Sunday, August 25, 2013

Obamacare and Health Exchanges: Four PowerPoints of View
The choice of a point of view is the initial act of a culture.
Jose Ortega y Gasset (1883-1955), The Modern Theme
PowerPoint presentations,  a Microsoft innovation introduced in 1990, have  had an outsized cultural impact among speakers and audiences.   PowerPoint is easy to load on a computer,  gives an immediate structural outline to a talk, and saves a lot of time presenting and summarizing concepts. You can rarely attend  any conference or hear any speech without watching  PowerPoint in action.
Powerpoint is not without critics, who have called its overuse  “Death by PowerPoint,”  “BulletPoint Poisoning,” “PowerPoint Rangers,” “SlidePoint Abuse,”  and “PowerPoint Hell.”   Pentagon officials have forbidden its use and insist upon oral presentations without use of slides.
Nevertheless, PowerPoint is useful for quickly and cogently presenting one’s point of view.
Here, I shall use a print form of Powerpoint, with bullet points to present four points of view health exchanges,  the lynchpin of Obamacare’s implementation strategy.   These points of view appeared in today’s New York Times under the title of “Sunday Dialoague: Blocking Heath Reform,  readers discuss Republican efforts to  undercut Obamacare.
How Health Exchanges Improve Health Insurance, Jon Kingsdale, managing director of the Wakely Consulting Group, who helped establish health exchanges in Massachusetts

·        " First, they will provide individual consumers something new: one-stop shopping with a side-by-side comparison of health plans. By standardizing coverage, patient cost-sharing, pricing, quality and service metrics, exchanges make informed choice of health plans easy. "
·         "Second, they will steer competition in socially beneficial directions. By empowering price-sensitive shoppers with information, they will put pressure on premiums. This can be further enhanced by the exchange’s own effort, à la Walmart, to press health plans to improve price, quality and service in return for “shelf space” — that is, access to the stores’ customers."
Why Health Exchanges Will Get Off to a Rocky Start,  James G. Russell, Alexandria, Virginia,  affiliation not known
·         "First, the Affordable Care Act was passed during a brief period of Democratic supremacy over almost universal Republican opposition. Republicans have no interest in the success of what they call Obamacare. They control many of the levers of government and can do much to impede the health law"
·         "Second, this complex law relies on persuading young people to take the positive step to buy insurance that has been heavily overpriced for them in order to underprice insurance for older people. The stick to encourage them to sign up is a trivial fine starting at $95. These are the same young people who are already burdened by Social Security and Medicare taxes to finance benefits for their elders that they do not expect to receive equally in their old age, and who often feel that health insurance is an unaffordable luxury."
There you have it – four bullet point  but necessarily bullet proof reasons health exchanges might improve choice of health plans and might encounter stormy weather.

Tweet:   The reasons for success or failure of Obamacare health exchanges are here reduced to four bullet points based on one’s political culture.

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