The Affordable Care Act, or "Obamacare" as many people call it. It's a flawed law meant to put true healthcare reform in play. But the dysfunction of both political parties has locked in this law's provisions, the worst of them requiring people to buy unsubsidized insurance because their states didn't accept the medicaid expansion to cover these people.
One of the problems insurers have in America is that there is no price control on prescription drugs. The largest buyer of these drugs is Medicare, and yet, the federal government prohibits Medicare and Medicaid from negotiating prices for drugs. As a result, we have the highest costs for healthcare in the world. No wonder why many insurers are bailing out of the Obamacare health insurance markets.
Another problem is the inability to force the states to expand Medicaid, even with a 90% Federal government subsidy for those costs. Without nationwide participation, a law like this will fail, as people will blame the law for their problems and not the law makers who won't tweak the law to make it work for all. One might argue that this part of the law was a failure from the start. But in any law this complex, the drafters were likely to make errors. If we looked at law as we do for computer systems, we accept the fact that there will be computer bugs, and that they will be fixed. Why are many people condemning a law, when they should be condemning congress for not doing anything important in this area for generations, and then not fixing mistakes when they do something?
To me, an understated problem is the inability of insurers to get young adults to sign up for the higher levels of healthcare. The ACA depends on a large number of young workers (who are in good health) to pay into the insurance plans, so that older, less healthy, people can buy affordable insurance. Obamacare is a health care transfer from the young to the old, in the same way as Social Security is an income transfer program from the young to the old. In both cases, it only makes sense. In traditional societies, the young take care of the old. In an age of the sub-nuclear family, government mandated wealth and health transfers from young to the old make sense. Most people can no longer depend on their extended families for help.
There were many lies used to sell the public on the need for this law. This is not uncommon with politicians. FDR lied about keeping America neutral before WW2, even with the obvious signs that we could not avoid getting involved with this worldwide conflict. And yet, people accept the story given by their political tribes, instead of seeing the reality behind the scenes of the kabuki theater of politics.
Obamacare needs fixing. There are not enough insurers willing to participate in markets where they can't make money. There are not enough people covered by this law. There are not enough choices available to people in need. But let's not throw the baby out with the bathwater. If we get rid of Obamacare, we will return to a worse system than we have now. The only question is: Do we provide a "Public Option" or not? If there is a public option, the average person will likely pay roughly the same rate as state employees do for their insurance plans. (I use COBRA rates for my analysis.) Without a public option, people will go uninsured.
Are we heading towards single payer healthcare? Maybe. But if private industry wants to keep making profits, it will have to find a way of fixing a system that was broken way before the ACA was enacted, and will need to find a way to do it within the spirit of the ACA.
As the title of this entry says - You can't make this shit up! We have an admiral in charge of US Navy intelligence who has not been able to see military secrets for years. Politics and institutional inertia has made it impossible to replace someone in his position, as a replacement must be confirmed by the Senate ....And the GOP isn't approving any of Obama's nominees these days.
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I'm a person who says that the larger the organization, the more inefficient it becomes. There are positions that must be filled - not because the person does that much real work, but is there to be nominally in charge of things. In short, this position is the interface between the political side of the organization and the side that is responsible for the day to day operation of the organization.
In the case of the Admiral mentioned in the article, he is under suspicion because of a corruption investigation involving a foreign defense contractor and Navy personnel. The Navy had to suspend his access to classified material, but no one would expect that he wouldn't be cleared or indicted over two years later. So the Navy has had to have a Kafkaesque situation of having this man perform the administrative responsibilities of his job, but have subordinates and colleagues perform ALL the tasks requiring classified information.
Given that we have deadlock between the Executive and Legislative branches of government, there is virtually no chance that we could get a replacement nominated by the President and approved by the Senate in today's toxic environment. So, we have a situation where politics is getting in the way of the Navy doing its job in keeping this country safe.
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What could we do to prevent situations like this from happening? First, we could have a process developed where certain backup personnel would already be nominated and approved in advance to take over these responsibility while the person nominally in charge is indisposed. We already have a constitutional amendment which provides for the temporary disability of a president, and who is in power and able to act when he or she is unable to perform his or her duties. Why not do the same thing for many of these critical positions?
This doesn't address the underlying problem - Political Gridlock. We are electing leaders in the Executive and Legislative branches who check and balance each others' actions. We are afraid of either party doing anything, so we do not let them do anything. Neither political party is trustworthy. The success of Bernie Sanders and Donald Trump in the 2016 POTUS election cycle is a reflection of the public's disgust for the two political parties who promise the world to their bases, but do not deliver anything - except to the plutocrats who fund their political campaigns.
How can we change this situation? To me, people have to stop "drinking the toxic Kool-Aid." When Ted Cruz's father, Raphael, says that Obamacare is a plot to bring ISIS terrorists over to the US as Doctors, why aren't the GOP loyalists shouting this lunatic down? (One could have had many of the same criticisms of leftist extremists, but they have been mostly muted and ignored by the press during this election cycle.) That's because the political elite in the party no longer have much power to keep things in line. They gave a seat at the table to extremists, and the extremists have since been allowed to bully everyone into submission.
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We have to stop giving the Wingnuts power, and force both political parties to again represent the center. When only one party represents the political center, we run a major risk that our political system will fail totally. It happened in Central Europe in the 1930's. Can we risk having it happen here?
