Since March 23, 2010 the country has been living in a constant
psychotic state when it comes to reforming health care. While some have tried to
implement the legislation and rules of the Affordable Care Act (Obamacare)
others have religiously tried get rid of it altogether. Neither side has
actually “won” as we have moved through the process but as a result we are now facing
a health insurance market that doesn’t look anything like what those who
supported the original legislation had hoped. It’s a mess.
Nobody should be
surprised that there are going to need to be changes to what was originally
written. The original legislation was much too complex, confusing, (and
costly?) considering where the country was
The Treasury Department announced last week that they are
pushing the employer requirement for providing health insurance (over 50
employees) until 2015. Additionally, the Department of Health and Human
Services published rules that stated they were going to allow self-reporting of
income information to determine insurance subsidies instead of verifying the
information through the government.
Some believe this is the “beginning of the end” of
Obamacare. (Republicans) Others view this as simply making the necessary
changes to respond to the market realities. (Democrats/White House) Still
others see these changes as the predictable outcome of creating something that was too big, too confusing, and too complex combined with poor implementation and
terrible communication. (including me)
An opinion essay in the Wall Street Journal (Obamacare’s ‘Lair’
Subsidies; July 7, 2013) stated, “All of
this fits with Obamacare’s entire bloody-minded history. Democrats were
determined to make their rendeveous with the liberal destiny of government-run
health care, so they imposed this debacle on the country on a partisan vote and
despite public opposition.”
I don’t think it’s quite as bad as the Wall Street Journal describes
it (and the position that Obamacare is “government-run” health care is a
stretch) but illustrates just how far apart the country continues to be when
it comes to health care reform.
Many will continue to move forward
to try to implement what was originally designed. Others will continue to
oppose every aspect of the Affordable Care Act. At the same time, more changes
to the original rules will likely occur and who knows what kind of health care
system we’ll ultimately create- and at what cost?
In the meantime many
individuals will have to continue to simply cope with the expensive and
selective health system model we have today and try their best to understand the rules they
are expected to follow. Citizens are going to need to be much more engaged in
health care reform than they are today to break the political impasse. In the book Health Care Reform and
American Politics; What Everyone Needs to Know, authors Lawrence Jacobs and
Theda Skoopol summarize where we are; “We will continue to live in interesting
times, where each citizen’s understanding, voice, and actions can make a
difference.”
Changes to the Affordable Care Act will continue to occur.
The more individual citizens understand the basics of what is going on, the
better the chances they will have to make a difference to influence the results.
Obamacare isn’t crashing, it’s just continuing to lose altitude
due to economics and politics. Ultimately, it’s going to be up to the
individual citizen to get health care reform on the right track again. As in
the past, they will be forced to live with the results.
