How to evaluate prospective healthcare legislation

Here is what I will yield to the Obamacare opposition:

1. The legislation was rushed in development.
2. The legislation lacked bipartisan development.
3. The Affordable Care Act contains flaws.
4. The Affordable Care Act implementation was bungled.
5. The resulting implementation of the ACA aka Obamacare has produced mixed results.
6. The Affordable Care Act theoretically appeared to produce favorable results.

Here is what I ask the Obamacare opponents, principally Republicans to address and consider:

1. Republican legislators opposed addressing the problem created by 30+ million citizens being uninsured or deficiently insured with affordable healthcare.
2. Republican legislators opposed addressing runaway healthcare costs that undermine American business competitiveness and quality healthcare for all Americans.
3. When forced, after years of trying to retract the Affordable Healthcare Act, they finally began to consider the topic but failed to advance legislation even when they controlled both Congressional chambers.

As the former CBS News Affordable Care Act writer, I know something about the subject. As former program manager for the Emergency System for the Advanced Registration of Volunteer Health Professionals, I am familiar with the issues concerning the unevenness of standards for health care among the states. As a former consultant to the federal government for 25 years in the realm of systems engineering, I know something about the process involved in transforming legislation into operational systems.

A fundamental problem persists, and that is how the branches of government, principally the Executive and Legislative branches address the development of laws and regulations that attend essential needs such as ensuring all Americans with the most affordable healthcare.

What appears to be one problem in the process is that actuaries underestimated the size of the population who have significant health care requirements. They did not allow for enough cost, and therefore the premiums must be raised. That situation is debatable and must be examined by third-party auditors to understand the facts.

Implementation of all laws and regulations should be modeled and simulated in advance to understand the projected performance and cost exposure. The Congressional Budget Office and Government Accountability Office are instruments for accomplishing this. When system performance deficiencies are identified and quantified, then analysts can determine causes with implications for precise changes and improvements. That is a part of the government continuous improvement process that is implicit in our Constitutional system.

Attacking the problem without engaging the system and offering transparent solutions, including competing performance models is unacceptable because it fails to provide citizens with proper information on which to evaluate alternatives.

As co-author of Smart Data, Enterprise Performance Optimization Strategy (c) 2010, Wiley Publishing, I have offered an explicit change in how legislators and the executive branch can address our considerable needs.

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