All Will Be Revealed in Vermont, Postscript on ACA Tea Party

I'm in a tempest in Vermont, very high stakes.  But information is coming out of Montpelier so slowly that it would be a mistake to come to conclusions too early.   Until 10 days ago I thought my company had been underbid... we waited though to see the contract.   Our bid was lower and our qualification score higher.

In court tomorrow.

But my mind is still idling, so let me say a couple of things about ACA, the Affordable Care Act, monikered "Obamacare".

"Half of the population spends little or nothing on health care, while 5 percent of the population spends almost half of the total amount.2 In 2002, the 5 percent of the U.S. community (civilian noninstitutionalized) population that spent the most on health care accounted for 49 percent of overall U.S. health care spending (Chart 1, 40 KB). Among this group, annual medical expenses (exclusive of health insurance premiums) equaled or exceeded $11,487 per person."  Mark W. Stanton, M.A. www.ahrq.gov

In other words, the USA already ate 90% of the public health care apple with Medicare and Medicaid.  The ACA will neither do much for the young (a small percentage of whom need care) nor for costs (we keep doing major intervention on elderly).  Public health care works in Europe because the average person there realizes something most Americans haven't come to grips with.  We are all gonna die some day.   I have had to watch 3 of my 4 grandparents basically be tortured to death with extended care.



I'm totally against the shutdown.   In part because the ACA is the tail on the health care dog, its merits and its downsides have been hyperbolized by both sides.  Obamacare is about getting healthy people into the pool because the old people cannot afford the surgery being administered them and they pass away without being able to pay the bills.  That's a more truthful explanation of why a procedure in Utah costs so much than one in Europe. It's not so much the cost of emergency room treatment of 29 year olds, it's the heart bypass surgery on the 90 year olds.

So neither is Obamacare as big a disaster as claimed, nor does our society's execution of veterans care or medicare give us much reason to support it enthusiastically.

We are not dealing with the unintended consequences of elderly care, and the percentage of health care dollars force-fed to us in the last years of our lives.   In that way, it's not a funding crisis, it's a spiritual crisis.

The "government shutdown" is being driven by bumper-sticker, meme-osophy, and tweet-thought.

"Tea Party" is the same as any new moniker picked up by the press (environmental watchdogs is another).  The idea is great but once a moniker is assigned, it's like a new line opening at TSA, everyone runs to get in the short line and you wind up with idiots like Ted Cruz.  As a lifelong and current environmental professional, I know what's happening in the tea party, they got their dunces in front of microphones and are afraid to step outside the groupthink because they fear dialectic and debate will be mistaken for weakness.  There are dumb environmentalists picking wrong battles, wrong health care advocates, wrong tea party boosters.   The ACA debate is best done in paragraphs, not bumper stickers and FB memes.  We are in an oversimplification decade, and that suits the weakest links in Congress just fine, thank us.