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Life Health > Health Insurance > Health Insurance

On the Third Hand: Bears

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For New Jersey residents who are timid, recreational campers, camping season is about to start. With camping season comes warnings about bears.

The bears are everywhere, and will eat you, especially if you leave your campsite a mess, according to warning notices plastered on every available campsite surface.

Aside from cleanliness, one of the main defenses against a bear is to bang on a pot. Another helpful tip: Give a bear room to escape from you that doesn’t involve coming toward you and eating you.

To me, it seems as if the strategy of banging on a pot probably would not do much to fix whatever ails the Patient Protection and Affordable Care Act (PPACA).

But, to me, it does seem as if the strategy of giving the bear a way to escape without eating you is highly relevant to efforts to change PPACA.

I don’t have any professional position on whether PPACA is really good or bad, or whether, generally, it’s being implemented well or poorly. Or whether government should be involved in any way in health care finance or health insurance to start with.

I do have general opinions that market forces are powerful; that capitalism has to compete in the marketplace of ideas, just as companies have to compete with one another; and that, of course, no matter how wonderful a giant piece of legislation could theoretically be, it must, inevitably, have stupendous flaws, just because 90 percent of everything human is messed up.

Who is the person who must hate PPACA the most, in the very best-informed detail? Probably Gary Cohen, the director of the Center for Consumer Information & Oversight (CCIIO), or other managers and workers at CCIIO. 

Health insurance producers and health insurance company employees simply have to deal with the turmoil and financial devastation that PPACA could possibly cause. Cohen and other folks at CCIIO have to understand every semicolon in the law and take responsibility for trying to make it work, even though they had nothing whatsoever to do with writing it and probably can’t imagine what kinds of lunatics drafted it. And then they have to go out and in public and say all nice things about it, all the time.

When agents, brokers, insurers and employers point out that there are problems with PPACA, Cohen et al. probably respond with polite, bland, reporter-proof sweet nothings they’re supposed to say, while, privately, thinking, “Uh, no kidding. You haven’t even found 99 percent of the serious flaws we’re trying to deal with.”

But I get all of these e-mails from public relations firms that seem to be in charge of stirring up trouble for the sake of stirring up trouble.

Instead of, for example, politely talking about why even reasonable Democrats agree that Part X, Y or Z of PPACA has problems and needs revisions, they take some fairly minor, innocuous, understandable problem with PPACA implementation (“Do you know that the Obama administration has already fallen behind with efforts to do G? Here’s evidence that the fact Obama has fallen behind means that all of PPACA is a failure and that Obama is controlled by space aliens who are going to join with the bears to eat you. And your cat.”) 

The trouble relations (TR) firms don’t seem to have any sincere interest in revising PPACA, by giving Democrats a face-saving way to change it without looking like dorks. The TR firms seem to be out to completely wall the Democrats in and make it absolutely impossible for the Democrats change one period in PPACA without feeling like vanquished losers.

On the one hand, the people at the TR firms are very smart and make a lot of money. Maybe Democrats actually hired them to pretend to be conservative and force Democrats in Congress to unite behind every last punctuation mark in PPACA, no matter what. 

On the other hand: If you’re a depressed camper, maybe one way to go out is to find a bear and corner it. Just force it to come at you and eat you. Maybe the TR firms are backed by someone (Republicans? hospitals? health insurers?) who want to force CCIIO to come and try to eat the health care system, for some strategic reason that’s too clever for me to grasp.

On the third hand, it could be that PPACA is going to stay in effect in awhile, no matter how well or poorly it works, and that it’s in the interest of the insurance community (and people who use health insurance) to let the CCIIO and other Democrats have face-saving paths (example: the ability to postpone the effective dates of programs and requirements) that they can use to back off a bit.

On the fourth hand, I’m not very strategic. Maybe the best strategy is to bang a political pot at CCIIO and force it to charge.

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