America has some of the finest hospitals, physicians and nurses the world has ever known. We also have a health care system that is struggling with issues of affordability and access.  We need a transformational realignment that moves us back toward a system that is affordable and once again, at its core, consists of a medical provider, and a patient, in an exam room.

Obamacare has undermined positive health care reforms that have been underway since the late 1990s and its skyrocketing costs have become a major deterrent to America`s corporate stability.  Even more alarming for individual taxpayers and families, congressional budget analysts are now estimating that nearly 6 million Americans - most of them middle class - will have to pay a penalty for not getting health insurance once Obamacare is fully in place.

That`s 2 million more than previously estimated, or a 50 percent increase, with an average penalty of nearly $1,200.

The recent Supreme Court ruling has brought Obamacare`s hidden taxes to the light of day and Dianne Feinstein proudly doubled down on her support of them. With a price tag double what the Democrats promised and growing exponentially every day, the "Affordable Care Act" may be the most ironic title for a major bill in the history of Congress.

This dishonest attempt at health care reform should be repealed before its regulations and price controls further damage availability and quality of care.  It should bereplaced with policies that target specific health market concerns: quality, affordability and access.

The Problem:

• Our system of healthcare in which third-party payers pay for care has worked to separate the consumer of health care from the provider, weakening the doctor-patient relationship.  Disconnected from the cost of care, some consumers have over-used the system. 
• Employers are encouraged by our tax system to be the purchasers of health insurance.  Attempting to contain costs, employers have opted for the various forms of managed care.  Health plan administrators have denied care, questioned doctors` judgments, and created a blizzard of paperwork in an attempt to limit their expenditures.     
• With rising costs, the number of uninsured patients has risen (including many working uninsured).  The rise in the uninsured led to a greater number of people with no preventive care, which in turn has led to people seeking care at trauma centers and emergency rooms.  
• With private health plans and government programs providing inadequate reimbursement, trauma centers and emergency departments are incurring huge losses.
• The fundamental problem is that the federal government has opted to use price controls and "command and control" style regulations instead of power of the marketplace.  The marketplace, with appropriate supervision and safe-guards, will always be the most efficient way to allocate health care resources.
• In addition to this basic problem, uncertainty over future regulations and costs of Obama-care is a major impediment that is making employers reluctant to hire new employees and expand their businesses.  This massive new federal law is exacerbating the budget crisis for states.  States have received little or uncertain guidance from the Administration on future costs and restrictions under the law.  This creates an unfavorable environment for state budgets and the economy as a whole. 

The Solution:

• Create a system that reconnects doctors and patients, both in the quality and cost of care, rather than a massive government health care bureaucracy.  Health insurance should be portable and insurers should not be allowed to discriminate based on pre-existing conditions.  Allowing consumers to buy insurance across state lines will lower the cost of insurance. 
• Remove Obamacare`s barriers to market-oriented solutions and force health care providers to compete for patients` business based on both quality and cost.  We must make it easier for individuals and small businesses to purchase coverage instead of tilting the scales for employer-provided insurance. 
• The key to making Medicare affordable while maintaining the quality of health care is more patient involvement, more choices among Medicare health plans, and more competition.  Market mechanisms should be utilized to drive down costs that are presently skewed by the government footprint in the healthcare system.  A menu of additional Medicare plans, some with lower premiums, higher co-payments and improved catastrophic coverage, should be added to the current program to encourage competition.  Only by empowering Medicare beneficiaries to exercise their purchasing power - instead of setting reimbursement rates in Washington - can we begin to have competition that will control costs and improve quality of care. 
• For Medicaid, modest co-payments should be introduced except for preventive services.  The program should be turned over entirely to the states with federal financing supplied by a "no strings attached" block grant.  States should then allow Medicaid recipients to purchase a health plan of their choosing with a risk-adjusted Medicaid grant that phases out as income similarly rises.
• Seniors and disabled individuals should have the right to opt out of Medicare or Medicaid if they so choose.  Seniors have no choice but to accept Medicare if they want to receive the Social Security benefits that they paid into the system.  Free citizens deserve better treatment under the law.  Similarly, some states require that all disability benefits be tied to Medicaid.  This means that families who seek help for one disability need are sent checks that they didn`t ask for and don`t need.  Our safety net system should be more flexible and provide more choices if it is to survive.  

Obamacare may be one of the most important reasons why retiring Dianne Feinstein is crucial to our national cause - she is painfully out-of-touch with the American people, and her insistence on cheerleading this law is the most profound demonstration yet why California needs new energy and a fresh start in the U.S. Senate.

The simple truth is that Obamacare will continue to have a negative impact on job creation and hiring, and businesses as well as families will be forced to continue to grapple with all of the uncertainty and costs the law creates.

Only with new leadership in Washington can we expand access and lower costs through competition and choice while keeping in mind our responsibility to care for the truly vulnerable without raising taxes or increasing debt. 

I will vote to repeal the Obamacare tax dragging down our economy and hurting families. Dianne Feinstein won`t. It`s a simple choice.