I don’t really have much of an opinion about whether the Patient Protection and Affordable Care (PPACA) exchanges will work, and, if I did, it doesn’t seem as my opinion would be very interesting.
I’m a reporter. I know as much about how to tell whether exchanges will work as I do about how to build a nuclear reactor with the contents of my desk drawers.
It seems as if really nice, smart people desperately want the exchanges and other PPACA components to work, and a lot of nice, smart people have great arguments about why the exchanges are doomed, but, I figure, everything is doomed. We all depend on the grace of God. If God wants something to work, God will figure out how to make it work, and if God is not thrilled with something, it will fail, even if it looks good on paper.
But I do agree with the general proposition that it’s reasonable for the government to be involved with health care finance, and that can put me in an awkard position.
Supporting some government involvement in a free-market health care system is analogous to thinking the National Security Agency and other agencies should maybe have some carefully limited authority to snoop in my inbox to see if I’m really, really scary.
But, of course, if I’m a shades of gray kind of person (note: in the old sense of the term; I haven’t read that book), and I talk about being sort of OK with the idea of the NSA, etc. having some kind of access to snoop in people’s e-mail, then those folks totally undercut me if they then go on to use their authority to, say, blackmail people, or learn more than they ought to know about the stars of Star Trek, for example.
Similarly, two Democratic state lawmakers in Iowa have just, according to the Associated Press, opened up what I think is a horrible can of worms by suggesting that Iowa ought to look into the $1.3 billion surplus of Wellmark because Wellmark has decided to wait at least a year to participate in the PPACA exchange system.