The ACA Endgame?

 

 

 

"I am sure it will be fine. Heck, they said it again on the news last night."

Yesterday was "day one" for not only this year's Federal Government shutdown, but also the Affordable Care Act, aka Obamacare. "Day one" of the shutdown went on as expected - very few people noticed. In fact, if were not for the shrill voices of the media, even fewer would have known part of the behemoth was asleep. "Day one" for Obamacare however, did not go well at all.

I know from my working days at IBM, any "go live" day is highly critical. The company would go over every detail in painstaking detail to make sure the debut of any new service came off as smooth as glass. If for some reason it did not, careers could end in a heartbeat. The big problem yesterday was the website. It seems that it was not "stress tested" nearly enough, and it could not handle the less than 3 million hits it received. You Tube can handle 3 million hits and then some. One Democrat said out of frustration yesterday, "Government just can't seem to do anything right". Yup.

So why are so many opposed to this bill, described as a way to solve a decades old issue of getting every American insured? People who have studied the math of this law understand it is put together like a house of cards. "If this happens, then that could be the outcome. If that does not happen, then so and so might happen." It is a maze of borrowing from Peter to pay Paul and more assumptions than you can find at the race track. If enough healthy, young people do not go to the exchange and buy expensive healthcare insurance, then there will not be enough left to subsidize older and sicker folks. Who picks up the slack? Uncle Sam will.

There are a growing number of people however, who believe the system was never meant to work. It is a ticking time bomb waiting to go off. The collapse will come when companies decide to pay a modest penalty to the government, and then throw millions of employees off their health insurance rolls. These people (some say as many as 30 million) will be forced to the exchanges. The result will probably crash the system. The insurance companies will be forced to take many who can't afford even the cheapest insurance. Some companies in the exchange will file for reorganization or fail. The government will step in with a new plan to save the day - Universal Health Coverage.

With Universal Health Coverage, we will all get to deal with the same group of folks who could not get a web site working yesterday. Every time you go to the doctor, it will be like dealing with the DMV or TSA. It will be expensive and inefficient. Our once great and admired health care system will become yet another Euro style failure. Death panels will not be called such, but they will be there. Since 50% of all health care dollars go to 5% of the population (sickest and oldest), the name of the game will be to reduce down the 5%. It will be a society even George Orwell could not have imagined.

Those who have not been paying attention to the details of this fight, had better start soon. Our future is at stake. Healthcare is 1/6 of our economy and we have people at DHS who know little or nothing about healthcare promulgating tens of thousands of pages of regulations. Thinking about how this could end up is really enough to make a well person sick.