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The unintended consequences of Obamacare is the real problem. Purported savings uses to justify the argument that there is no defecit portend serious rationing for seniors and the poor should be the primary issue being discussed now. The other is the savings that are ignored such as Tort Reform to reduce the cost of medical malpractice insurance, elimination of prescription drug advertising that would cut health insurance premiums by 25% more than anything else could. A serious individual mandate like that proposed by former President Ronald Reagan which could dramatically reduce cost shifting. Needed Medicaid fraud prevention especially in the relm of unneeded but highly advertised durable medical equipment and medical testing fraud using the homeless on our nation's skid rows also could save billions Other ignored reforms include appropriate gengraphic providor reinbursement changes that take into account the disparity in local costs of living and the costs to operate a practice. More impiortant than anything else we need reform of medical billing so billed costs from providors more closely resemble actual providor costs not some artificial amount driven buy CMS accounting rules that only make the consumer more confused as to what the problems are. Kurt Hahn, a hospital director from California