Leadership



Obama took the easy way out on many things including illegal immigration and health care. Just give it to them. Whatever they want. Even though many innocent people including legal immigrants got hurt badly. That’s playing Robin Hood, not leadership.

Now The Left leaves Trump with the Sophie’s Choice.

ACA or Obamacare



The Right should stop calling ACA, ObamaCare.  Stop trying to pin this on Obama.  Stop trying to crowd shame him.  The race card is often dealt in response and the narrative breaks down.

Because Obama self-identifies as black, many see any opposition to his policies and ideas as opposition to him, and therefore racist.  Why give The Media anymore ammo.

If Obama, Warren had checked the Other box, maybe history would have been different. “What difference at this point does it make?”

Health care – there is no problem



Step1: There is no “problem”.
There is no solution to the so-called health care problem because there is no problem. The first step is to realize that this is not a problem in the traditional sense with a fix or a solution. It took Bill Clinton 70 years to have this epiphany, but at least finally someone has.

Step2: The role of government.
Now, is health care (whatever that means to each of 330 million people) not just a philosophical right, an ought to be? Or is health care a political, from the government right to members of the society? Should the development and delivery of health care related products and services be a for profit, private sector industry or entirely a non-profit, public sector “right”, or a public-private partnership?

Step3: The real issue(s).
The next step is to admit the issue is control and management of costs, access, quality, timeliness, and outcomes. No one time fix, no final solution, no silver bullet. The goal of course is for the system to “work”.

Step4: A framework.
Once the real issues are accepted, a framework, like the current ACA (mandatory) shared cost pool can be decided on. All private, all public, a combination.

Step5: Control.
Then finally, back to the operative trigger word, CONTROL. As usual, what liberties will people sacrifice, what control will they relinquish, in return for security? What shall be controlled? What must be controlled? Who shall decide?

There is a long list, but generally two often conflicting categories. Patient behavior (discretionary and non-discretionary) and Provider products and services.

No pre-existing conditions. No risk adjustments other than age. No cancellation. No lifetime caps. No rationing. No behavioral controls. No price controls. No effective mandate.  Kids stay on until 26. Sign-up or don’t, get sick, then sign-up, get treatment, quit paying, again. Good asset protection for the rich.  Deductibles so that many essentially have NO insurance, only a very expensive catastrophic policy.

There is not enough money in the world to provide the quality and timeliness US citizens will demand of their health care system that the Fed govt. says is their right.

ACA, a paradox



ACA is just asset protection. ACA works quite well for a narrow segment of the populace. Those with assets to protect and income to afford the first dollar expenses (or first thousands of dollars).
No pre-existing conditions, no cancellation, no lifetime caps. A gift for the upper class. For everyone else, for the middle and lower classes without assets to protect and cash flow not so much.

And Bill Clinton is right. Health care if defined politically as a right that should be available and affordable to all is not insurable.

ACA is not insurance



ACA is NOT insurance.  ACA is more like a co-op, a communist-like shared cost pool. All people (all risks) are “forced” to jump in the pool evenn if they can’t swim and pay what they can and take out what they need.

Constant tweaking and extreme command and control must be applied for the plan to break even financially.

Since some issues cannot be controlled, an aging demographic for example, increasingly expensive R&D, rationing and behavioral controls (wear your seatbelts) MUST be applied from time-to-time.