Watch Where You Step

Friday, June 21, 2013

I admit that I was a bit confused. The key employee of a local not-for-profit was about to give us the “30 Thousand Foot View” on a particular issue. My confusion? I had always thought that it was easier to find bullshit in a cow pasture. Our guy proved me wrong.

I was reminded of our captain of the shovel brigade Wednesday afternoon when I had the opportunity to take part in a special government sponsored online seminar on the Patient Protection and Affordable Care Act (PPACA). The facilitator promised a High Level Overview of the new law. What we got was a cheerleader who attempted to substitute PowerPoint for back flips and the ubiquitous can-can line. If one-sided hyperbole is your favorite way to spend an hour, you would have been in heaven.

Though this briefing was by invitation, only, there were no requests to keep the contents secret. Reporters were supposedly on the line. We were even provided a link to the presentation. I would include it, but It Doesn’t Work!

I knew we were in for an informative webinar when the first slides told us why we had to have the PPACA. “Insurance companies could take advantage of you and turn away 129 million Americans with preexisting conditions”. We learned that the law was built on everything that worked in our system and fixed everything that didn’t. I turned away for a moment, but I’m sure that one of the bullet points was that the President and the PPACA guaranteed that the sun would forever rise in the east and set in the west.

The twenty-eight page presentation covered little substantive ground. The slides extolled the virtues of the yet to be created exchanges and the new heroes of healthcare, the Navigators. Our facilitator mentioned a new class of participants, Certified Application Counselors, but her screen presentation failed to note or define them.

For someone who has spent almost 34 years in the business, it was an hour of total frustration. How do you unlearn what you know to be true? Can you pretend that up is down or that black is white?

I didn’t have time to dwell on the seminar. Dinner Wednesday night was to be downtown with friends. Flipping through the stations as I was driving on I 90 into town, I happened on to Neil Cavuto on FOX. He was interviewing Dr. Ben Carson, a noted pediatric surgeon from Johns Hopkins and a FOX favorite.

Dr. Carson is a really, really smart guy. And if I was looking for a surgeon to separate conjoined twins, he would be at the top of my list. But his political rants aren’t in that same class. I’ve included the link. While his voice went high and shaky, his argument sunk to the level of your average FOX talking head. The segment ended with Cavuto and Carson delivering what they hoped to be the fatal dagger to the heart of the PPACA – IRS involvement.


There is no reason to expect more than this from FOX, but we need more from someone. We are months from the real start of the PPACA, the opening of the exchanges, and the wholesale upheaval of our current payment system. Businesses have already spent millions of dollars in an effort to be in compliance with regulations that are still being drafted and changed. Neither one-sided cheerleading sessions nor silly rants will help us efficiently pay for the medical services of over 300 million Americans.

There is still time to modify the Patient Protection and Affordable Care Act to make it more effective. All we need is a Congress more interested in fixing problems than scoring political points. We don’t need more grandstanding. We need action. But I’m not holding my breath. I am, however, watching where I step.   DAVE