Dear Secretary Sebelius:
I understand you have been trying to round up bloggers to write about Obamacare. (We can call it that, right?) I totally understand the need. After all, support for the president’s top achievement is reaching all-time lows. And, boy, you gave the Obamacare promoters a challenge when you delayed the start of the employer mandate. (I have to say how much I admire your nerve in doing that yet continuing to stick it to individuals. . . er, stick with the individual mandate. And they say the Obama administration isn’t friendly enough to big business.)
Before engaging in the effort, I thought I might run some ideas by you.
I know how much trouble you and the states are having in setting up health-insurance exchanges. But, look on the bright side: All the young people who can’t find jobs in this economy can volunteer to help fix the IT problems. “Obamacare’s failure is your unpaid internship.”
Not loving it? Well, let’s look at the medical device tax. Yes, it’ll make it hard for entrepreneurs to start up businesses, but investors have many options. The administration wants to “pivot” to Asia, right? “Obamacare: Doing what the State Department cannot.” But maybe that isn’t exactly what you had in mind.
The Independent Payment Advisory Board is my personal favorite. The unelected board (thank goodness; otherwise, it’d be approving treatment right and left) won’t tell grandpa he can’t have his hip surgery. Rather, the warm and fuzzy bureaucrats will just explain that, because the provider rates have been pushed down so far, he’ll have to wait a year or two. And, between us, some of the elderly might, you know, pass on before we spend the money on them. So, I’m thinking: “Let IPAB tell grandpa no so you don’t have to.”
You see the problem. I’m having trouble coming up with something that might be of use to you. Most Americans get health-care insurance through their employers, and heck, it’s not even clear having health insurance leads to better outcomes. Young, healthy people (the kind that bought into the “Hope and Change” jazz) are happy with a catastrophic plan or even with self-insuring. The poor have Medicaid and the old have Medicare (granted, in many cases they now don’t have Medicare Advantage because you stole from Peter to pay Paul).
So what we are really looking at is insuring non-seniors who want health coverage but don’t get it through their employers and don’t qualify for Medicaid. That’s a comparatively narrow problem, so it is hard to justify the taxes, expense, disruption, loss of existing health-care plans and impact on employment that go along with Obamacare. I mean, a few high-risk pools would deal with that. And then we can work on making health care affordable. (I think the Really Affordable Care Act sounds good.)
Come to think of it: If Obamacare is so great, why do you have to recruit bloggers to hype it?