Obamacare, officially known as the Patient Protection and Affordable Care Act (PPACA) was signed into law March 23, 2010. It’s now being challenged in the Supreme Court by the Department of Justice and 26 states on constitutional grounds … namely that the Federal Government has no basis to mandate individual purchase of particular products or face financial penalties. Regardless of what happens in the courts, PPACA has set a new standard for bureaucracy (approximately 2700 pages worth), adding only complexity and cost to a system desperately needing radical reform.

One centerpiece of the law, the Accountable Care Organization (ACO), exemplifies this issue. On October 20, CMS released final regulations for the Shared Savings Program. Industry organizations like the AMA (American Medical Association), the AHA (American Hospital Association), and AMGA (American Medical Group Association), who had been full-throated in their critiques of the proposed preliminary rules six months earlier, dashed out statements supporting elements of the program almost immediately, praising CMS’s willingness to adjust the rules, offer greater incentives for participation and actually listen to those providing the service.