I’m an optimistic sort of guy, really. Kind of a contrarian because I get to explore and test my thinking and assumptions better that way, but I’d rather look at the bright side, all things being equal. So, what’s the possible bright side of the ObamaCare crap sandwich we have been handed? Just spitballing a few thoughts, here…
Well, it’s not likely to be repealed in the next month and a half, and I can’t see the Rs getting their collective shit together to actually get a good delay + automatic sun-set bill passed before the end of the year. I also can’t see Ear Leader totally folding and allowing it to be threatened with sun-setting or repeal. So, it’s still on the books and nominally active for a little while, but there is chaos because people can’t all get signed up for new stuff, or can’t afford it and will scream at being taxed for not buying something they can’t afford. (Does Turbo Tax properly account for it?) Insurance companies sent out a lot of cancellation notices. People don’t like getting them, bitch about it to their friends. The backlash from independent voters looks like it’s building fast, and may be REALLY hostile. Horror stories of people with their “much better ObamaCare-Compliant plans” getting totally screwed make the news, where someone goes out of network and has ZERO coverage, because there is no quality care in their network (see Maine, for example – all the serious stuff they send to Boston, but the sole exchange provider doesn’t pay for anything out of state, so they are stuck with crappy in-state care, or billed full-boat for quality out-of-state care). All the proposed “tweaks” look to break the basic funding mechanisms, or take a while to implement, and in the meantime people are twisting in limbo, with plans they might or might not have paid for (because the Healthcare.gov doesn’t have the back-end payment system even kind-of-built, yet.) Costs explode. Data gets hacked, identities stolen. Fraud stories become so common they move off the front page from sheer volume. Payments get messed up, and bank accounts drained or messed with. Then the rumors start floating, then hitting the front page, that when the employer mandate hits, there will be a metric shitload of policy cancellations and coverage-drops with no place to go. Independents get scared of government power, and even some of the hard left, having gotten beaten about the head and shoulders with their problems dealing with it personally come to their senses enough to realize that it’s not just that it’s the wrong people in charge, but that no matter WHO is in charge, this sort of program will always fail. The DC and state-level political back-stabbing and infighting and blame-shifting and finger-pointing in the war for political survival might be epic. People will want a blood-in-the-streets level of accountability, and calls for more data and transparency will be loud.
If things get bad enough, fast enough to make news every day even on the most liberal MSM outlets, slow enough that the guys at the top can keep lying to themselves that it’ll take just another few weeks, for enough people across the political spectrum, it’s possible that out of the wreckage of our healthcare system might (might, not a certainty) emerge a broad consensus that big government doesn’t work, and we really need to hack it back, like taking a machete to an overgrown back yard. Yes, you might take out a few roses, but getting all the blackberry bramble under control is worth a few flowers. (Isn’t eggs and omelets a common statist refrain?) It’s possible. Turnover in congress could be record-breaking, if we are lucky. In the mean time, looks like we have some rough sailing, and a lot of places where the Stupid party can earn their name, while the Evil party keeps trying to destroy the nation.
My “perfect vision?” All care providers (docs, hospitals, Big Pharma on a per med basis, everyone) are required to post prices on their websites, as well as average outcomes. Insurers must post what they pay out for procedures, outcomes, etc, both summary and details. This allows consumers to shop around and compare in an intelligent way. Most people will be able to move to high-deductible Medical Savings Account and associated catastrophic care policy, so it’s insurance, not a paperwork-heavy medical pre-payment plan. It becomes openly competitive across state lines, simply because the information is available to the consumer, so they are motivated because they CAN control costs. And for the most part, the government just butts the heck out, except for fraud prosecution and such-not. Oh, and the BATFE gets disbanded, and all the Form 4 items become nothing more than an ordinary 4473 item, because range-time is good for the blood-pressure.
Hey, I said I was an optimist… And I’m usually wrong when I make predictions, particularly about the future. *shrug* Doesn’t mean I can’t dream.