Repealing Just ObamaCare Is Not Enough

More Federal judges continue to properly find the insurance mandate unconstitutional, though most of them are ignoring the fact that the law being challenged has no severability clause, meaning that technically finding one piece of the legislation unconstitutional should actually negate all of it.  But since when has following the letter of the law mattered to a Federal judge?  Despite the not-unreasonable expectation that the Supreme Court will kill this nightmare once and for all, legislators on the right continue to call for the repeal of "ObamaCare", and the candidates for the Republican nomination for President are falling over each other (at least most of them) to try to make us think that he or she alone is the one who can best accomplish this task.

I must insist, however, that if we are to repeal "ObamaCare", repealing just ObamaCare is not enough.

In order to make myself clear, we must get technical.  When most people, and especially most politicians, refer to "ObamaCare", they are referring to the piece of legislation that is more accurately called the Patient Protection and Affordable Care Act of 2010, or PPACA for short.  This is the law that is undergoing all the legal challenges, and the law that public opinion is increasingly opposed to.  The PPACA is not the entirety of "ObamaCare", and if we are to get rid of "ObamaCare", the repeal bill needs to address all of it.  I have actually discussed this with my Congressman, but it appears that he didn't get the point, as the House has passed a repeal bill for only the PPACA.

There are two additional pieces of legislation that must be disposed of in order to repeal "ObamaCare".  Leaving either one in place provides a framework for the reinstitution of this monster.  What makes this interesting is that Dear Leader had absolutely nothing to do with the passage of one of these pieces of legislation.
Some explanation of how these laws are connected is required to fully understand why repealing the PPACA alone is insufficient.

PPACA is the final implementation of the Obama "healthcare" reform.  It is the law that has everyone so hot and bothered.  It is my considered opinion that the PPACA was never intended to function as it is designed, but is actually a veiled program to drive the insurance companies out of the medical insurance business, destabilize the current medical care system, and then force the imposition of a single-payer, government-run system.  But whether it works as written or as I suspect, it is built on the foundation of two previous pieces of legislation, without which PPACA makes no sense.  Since these two pieces of legislation are fundamental to the intended (or suspected) operation of PPACA, they must be considered to be parts of "ObamaCare".  The first of these is the so-called HITECH Act.

The HITECH (Health Information Technology for Economic and Clinical Health) Act is not a separate piece of legislation but rather a section of the American Recovery and Reinvestment Act of 2009, usually referred to as "the Stimulus Bill".  This section of the stimulus bill is generally considered to be simply an act to promote the use of electronic medical record systems by doctors' offices and hospitals.  Many parts of PPACA do not work without these electronic record systems.  PPACA calls for the creation of "Accountable Care Organizations" and calls for a substantial amount of reporting (to the Federal Government) of healthcare "quality measures", both of which are tremendously burdensome if not downright impossible to comply with without the use of electronic record systems.  Where the insurance mandate is the financial glue that holds PPACA together, these EMR systems are the operational glue that binds your personal health records to the Federal overseers, uh, holds the PPACA together.

While compliance with HITECH is technically voluntary, meaning doctors are not mandated to adopt these EMR systems, in reality there is nothing very voluntary about it.  By offering incentives to act now to install and "meaningfully" use an EMR, and by implementing penalties (in the form of Medicare and Medicaid payment reductions that can be increased without limit if not enough doctors adopt an EMR), few doctors will be able to refuse to comply and still stay in business.  But the catch is the "meaningful" use part; the criteria established at present to "meaningfully" use an EMR (required to receive the incentives) are designed around those things needed to funnel information to the Feds, as well as a few other "feel-good" liberal functionalities that do nothing but get in the way of actually caring for patients.  There is even talk that the informational needs of operating a PPACA-defined Accountable Care Organization may be substituted for the currently proscribed meaningful use criteria.  And if that isn't a way of tying PPACA to HITECH, I don't know what is.

HITECH also makes changes in another, older piece of legislation, making the older bill's penalties stronger.  This older legislation is the bedrock upon which all of "ObamaCare" is built.  This would be the Health Insurance Portability and Accountability Act of 1996.  Yes, good ol' HIPAA, those letters that strung together give us doctors heartburn.  And yes, you read that right -- 1996.

What does HIPAA, the so-called Federal Privacy law, have to do with "ObamaCare"?  Simply put, HIPAA created the Federal "right" to privacy of medical records while at the same time setting down regulations to secure that new "right".  Prior to 1996, the privacy of medical records was a state issue, and HIPAA added no new privacy protections than 50 state legislatures had not already provided; it merely wedged the Federal Government into what had previously been considered a function of the individual states.

So how does HIPAA have anything to do with "ObamaCare"?

HIPAA wedges the Federal Government into medical records privacy and thus into the provision of medical care at all levels, whereas prior to HIPAA the Feds' involvement had been limited to Medicare and Medicaid.  Part of HIPAA was to guarantee the standardization and security of the electronic transmission of medical information between providers and insurance companies.  (Actually this was all HIPAA was really supposed to do regarding medical records, but the enabling regulations written by the Clinton White House went waaaay beyond this.  Don't believe me?  Read the law; subsection F starting on page 87 deals with the security rule.)  With their feet in the door, the Federal Government creates HITECH as another way to standardize and secure such transmissions.  HITECH then serves as the operational conduit of the information that is necessary for PPACA to work as intended (interpret that as you may; you know where I stand on that).  A leads to B leads to C, and if you don't think this was planned, then you have not been paying attention for the last 20 years or so.

Repeal only PPACA, and HITECH and HIPAA remain to allow the creation of another monstrosity like PPACA at any time in the future.  Repeal PPACA and HITECH, but leave HIPAA, and the Federal Government remains inside the medical house, ready to grow like kudzu.
Only by repealing PPACA, HITECH, and HIPAA can we be truly free of what we refer to as "ObamaCare".  Of course, this means that "ObamaCare" really has nothing to do with Obama, as it has been in the works now for over 15 years.

Only after ALL of "ObamaCare" is repealed can we get down to the business of truly fixing what is wrong with our medical care system.