Monday, October 28, 2013

My Problem with the Affordable Care Act

I have lots of issues with the Affordable Care Act (aka ObamaCare), the least of which is it is called 'ObamaCare'.  For the Republican's who want to rid themselves so badly of President Obama, they sure have found a way to tag him with his 'signature domestic piece of legislation' that will live long after he is out of office and on the speaker's circuit.  See I am already off topic...

My main problem is how each side is packaging their product or hate for the product.  The White House's twitter feed is spewing out ACA facts trying to sell us on the many benefits of the act. 


This sounds wonderful.  I am all for women's health and for them staying healthy.  Go get your who-ha checked, complete with a pap test and tack on some birth control annually, please!  While you are there save that ta-tas and get them squeezed with a picture.  But lets not act like these are free.  They are not.  Lets not act like the insurance company is giving them to you for free.  They are not.

Let's be clear: No Business Stays In Business Giving Away Free Services.  Put another way, the economic principle of 'there is no such thing as a free lunch' (TINSTAFL) applies.  Someone has to pay for it.  Someone has to pay the front desk lady who checked you in, the nurse aide who weighted you, the nurse who prepped you, the doctor who saw you, the lab technician who analyzed the pap, the courier who ferried it to and fro, the front office lady who opened the mail with the results, scanned it and filed it, and the office manager to supervise all of this.  Someone has to pay the electric bill to run the machine, the office rent to the lease holder, the debt payment on the machine, and all the supplies and drapes used along the way.  And then, somewhere all of the in between people, and yes the doctor, has to make a profit.

We can argue all day what that profit should or shouldn't be, but the reality is that these people work for profit.  The ugly middle man of all of this is the insurance company.  We can hate them all we want, but the reality is we really do want them.  We want Blue Cross Blue Shield putting us and their other 99 million members together (wiki article here) and power negotiating our cost down with the providers.  (for the record: a study recently concluded insurers only make about 2.2% profit, while the pharmaceutical companies and medical device companies were raking in 20% profits)  We actually need them in this debate to be the balance to a highly dysfunctional three legged stool of patients, providers and insurance companies.

The ACA, at its core, is not a bad piece of legislation.  It aims "to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of healthcare for individuals and the government".  It attempts to make health insurance, and by the health care, accessible and affordable across a broader spectrum of our populace.  It attempts to solve huge issues with the current methods deployed by health insurance companies and thereby eliminate many of the major hurdles found by many in lower income brackets.

However, in my opinion, it is trying to solve our health care problem by not attacking the problem.  The act is 381,871 words long.  The result regulations, or rules, on how to implement the act is 11,588,500 words (as of 10/14/13).  As printed by the Government Printing Office, the law is 906 pages long.  That is a lot of words that fail to attack the true issue, in my mind.

What's the problem you ask?  The lack of transparency across the system that allows the free market system to really work.  In my town there are two major hospitals, several critical care and specialty hospitals, and dozens of walk-in clinics.  I have simply no ability to determine if I want to pay the specialty hospital or the county hospital to do my heart bypass.  I can't get that information.

Several times (even now) over the last two years my wife has had simple outpatient procedures.  I literally have to wait for a full month to get the picture of what that procedure cost me.  I have no way to know that upfront to plan or decide if I want to do this procedure now.  I need the doctor, the hospital, the anesthesiologist, the lab, and any other one off bills to come in to understand what the procedure cost.  Did I get a good deal?  Should I have gone to the other hospital?  I can't answer that.  That data simply isn't there, and the hospitals, providers, and ancillary business don't want you to have it.  They make their markup on our ignorance and controlling all pieces of the non-transparent pie.

And frankly, it angers me.  So I say to republicans: You want to rid yourself of 'ObamaCare', fix the real problem and I will vote for the your guy to go and repeal it.  I say to democrats: You want 'ACA' to be the paramount social program of the 'teens', then get on board with a real fix to the system, not a 900+ page patch.

Now off to pay medical bills...seriously...that is next on my to do list.

Sunday, October 13, 2013

a "Living on Wheels" update

I was going through our blog and realized that it is silent about a huge purchase of ours...our own fifth wheel RV!  After extensive looking, reviewing, shopping, looking, reviewing, taking notes (get the picture?) Holly and I special ordered a 35 foot Open Range Light 305BHS.  We love our RV.  It has three bunks in the back, an outdoor kitchen, and it is large enough not to be stepping on each other when the mountain rains run us inside.  We took delivery of it in early July 2012 from Pharr RVs in Lubbock.  If you are in the market, look us up.  We will hook you up with a great salesman!

Anyway...so let's catch up on our trips thus far:

1. The "Getting Acquainted" trip: July 13-15, 2012: Brantley Lake State Park; Carlsbad, NM

2. The "Mountain Getaway" trip: July 27-August 4, 2012: San Juan National Forest; Pagosa Springs, CO

3. The "First Solo Trip": October 5-7, 2012: Palo Duro Canyon State Park;Canyon, TX

4. The "Sand Camping" trip: May 24-26, 2013: Monahans Sandhills State Park; Monahans, TX

5. The "Cave" trip: June 14-16, 2013: Carlsbad KOA; Carlsbad, TX (visited Carlsbad Caverns NP)

6. The "Annual Jack Family and Friends Mountain Trip": August 2-10, 2013; San Juan National Forest; Pagosa Springs, CO

7. The "Zay's Birthday and Hotter than Heck" trip: August 30-September 2, 2013;  Palo Duro Canyon State Park;Canyon, TX

8. The "Scrub Brush Camping" trip: October 10-13, 2013; Lake Colorado City State Park, Colorado City, TX

So that catches you up!

Man, we are already making some great memories and learning a lot about this side of the state and eastern New Mexico.  I know everyone says our boys' schedules will keeps us from really using our camper, but I am hoping not.  This time away, even if just to sit around and laugh while they learn to ride bikes, is so refreshing.

Anyone want to go on a weekend trip?  We will meet you there!



 (Better Photos to Come)

Friday, October 04, 2013

Tap...Tap..Tap...This Thing On?

I said I was going to post more, and I haven't.  So very sad.  Before I start again I was wondering if anyone was even still listening.  Anyone here?