Site menu:


March 2013 Policy Study, Number 13-3


Just Say NO – and Keep Saying NO – to Federal Health Care Exchanges and Medicaid Expansion


Comments From Health Care Providers



Irrespective of how the health care exchanges work, the Iowa medical-industrial complex bureaucracy is well into expansion mode. An October 2012 article in the Corridor Business Journal (CBJ) detailed the “proactive” cooperation by the University of Iowa Health Care, Mercy Health Network via Medical Center Cedar Rapids, and Genesis Health Systems to form the “University of Iowa Health Alliance,” a statewide Accountable Care Organization (ACO) network “devoted to achieving the triple goals” of high-quality and patient-focused care, improving the health of communities, and reducing costs by providing “seamless, personalized care for all” medical needs.[29]


According to the leaders of these organizations, key to this effort is “streamlined and coordinated” care, with “improved” clinical integration and “greater standardization of care based on best practices” to reduce costs. This will involve multiple locations and hundreds of individuals involved in every aspect of care authorization.


They did not detail the number of meetings and administrative, overhead staff involved in this alliance, nor their salaries. Every person working to implement this ACO is not providing direct patient care. In addition the article referenced the improvements and cost saving to be made by using the ubiquitous electronic medical record.


What happens if standardized care is not the right answer for your individual situation? Sorry for being skeptical, it all sounds like rationing to me.


In a January 2013 article from the same publication, the CEO of St. Luke’s Hospital in Cedar Rapids added further commentary, saying that health-care providers will be moving from running brick and mortar hospitals, using technology for tests and diagnosis, and prescribing needed medicines to being “health coaches,” your friend and partner.[30]


He encouraged business leaders reading the CBJ to lead by example – to lose weight and get in shape, to insist providers focus on health promotion, and work to transform the “high utilization,” “entitlement” mentality health care culture we’ve come to expect.


Unfortunately, this does not sound as if medical care access is being expanded under Obamacare, but rather as if these health care executives are planning to reduce the actual medical care received and replace it with….a $15,000-a-year friend. Wonder if they’ll buy dinner next time we go out together?



Click here for pdf copy of this Policy Study


All of our publications are available for sponsorship.  Sponsoring a publication is an excellent way for you to show your support of our efforts to defend liberty and define the proper role of government.  For more information, please contact Public Interest Institute at 319-385-3462 or e-mail us at