While our country desperately requires health care reform to decrease costs and improve access to care, the Patient Protection and Affordability Care Act not, a.k.a. Obamacare, will bureaucratize and regulate health care delivery to the great detriment of patients, the profession of medicine, and American health care more generally. Further ObamaCare imposes a huge new unfunded liability of trillions of dollars on our children’s and country’s already disheartening futures.

Despite the majority of citizens favoring repeal of this catastrophic “reform” bill, Governor Corbett plans with the approval of the Republican-controlled legislature to facilitate ObamaCare in our commonwealth by establishing a PPACA-compliant health care insurance exchange. Facilitating the exchanges facilitates the entire ObamaCare catastrophe: the individual mandate, the loss of physician and patient medical decision making, tens of thousands of pages of regulation controlling every aspect of health care, and the creation of massive new federal bureaucracy.

Incredibly, it was Governor Corbett, as Attorney General of Pennsylvania, who brought suit against the federal government on behalf of the Commonwealth. Yet his plan to move ahead with the exchange undermines this very case that now has moved to the Supreme Court. To argue the unconstitutionality of the individual mandate and the violation of states’ rights by the forced expansion of Medicaid while at the same time moving forward with implementation of the exchange that enforces the mandate and expands the state’s Medicaid liability, challenges logic and the sincerity of the suit itself.

The Governor and the willing Republican leadership erroneously or disingenuously claim Pennsylvania must be ready to comply with PPACA if the Supreme Court fails to uphold the Constitution and strike down this destructive legislation. They allege, but are mistaken, that the state-implemented exchange would give Pennsylvania more control than if the exchange is set up by the federal government.

As pronounced on the CATO website: “The promise of local control is a mirage.” PPACA “authorizes (the federal government) to ensure that States with Exchanges are substantially enforcing the Federal standards … and to set up Exchanges in States that elect not to do so or are not substantially enforcing related provisions”. The fact that an exchange is state-run does not diminish federal control by one iota. There is nothing that a federal exchange can do that the federal government cannot also force a state-run exchange to do through regulation.

Recently, Health and Human Services (HHS) released regulations that give the states some flexibility in providing essential benefits. In fact the PPACA statute as written does not allow such flexibility, but this administration routinely steps on the rule of law; just consider all the waivers to ObamaCare provisions granted to political allies. Nonetheless, this “flexibility” was granted by regulatory fiat and is no more than a ruse to encourage states to set up the exchange. The regulations could be changed again on the whim of HHS.

Allegedly the exchange will improve competitive forces in the health care insurance market. We are expected to believe that more mandates and regulations will increase consumer choice and lower costs. New ObamaCare regulations in effect this year have been estimated to have increased premium costs by 8% for individuals and 9% for families. A vibrant health care insurance market does not require additional mandates but rather deregulation to provide individuals with more choices for a policy that best fits their needs. Most of us are happy with our auto or home insurance because we have many coverage and cost options when we shop for those insurances. Would more regulation and mandates in those insurance markets increase or lower choice, increase or lower costs? Would imposing a state-run exchange on the auto or home insurance markets improve or worsen customer service or cost?

So if consumers don’t benefit from an exchange, then who does? The Pennsylvania Insurance Department would expand its rolls of employees, including their taxpayer-guaranteed salaries, benefits, and retirement. The federal government would fund the exchange through 2014 when it becomes another unfunded mandate and liability for the state’s taxpayers. Big insurance companies have lobbied strongly for the exchanges. They see billions of dollars of new federal spending –financed by more deficits – flowing through the exchanges, and regulation limiting competition. They will have guaranteed, albeit regulated, profits; and that is just fine with them.

Rather than facilitating ObamaCare by implementing the exchange, Pennsylvania should resist this terrible law regardless of the Supreme Court decision. There is only one exchange – the exchange approved by HHS. The more barriers we put up to Obamacare, the more time to defund or even repeal it.

Contact Governor Corbett’s and your state legislators’ offices. Tell them you will not be duped. The exchanges will benefit big insurance and big government, worsen our state’s fiscal condition, and decrease consumers’ choices for health care insurance and their ability to afford it.

Nicholas Pandelidis, M.D. VP PA state Chapter of Docs4patientcare