those policy provisions have names: individual mandate and health exchanges.

Now, after four years of partisan antics, critiques of Obamacare are growing old and stale. Serious people with real ideas will offer legitimate alternatives. Section 1332 is the open invitation.

Any takers?

Michael J. Pramenko M.D. is the executive director of Primary Care Partners. He serves on the Club 20 Health Care Reform Committee and is a past president of the Colorado Medical Society.


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Is there anyone in the Grand Valley who sincerely believes Pramenko is remotely a “serious” thinker in the aubject of Economics 101? If so, I have some nice oceanfront property near Mack I’d love to sell them real cheap. Besides, since when was Pramemko promoted to the position of definer of what constitutes “serious” thought on any subject? In and of itself, that notion is a self-evident joke.
From an intellectual point of view, I find it amazing that the shrinking vestigial dinosaur Sentinel wastes any of it’s precious space promoting the various incarnations of long-failed socialist/fascist economics. Perhaps a closer look at the old “follow the money” axiom is in order.
Obamacare is like trying to herd cats. It’s impossible. It’s a mathematical, political and moral fraud. It’s not for nothing that a huge majority of Americans hate it.
Before America can get past the ongoing debt-as-money currency collapse, it will be a necessary first step to shrink the size of government to a degree not seen since the days of Thomas Jefferson’s presidency.
Under “normal” political circumstances, Americans would not elect another Democrat for 100 years. But watch the GOP RINOs try to save the Democrats’ political bacon. The GOP desperately needs the Democrat Party to continue the duopoly “dog-and-pony” show for the amusement of the masses, just as the elite used “bread and circuses” to amuse the yokels during the Fall of the Roman Empire.
Collectivists of Pramenko’s ilk don’t want to learn anything. It’s a major strategy error to not understand that simple fact. They just doggedly (and shamelessly) keep spewing their same old tired blather and trying to demonize and destroy as “uncaring” those who hold opinions with which they disagree.
I’ve noticed fewer and fewer people respond to Pramenko’s neofeudalistic garbage. The only reason I bother is to demonstrate that opposition to such determined collectivist propaganda needs to be just as tireless and unyielding as the propaganda itself. The alternative is to risk allowing the propaganda to “gain traction” by virtue of sheer mindless attrition.
And the very thought of that must necessarily be anathema to any person who believes, as I do, in self-ownership, self-determination and free marketplaces of both material goods and ideas.

I called Primary Care Partners and asked if they are taking new MediCaid patients.  I was transferred and spent a long time on hold and was finally told, “on a case by case basis”.  You would think a physician who constantly expounds on the the wonders of Obamacare would be willing to see patients who need care because of it.  MediCaid patients can’t find physicians now, what happens when we add a bunch more to MediCaid?  I feel really sorry for patients who need this care.

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