Interesting article, but the last premise is fairly disingenuous. He lists 6 reasons why healthcare is expensive, then claims that Obamacare doesn't fix any of them, but he's entirely wrong on at least 5 of the 6.

1. Medicare / insurance fraud --- The author obviously hasn't heard of the Health Care Fraud Prevention and Enforcement Action Team (HEAT). HEAT led to the record number of fraud charges in 2012. In addition to that, ACA standardized fraud convictions, so any provider convicted of fraud can no longer claim any federal money (Previously, a provider convicted of medicare fraud could still collect payments from medicaid et al).[2] These are only 2 provisions of the roughly 50 that directly address fraud. [2a]

2. Massive amounts of Paperwork --- This paperwork is moving to EHR / EMR systems that will file it automatically for the vast majority of patients. ACA mandates that the systems must use a standard format, so that any system built can communicate with all federal / private insurance carriers. [2]

3. Since doctors have direct contact with patients, and insurance companies don't it's easy for docs to blame insurance companies for unnecessary procedures --- I'm confused by this point, it seems a bit confused and contradictory toward his other points.

4. Doctors perform needless tests for fear of being sued --- The author has clearly never heard of ACOs. One of their primary goals is to limit the number of tests and procedures done. Insurance companies and the government will provide fairly significant bonuses when the cost of provided care comes in below average. [4a] In addition, the ACA provides research grants to study best practices and patient outcomes, having published, peer-reviewed research for common diagnoses will greatly limit the ability to sue for stuff considered CYA. [4b]

5. End of life care is insanely expensive --- This would've been addressed in the ACA, but Sarah Palin, Newt Gingrich and their dimwit followers torpedoed the 'death panels' to score some cheap political points.

6. Life is prolonged without living will --- Again, thank Sarah Palin, Newt Gingrich, and the Fox News brigade for their insane rants against 'death panels' which would have directly addressed this.

[1] - http://www.npr.org/2011/12/30/144491419/doj-posts-record-for... [2] - http://www.healthit.gov/policy-researchers-implementers/stan... [2a] - http://www.btlaw.com/files/ALERT%20-%20Healthcare_Health%20C... [4a] - http://www.washingtonpost.com/blogs/wonkblog/wp/2013/08/29/o... [4b] - http://www.nlm.nih.gov/hsrinfo/cer.html [5 & 6] - http://en.wikipedia.org/wiki/Death_panel