On June 29, 2012 the Des Moines Register published an opinion piece written by Bill Leaver and Eric Crowell, both with Iowa Health System, in which they advocated moving ahead with Obamacare and not “ripping apart health care delivery provisions…” They wrote that Iowa Health System, the largest group of hospitals and health care providers in Iowa, “…has invested millions…”, along with Blue Cross Blue Shield of Iowa, to create an Accountable Care Organization (ACO). There you have it. They have invested millions of dollars in Obamacare and, therefore, have a vested interest in going ahead. They wrote that Obamacare will, “lower the cost, increase the quality and improve the patient experience in the health care setting.” They provided no evidence and there is no evidence that Obamacare will fulfill any of those promises. In fact, there is evidence that the provisions of Obamacare will increase costs. The ACO that Iowa Health Systems is developing is very much like HMOs of the past that failed to contain costs. Obamacare does fulfill the promise of covering those with pre-existing conditions and of preventing those with high costs from losing their insurance. But those benefits come with increased costs, not lower costs. We do not have the financial ability to pay for everything for everyone. So, there will be “death panels” that will decide what is and is not covered. That is the way it will be.