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WASHINGTON — Here’s the idea: Swiftly pass a repeal of President Barack Obama’s health care law, perhaps soon enough for Donald Trump to sign it the day he takes the presidential oath. Then approve legislation restructuring the nation’s huge and convoluted health care system — despite Republican divisions, Democratic opposition, and millions of jittery constituents.

What could go wrong?


With Republicans controlling the White House and Congress in January, they’re faced with delivering on their long-time promise to repeal and replace “Obamacare.” Here are hurdles they’ll face:

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  • The ACA and its ultimate revision is of interest to me. I would be pleased
    to participate formally in this discussion.
    I am beginning my 47th year at Massachusetts General Hospital . During
    that period I was on active reserve duty as LCDR at NRMC Pearl.
    Along with my Officer in Charge Dr. Nowel Howard; and under the Command of Admiral Thor Hanson ( Deceased ) . Dr. Howard and I
    addressed the psychiatric needs of all Naval and Marine personnel and
    their families in Hawaii and Midway. When I returned to
    MGH I joined The MGH Transplant Service and worked with that
    group fulltime until 2013 . I now continue as Associate Professor at Harvard Medical School ; and in part time work in the Psychiatry OPD at MGH. I have a small private practice and continue to look for meaningful opportunities.
    In my Transplant Psychiatry work I played a role in regard to ethical
    issues regarding candidate selection. In 2002 I participated in a
    group organized under the oversight of The New York State Dept. of
    Health in review of changes required following the unfortunate death
    of a living partial liver donor at a major NY Hospital. I am a special
    fan of William James whose ” Pragmatism” led to the conclusion that
    there are many good ideas; but, in the street, things are messy ! I
    am beginning to look at perspectives regarding abortion with a colleague
    who was formally Chief of OBGYN at MGH and Brigham and Women’s
    Hospital. As for change in the ACA I was stunned by a piece in the
    Wall Street Journal that would eliminate or otherwise compromise
    funding for psychiatric care in a new health care plan. This is stunning
    given the impact of psychiatric disorders on medical disability–among
    the top 3-4 causes world-wide. What would omitting psychiatric care
    do to the ultimate contagion in families; and what would it do in regard
    to the untoward social impact when serious illness ( of any nature is
    unmet by available advances in health care. The failure of the ACA
    had multiple cause; the worst of which was Corporatization of Medicine
    by land mines in the ACA that would withhold payment to Hospitals
    if physicians did not fill in all the required forms. This has been destructive
    beyond measure.
    Thanks for the opportunity to respond: Owen Stanley Surman M.D.


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