1. Healthcare Is A
Critically Ill Patient
J. Deane Waldman, MD MBA
Emeritus Professor, UNM Med & Mgt Schools
Board, NM Health Insurance Exchange
Adjunct Scholar, Rio Grande Foundation
Book – “The Cancer In Healthcare”
and
Host of Newsletter – The Hidden Enemy
Go to: www.deanewaldman.com/newsletter

2. Approach to Healthcare
• Not political
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Republican
Democrat
• Not financial
Subsidize insurance
Cut spending
Penalize uninsured
• Not social
Extend insurance
Right to health care
Wealth redistribution
• Deane’s approach is: doctor-to-patient

3. A good doctor would…
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• Ask pt for signs & symptoms (S&S)
• Determine the cause(s) of illness
• What has worked? What
hasn’t?
• Is current treatment plan working?
Develop treatment plan that works, for U.S. & for us
That is what I did here:

4. The Good Doctor:
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Good doctors do not tell their patients
what they want to hear.
We tell you what you need to hear.
Good doctors do not recommend that you take
what we believe or hope will work.
We recommend what the evidence
PROVES will work.
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5. ACA promises:
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• Health care ( Law’s title: PPAHCA)
• Cover the uninsured
• Reduce U.S. spending on healthcare
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insurance
• Reduce costs to individuals & families
• Use market forces to economize
• Improve quality; reduce errors (title: PPAHCA)
• Restore fairness: “Americans are a fair people.”

6. ACA will spent
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• 1.3 – 2.7 trillion dollars
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7. What ACA did:
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• Spends 1.3 – 2.7 trillion dollars
• New taxes; $ penalties to the uninsured
• Establishes mandatory “Essential benefits”
• Reduce payments to providers cut services
• Increases informational security
• > 1400 Exemptions & waivers
Expands federal bureaucracy & regulatory apparatus

8. The Hidden Enemy at:
Waivers given to… www.deanewaldman.com/newsletter +
None for you & me
“We The Patients”
And what happened to those Union waivers…?

9. ACA actions:
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• Spends 1.3 – 2.7 trillion dollars
• New taxes; $ penalties to the uninsured
• Establishes mandatory “Essential benefits”
• Reduce payments to providers cut services
• Increases informational security
• > 1400 Exemptions & waivers
Expands federal bureaucracy & regulatory apparatus

10. Effects of ACA:
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• Increase costs to individuals & businesses
• New spending dramatically nat’l deficit
•
providers;
provider/patient ratio
•
security 
error rate
• Control supply/demand
market forces
• No help for unfunded mandate
More uninsured:
cost, fewer jobs, fewer insurers

11. Albuquerque Journal
Wednesday, 8/14/13
Shock
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Average
$5500
of us?
What does that mean for 52%
What about small business (in NM)?
What does that mean for all of us?

12. What will ACA do to you?
•
Admin costs to insurance
•
premiums (30%––100++%)
• “Cadillac” tax probably applies
•
Teachers
Police
Construction
Small businesses
income: fewer hrs, RIFs, no hires
• Reduce your access to a physician
• Deny medically feasible treatments (IPAB)
• For more, read
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