Obamacare: I watched the crafting of the Patient Protection and Affordable Care Act (PPACA) from pretty close up, both as an interested observer and lobbyist with client interests in the complexion of the legislation. I attended more hearings and mark-up sessions dealing with it than I can possibly remember -- all in all a very exhausting process. Prior to its crafting, everyone with any sort of reasonably detailed understanding of how our health system was working, knew that in the long-term that the system was unsustainable and that something had to change. Personally, I will give a great deal of credit (in terms of good intentions) to those in Congress that had the courage to deal with the difficult and complex issue of national health reform and who spent endless hours trying to craft the legislative solution that became the PPACA. They are to be commended for, among other things, their ambition. Having said that, it was abundantly clear, that the legislation was hugely complex and had many working parts that would need to all work together in a pretty much seamless fashion to produce the results intended by the laws crafters. There never was a guarantee this would happen -- but there were plenty of doe-eyed pronouncements that it would. It was also clear (or should have been to any politician involved in its passage and implementation) that the promise of if you like the insurance you have, you can keep it was, at best, a temporary salve and one that would, as the law became fully implemented, evaporate away. It was an obvious mistake to trumpet this over and over again, regardless of the motives for doing so. So, where do we stand? Well, having gotten off to a bad start (an understatement) we still dont know how or if the fundamental market and economic assumptions behind the law, and upon which it was substantially built, will pan out as expected over the long-haul. If anything, the future of the law has become more clouded and it remains unclear whether future tinkering to it will satisfactorily address its deficiencies. Stand by for plenty of more anguish and wrangling about it as we go forward. We are reminded of the famous motion picture line of Betty Davis: Fasten your belts -- its going to be a bumpy ride.
Posted on: Fri, 15 Nov 2013 14:32:38 +0000
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