Years ago, prior to passage of the ACA, I served on the board of a local, critical access hospital. As part of my training, I attended a medical conference put on by the Estes Park Institute. This conference was highly regarded in the industry, and the attendees were about 40% physicians with the balance consisting of Administrators and Trustees. A conservative bunch, nearly all of whom had profited greatly from the existing system. At the four-day conference I attended, the overwhelming message was that the health care delivery and financing system in our country was going to change because it had to change, whether the medical industry wanted it to or not. Costs were rising at 7% or more per year, and people's deductibles were rising in response. Medical tourism (people being flown to other countries for surgical procedures and recovery) was on the rise because medical care in this country was becoming less and less competitive with providers in other countries who could provide the same level of care. These were not politicians saying this. These were people who had every reason to continue the status quo. Yet they were saying change was coming whether medical providers liked it or not and that medical institutions better be prepared for change.
Maybe Obama could have come up with a better system. Perhaps the Romney plan was better or should have been adopted in larger part. But it is a convenient fantasy to hold on to the belief that change was not coming or that the "old system" could have been left alone to everyone's benefit.
