Federal Government Shutdown

[Airyaman]

I wish I had a solution, if I did then you'd see me on TV! But the PPACA is so huge that we won't know how good or bad it is until we see parts of it roll out.

I simply don't like the idea of forcing people to buy health care coverage, and I really don't care if it was an idea stolen from republicans or Massachusetts.

But why? Do you think you will never, ever need it? No one can guarantee that. Do you object to being made to carry auto insurance, too? What's the difference?

Most states (if not all) only force people to carry liability auto insurance, you'd have more of a case if they were also forced to carry comprehensive/collision. The reasoning though is simple: your auto insurance covers the other people's property that you damage.

Health insurance is different. You carry it for yourself. Your health insurance will not cover my medical bills if you hurt me in some way.

As to ever needing it, sure I will. I'm all for catastrophic coverage, but this idea of forcing people to buy coverage that covers birth control pills when I am a 46 year old male is ludicrous. I personally believe that most health care transactions should work like every other transaction between two parties. It is much harder with what we have in place now, but these types of efforts make much more sense, imo.

I also don't like that the administration has made changes to the law by executive order, and think he should be taken to SCOTUS over some of those orders to see if he has the power to actually do some of the things he has.

If you were as knowledgeable about the legislation from the employer side as I am (not by choice, but by reason of my work), this would make total sense to you. Health care in this country as it has evolved is a massive, Gordian knot. Are you familiar with Health FSAs, HSAs, HDHPs and HRAs? I am. Most everyone in this country uses one or more of those. There is preferred tax treatment involved in the use of each. How does the PPACA interact with all those programs? What about employees who elect to go outside of their group health plans and instead sign up for coverage offered through the PPACA? Should they still enjoy tax-favored treatment for the premiums they pay? If yes, how? Through which mechanism? What if the employees elect differing coverage through the Exchange? Does the employer pay the providers directly, or does the individual employee? How many full time employees did you have in your last calendar year? How do we define a "full-time" employee? Do we count those who terminated, or only those who are presently still employed with the company? How do we determine whether our current group health plan is "affordable," as defined by the PPACA?

Do you begin to appreciate the complexity of how the PPACA will interact with the health care system as it currently exists for employers? This is NOT a problem created by the PPACA. It's a problem created by the fact that the PPACA must be made to work with what we already have -- which is a pretty big mess.

On the employee side, it's simple: Enroll in something, whether company sponsored or otherwise, or pay a fine.

That's why Obama made an executive decision to delay fining employers for a year. And trust me; if there is a way for that to be brought before the SCOTUS to determine if he was outside his authority, it will.

Quite a bit there that I have no clue about, and I'll honestly admit that. Gives me something to mull over.

In the end though, I believe the PPACA is the result of lazy ass politicians who push problems down the road until someone takes extreme action. Its the same way with the debt, immigration, etc.

I don't think you have any authority for such an assertion beyond how you "feel" about it. I think the PPACA was an Herculean effort, successful against leviathan, well-monied corporate interests exerting massive lobbying efforts, and about as thoughtful a program as could be mustered given the enormous complexities built within the existing system. Are there ways it can improve? Oh, yes. Many. Those will shake out as it goes forward. They're shaking out now, as they work the kinks out of their websites (overwhelmed because of SO MUCH interest), and in the guidance we as workers in the health care industry are receiving.

Your use of the word "think" is really no different from my use of the word "believe". Neither of us presently have any real evidence that the PPACA will fail or be a success. However, government track record is not on the side of "success", so I work with history to help predict future.

Congress simply does not do its job until they are forced to, yet we keep voting the same dumb asses back in because none of us want their jobs, and only clowns run for political office now.

Again, I think this is something you feel is true without any real authority for your position. I can't speak for your Congress critter, but whenever I interact with mine, I see a man who works so hard it makes me tired to watch him. I could not endure the constant stupidity and ignorance he must face among his constituency every single day, but he does it tirelessly, with class and equanimity. The clown in the room when he is holding a meeting is not him. And yes, I will keep voting him in to do the job I feel he is doing so well -- far better than I ever could.

My real authority is performance and results. Those support my views, and I think you know that. Have you not wondered why congress approval rating is less than 10%? Because they don't get anything real done.

It really is a fucked up mess, but its that way because most of us allowed it to get there. I say "us" to include myself.

On this, we utterly agree.

I knew we could see eye-to-eye on something.