My premise for this blog is that the basic tenets of health-care reform found in the Affordable Care Act (ACA) are sound. I have for years advocated for universal coverage, an individual mandate, care coordination as a way to improve the quality and cost of health care, an employer mandate (as limited by the ACA), improved private-insurance competition, Medicaid expansion for adults below the poverty level, and improved insurance regulation. I will not categorically support every action found in the 2,000 pages of the law, but, by and large, I think it provides a framework that can produce positive, significant change and that, over time, can be improved as necessary.

This middle approach has unfortunately left the law without strong support at times. The Right has castigated it from the start — one Republican physician congressman from the South told me there was not one good idea to be found in the 2,000 pages of this law — whereas, the Left, favoring a public option and for some, ultimately, a single-payer system, has not provided the vigorous response needed to counterbalance the din from the Right. Most importantly, the vast middle of the political spectrum has stayed out of the fray. The result is a law creating major changes on January 1 of next year that is being undermined by poor public relations and by Republicans using every effort possible to repeal and discredit it, leaving the minds of the public with a great deal of misunderstanding and fear.

At church this Sunday, a hymn we sung went, “In the land there is a hunger; in the land there is a need.” One of our country’s greatest hungers and needs is a reformed health-care system. The problem goes to the heart of what is said in our Declaration of Independence regarding people’s desires for “Life, Liberty, and the pursuit of Happiness.” Separate from recognizing the loss of life that occurs daily because individuals lack health-care coverage, I want to discuss the loss of liberty and the pursuit of happiness. I believe President Obama had it somewhat wrong when he said that people with private coverage (the vast majority of working Americans) would be happy to keep their current insurance. Through my years of taking care of patients, I have learned of many incidents of patients trapped in jobs because they couldn’t afford to lose health-care coverage for themselves, their partners, or their children due to chronic health conditions. Near-universal health-care coverage, I guarantee, will allow thousands of individuals to quit their corporate jobs and either find employment with new firms or start their own companies; separate are the untold thousands who would quit their jobs to enjoy early retirement. One of the great secrets in the effects of this law is the economic boost the United States will receive from these individuals leaving their jobs, allowing them to pursue new opportunities while others can then take these jobs.

Besides sharing my thoughts and the thoughts of others on this blog, I will make available to you my years of collective thinking regarding health care. It exists in several forms of communications media that I will place in categories of interest. In the meantime, I look forward to sharing with you my thoughts.