The Health Reform Endgame

1.      The final stages of an extended negotiated process or action.

2.      The final stages of a chess game in which most of the pieces have been removed.

Definition, Endgame or End Game

What is the ObamaCare endgame?

Is it single payer?   Was the intent all along to set up a program that was doomed to fail and the only remaining alternative was a government-run single payer system offering universal coverage?    

That’s too cynical for me.

Is it a utopian - state in which every everybody is equal but some – the government elite and their cronies – are more equal than others, in which income inequality no longer exists, in which everybody receives the same health care benefits, in which wealth and health are redistributed.?    

That’s simply unrealistic in America.

It is Medicaid for all,  Medicaid on steroids, in which the federal government sets the standards, lowers the level of quality, discourages innovation, rations services, dictate what health care providers can do.   

That will never sell in America, and the Supreme Court has already ruled states can opt out of the Medicaid system and run their own shows.

Is it waiting for the Patient Protection and Affordable Care Act, which neither protects middle-class patients from having plans cancelled, keeping their doctors and health plans,  lowering  costs, nor making  care affordable for most Americans, to collapse because of its unaffordality and unworkability? 

That’s a possibility.

Is it reasonable to chip away at the existing health law, changing it, delaying it, defunding it, suggesting alternatives, even repealing it in the end, just because the uninsured oppose it by s 2:1 margin and the American people oppose it by a 3:2 majority?   

That would make sense in a country in which the majority supposedly rule, but do ntot hold sway when one party representing the minority controls the Presidency and the Senate.

Answers to these questions will continue to bewitch, bother, and bewilder the American people until they are answered.  

The health reform endgame is not yet in sight.  It may await further Supreme Court rulings defining Presidential and Congressional limits and powers.

Tweet:  The endgame defining where health reform may end may depend on Supreme Court rulings clarifying executive and Congressional limits of power.