The Road Most Traveled By.....

"By three lessons we may learn wisdom: First, by reflection, which is noblest; Second, by imitation, which is easiest; and third by experience, which is bitterest."Confucius

I'm not crazy about the term "Obamacare"... Partly because it's derogatory, and partly because nobody named Obama had anything to do with the plan's design... The President merely recognized the issues, saw government as the solution, wanted healthcare reform on his list of achievements, and seized an opportunity...

At the risk of being labeled fatuous (it happens, regularly on this topic) by those more informed, I'll herein offer my critique... And yes, today I'm the griper who offers no 'acceptable' solution... That said, I'd rather confess my ignorance when it comes to our health care challenges, than suggest government would be the solution..

Even someone as far-removed from health care finance - from the understanding of the challenges of balancing services and reimbursement - as myself (as a good friend, kindly and accurately, reminded me recently) can speak to the importance of addressing, first and foremost, philosophically, any undertaking that would reach deep into the very fabric of everyday life...

(Before we move on; make note of that point; the consumer of health care services is "far-removed from health care finance"... That, by itself, I suspect, is a large part of the problem...)

I know, you're thinking the time for philosophizing has passed; that we need expedience! That we need to meet this monster head-on and contain it! And believe me, being a business-owner myself, oh how I can relate... But, alas, we humans tend to follow the road most traveled, the path less resisted, and that my friends makes all the difference (and that is why our nation is $16 trillion in debt)... We must know thyselves, we must know from whence we came, and proceed in a manner consistent with the philosophy that made this very young country the very greatest on earth!

"I have never known much good done by those who affected to trade for the public good."Smith

I believe the fundamental problems stem from the view that this is "our healthcare system". Operative words being "our" and "system". "Our" as in "ours collectively" - i.e., we are to somehow accommodate for each other's health care needs... And "system", as in a source of systemic risk - something to manage, something to protect the public against...

In terms of "our"; would you agree that as we attempt to handle more things collectively - as government extends its reach - that the things we might do well, well, we're not doing so well? I won't name all the government agencies that, if held to private-sector standards, would be failing... Or should I say, I won't name all the government agencies?

As for viewing it as a "system"; that view, in and of itself, is fine - and, by definition, accurate... However "our" problem lies in our seeing it as a system to be managed by government, like say "our" educational system... As opposed to a free market system...

A managed system would be governed top-down by some planning or controlling group, generally consisting of well-intended individuals and those intent on exploiting well-intended individuals... While a free market system, having no controlling body, comes together as a result of individuals acting, not in the interest of the greater good, but in their own separate interest... Which, unlike any managed or "social" system, inspires quality, frugality, efficiency and integrity...

The Affordable Care Act is beautiful, utopian even, on the surface: Everyone is covered (the "richest nation" loses a stigma), no preexisting condition denied, men and women are treated like children to the age of 26, seniors pay less for drugs, insurance companies compete within the strictest of boundaries for your business, etc.... Forgive me, but I must ask that oft-asked question; who pays for it? The young healthy members of the group who currently opt for no coverage (not an option after 1/1/14)? Government (that would be all taxpayers)? Do we truly know what we're getting ourselves into?

Here's one of our politicians, a proponent, from a CNBC interview two weeks ago:

"Many parts of this plan are very popular: Not having insurance companies able to preclude you from getting insurance because of preexisting conditions - everybody that I've talked to thinks that's a good thing... Having the ability for young people able to stay on their parents policy up to the age of 26 is a very popular policy... Bringing down the cost of senior's prescription drugs which has already been effected and will be phased out over the next 8 years so they'll be more available to seniors is a very popular provision... So many of the parts of this bill are very popular with the public..."

You mean no preexisting preclusions, "kids" eight years into adulthood still on their parents' plans, lower cost meds for seniors "are very popular with the public"? Ya think? I imagine Social Security was very popular with the public back when politicians promised voters their basic retirement needs would be met through a nationwide spreading of the cost...

When we consider the road we're traveling, when we consider the efficacy of present government-run programs, regardless of your role in the balancing act of our current system, do you truly, in your heart of hearts, believe government can ultimately make it better?

What do you suppose would happen if we went entirely in the opposite direction, if we took the road less traveled by? What would happen if providers had the right to refuse service to anyone? Would we allow the uninsured to die in the street? Or would caring people of means provide the basics? What does our history tell us?

What would happen if insurance companies could refuse to cover anyone for any reason, charge what they wish, and drop anyone on a whim? Do they need government-imposed restrictions, or would they learn to profit in a world where they'd compete based on service, price and benefit payment history? What if, for once, we truly lived the free market philosophy? Dare we?Fear not my good central planners, for, alas, it will not come to pass...

Now as you reflect - as you yourself philosophize over "our" conundrum - before entertaining the notion proffered by ACA proponents - that "our" healthcare crisis is an example of a market failure - understand that that's literally impossible... The healthcare "system" has been rife with government intrusion for a very long time...

Read the following from a study published April 2006 by Georgetown University's Health Policy Institute:

"The federal government has historically respected the state