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Book Review: An Obamacare Survival Guide: The Affordable Care Act and What It Means for You and Your Healthcare by Nicholas Tate

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An Obamacare Survival Guide by Nicholas Tate is a good resource guide for explaining how the new legislation will impact citizens in 2014. The thrust of the new law is to level the playing field and lower costs through major purchasing exchanges which consolidate buying power to negotiate for better prices from providers of medical services and pharmaceuticals.

The theory behind the medical healthcare exchanges is greater choice for consumers, standardization for processing transactions, consistency, and significant economies of scale which evolve from learning curve over time. Medicare recipients will experience nearly $455 billion dollars in spending cuts and citizens will pay a penalty for not opting into the system. There will be no co-payments for approved preventive services as set forth by the law.

Tate explains that Obamacare will provide greater access to healthcare for the uninsured who number into the millions right now. Obamacare will be good for employees of small business since many are either under-insured or uninsured right now. Obamacare is projected to cost a trillion dollars in this decade. Approximately 84% of Obamacare expenditures are slated to reduce the legions of the uninsured.

Tate is concerned about the details of placing too much discretion into the hands of the Independent Payment Advisory Board which will make recommendations on cutting Medicare subject to a super majority vote to over-ride by the United States Senate. In addition, the President will have the discretion to appoint members to the Board. The author criticizes the idea of having a board but he does not make recommendations for improving how the entity should operate in practice.

This is an area which may require amended legislation to cure potential inequities in how the Board will function. For instance, the Board should have a majority of representation by physicians and not simply actuaries, accountants and financial people. In addition, the Board should have some representation by mayors of cities, as well as constituencies like AARP. The most concerns are voiced by physicians who seek to maintain control over the diagnosis and treatment of patients.

Obamacare does not address the Hill-Burton Act of 1946 which provides for free or significantly reduced health care costs for families who either cannot afford to pay for health care insurance or have limited financial resources to devote to health care even without having to pay for medical insurance. The program has worked well for 67 years. Medical Schools provide free or reduced health care services in exchange for reductions in their facility mortgage payments.

An Obamacare Survival Guide is a very helpful resource for patients and their physicians. The contents explain how to navigate through the myriad of requirements set forth in Obamacare, as well as areas of the law which could be clarified or amended over time. The author should have discussed potential enhancements to the structure of the Independent Payment Advisory Board, as well as revenue enhancements through the taxation of junk food.

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About Dr Joseph S Maresca

I've taught approx. 34 sections of collegiate courses including computer applications, college algebra, collegiate statistics, law, accounting, finance and economics. The experience includes service as a Board Director on the CPA Journal and Editor of the CPA Candidates Inc. Newsletter. In college, I worked as a statistics lab assistant. Manhattan College awarded a BS in an allied area of operations research. The program included courses in calculus, ordinary differential equations, probability, statistical inference, linear algebra , the more advanced operations research, price analysis and econometrics. Membership in the Delta Mu Delta National Honor Society was granted together with the degree. My experience includes both private account and industry. In addition, I've worked extensively in the Examinations Division of the AICPA from time to time. Recently, I passed the Engineering in Training Exam which consisted of 9 hours of examination in chemistry, physics, calculus, differential equations, linear algebra, probability/ statistics, fluids, electronics, materials science/structure of matter, mechanics, statics, thermodynamics, computer science, dynamics and a host of minor subject areas like engineering economics. A very small percentage of engineers actually take and pass the EIT exam. The number has hovered at circa 5%. Several decades ago, I passed the CPA examination and obtained another license in Computer Information Systems Auditing. A CISA must have knowledge in the areas of data center review, systems applications, the operating system of the computer, disaster recovery, contingency planning, developmental systems, the standards which govern facility reviews and a host of other areas. An MBA in Accounting with an Advanced Professional Certificate in Computer Applications/ Information Systems , an Advanced Professional Certificate in Finance and an Advanced Professional Certificate in Organizational Design were earned at New York University-Graduate School of Business (Stern ). In December of 2005, an earned PhD in Accounting was granted by the Ross College. The program entrance requires a previous Masters Degree for admittance together with a host of other criteria. The REGISTRAR of Ross College contact is: Tel . US 202-318-4454 FAX [records for Dr. Joseph S. Maresca Box 646 Bronxville NY 10708-3602] The clinical experience included the teaching of approximately 34 sections of college accounting, economics, statistics, college algebra, law, thesis project coursework and the professional grading of approx. 50,000 CPA examination essays with the American Institute of Certified Public Accountants. Additionally, membership is held in the Sigma Beta Delta International Honor Society chartered in 1994. Significant writings include over 10 copyrights in the name of the author (Joseph S. Maresca) and a patent in the earthquake sciences.
  • pbd

    Dear Dr. Maresca, thank you for the review.
    Please provide reference for a better summary of Obamacare if and when avail, and other than the bill itself.
    Thanks-pbd

  • http://affordablehealthcareactpenalties.com/ Jason

    pbd,

    If you’re looking for more information regarding penalties of the act, we’ve created a site that gives some detailed information on the Affordable Care Act.

  • Dr Joseph S. Maresca

    There are penalties under the legislation; however, there is no enforcement mechanism similar to the accumulative penalties of the other government agencies. Time will show how this legislation is implemented.
    i.e. criminal penalties for non-compliance