Monday, February 11, 2013

Obamacare: A House of Cards on Wheels
Thou shalt not mix one’s metaphors.
Cardinal Rule of Writing
February 11, 2013 -  Obamacare critics are mixing their metaphors.
·         In yesterday’s New York Post, Betsy McCaughey, former lieutenant governor of New York and author of Beating Obamacare,  claimed the wheels are coming off of the health reform law (“Wheels Are Coming Off” ). McCaughey says Obamacare  will cost more, will  provide fewer benefits, and will cover fewer than promised. The IRS estimates by 2016 the cheapest family plan will run $20,000 and will  cover only 60% of medical bills.   The CBO projects 8 million fewer people will be covered by 2016 and 12 million by 2019.   By 2020,  more than 40 million will remain uninsured.  In McCaughey's Humpty Dumpty  scenario, the formerly insured will become uninsured, while the previously uninsured will become insured.  The question will be: can  all the President’s men and all the President’s horses  put Humpty Dumpty together again.

·         John Goodman, who dubs himself “Father of Health Savings Accounts", asserts in his Health Alert Blog today, that Obamacare is nothing but a deck  of cards,  as played in the game of "52 Pickup", The reform cards are  being thrown into the air to see who picks up what cards. Goodman says the cards in the deck  include cards introduced by FSAs (Flexible Savings Accounts), MSAs (Medical Savings Accounts ),  Health Reimbursement Arrangements), and HSAs (Health Savings Accounts). These new cards have introduced  another set of cards, the Banks, which offer other cards (credit, debt, and discount),  which pay benefits to doctors, hospitals, other health care professionals, which in turn bring in other cards – wellness clinics, retail clinics, cash-only  and concierge practices, and which revolve around the whole idea of defined contributions and private exchanges, all of which add to the “Which Hunt” for a better system.

Mixing these metaphors is enough to confuse and  boggle the mind, shuffle and scramble the cards, and create and offer  new deals on wheels.  Winners will be those who can best shuffle and rearrange the cards.  Health reform may turn out to be a House of Cards.   \

I’m reminded of the advice given by a little old lady to Nelson Algren (1909-1981), an American novelist.   If I may paraphrase this advice , “Never play cards with aanyone called ‘Doc.’  Never eat at a place called ‘Medicare.’ And never sleep with anyone whose troubles are worse than yours.”

The name of the new game is: Which card do I play?


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