Tuesday, October 8, 2013

Government Shutdown vs. Health vs. Debt Ceiling


The present stalemate in Washington reflects how ridiculous it is for anyone to think that government can really “run’ health care.  Does the world’s economy really depend upon making the right decision regarding the American Health Care system, or how it will effect the American Debt Ceiling. How much grandstanding is taking place in D.C. ?  What is true?  That depends upon which side of the aisle you live in.

It may be a good thing that we have become more of a paperless society, because the sheer weight of what might have been printed regarding the affordable care act (not to speak of the law itself) would tip the spinning globe off it’s orbital axis.

The real issue now before us in regard to the Affordable Care Act is how to amend it and maintain it’s worthy, lofty and principled goal to provide good health care to all. No one can even define what ‘good health care’ means.  Let alone to fund it.

The law was passed, and Speaker Pelosi said we would not know what was in it until it passed.  So be it. Neither Pelosi, Obama, Reid, and others knew how this law could or would play out.

The beginning is not promising as we have seen with several delays and one of the principle components, the health benefit exchange portals being  broken and incomplete.  Despite input from credible business, and healthcare sources the reaction of the administration is both defensive, and arrogant.

The segment of the industry that seems to complain the least is the insurance companies, for they have gained the most, and lost the least. Even with the mandate that they must allocate 85% or more of their income to direct patient care, insurers have other means of restricting their cost and maintaining profitability hidden away in increased deductibles, and larger copays as well as raised premiums.The government claimed that health spending is out of control, and the only means to correct it is for them to ‘regulate’ it more.  The truth is that most of the increase in cost has been fueled by regulations in all areas of healthcare.

Haste does make waste and it is time to call a time-out and halt further mandate deadlines.  During this period an assessment needs to be made in regard to repairing what is already in place.

The real uncertainties of the Affordable Care Act, in addition to the funding impact, now include whether it will be fully implemented at all.  The final word is not yet out. (this despite Democrats clearly pointing out it is the law of the land).Clearly there are many Americans, democratic and republican opposed to it’s present form. Any law popular or not must face the test of logic, and rational thought. Pipe dreams do not fit in this category.

Do we need to sacrifice 40 million people to be without health care? Certainly not, while a means can be had to insure almost all Americans with a sound business model.

The current form of Obama care is fraught with chaos, and an attempt to manage, manipulate and coerce different health segments with economic sanctions and reward. The problem is that a sanction to one segment is a reward to another, and rewards to one segment may be a sanction to another.  Each segment may have competing interests.  The result of this Gordian knot is the unpredictability of what secondary effects will occur, as has been shown during the run up to the employer and the individual mandates, and it’s effect on employment by small businesses.

The verbal assurances by the Obama administration of lowered insurance premiums are in doubt as real figures begin to emerge.  There is great fluctuation in premium estimates on a state wide basis. This seems to fly in the face of a National Health Care System.

While many of the previously uninsured will receive an “insurance card” there is real expert opinion that it may not be worth the paper it is printed on.  Like many patients with Media-Cal’s blue and white “BIC” for many it will be worthless or even worse, a liability.  Many providers will not deal with programs that require inordinate bureaucratic burden for inadequate reimbursement.

In a recent non scientific sidewalk study by FOXNEWS there were many who thought Obama care was not the same as the Affordable Care Act.  Some even thought that Obama care was better than the Affordable Care Act.

1 comment:

Sid Schwab said...

Well, other than "running" Medicare, and the fact that the ACA really isn't "running" health care, I agree with your premise.

I just wish it weren't being used as an excuse to burn down the house; or, as others have called it, effectively seceding from the Union, or petulant nullification using threat of worldwide devastation.

And, of course, it's anything but a "national health care system." It's a sop to private insurers, originally designed by conservatives as an alternative to single payer. Which explains a lot. Sigh.

What I can't figure out is why multibillionaires like the Koch brothers are willing to spend so much money on ads and on buying politicians to prevent its success? In what way is it a threat to their vast wealth? I can only figure they worry that it'll actually work, in which case people will reward Ds in future elections, and the Koch paradise of zero regulations, allowing them to exploit the environment, workers, etc, will become impossible. Honestly, I can't figure anything else to explain it.