Tuesday, August 20, 2013

Obamacare: The Hodgepodge and Ripple Effect
A heterogeneous mixture, jumble.
Definition,  Hodgepodge

A gradually spreading influence.
Definition, Ripple Effect

Obamacare has been called a lot of things – a morass, a maze, a smorgasbord, fiendishly complicated, a monstrosity,  a train wreck, a signature political achievement, the path to single-payer.
Designating it as “hodgepodge” is new (Tom Wilemon, “Paying for Obamacare: Some Feel Singled Out: The Affordable Care Act Generates Revenue Through a Hodgepodge of New Taxes , Financial Penalties , and IRS Rule Changes,” The Tennessean, August 18, 2013)
Hodgepodge is an alteration of Middle English hochpod, from the Old French hotchpot, a stew.  
A “ stew, ” of course, is a mixture.  Obamacare is definitely a mixed collection of different ingredients.  
As Jonathon Oberlander, a health analyst at the University of North Carolina, explained,
“The law is not a single program. It is a collection of mandates,  public insurance expansions, and regulations that affect different groups of Americans in different ways at different times.” ( Jonathon Oberlander, “The Future of Health Reform,” New England Journal of Medicine, December 9, 2010).
Obamacare is a mixed collection of reforms  that will  have a ripple effect.  As Obamacare  spreads,  it will  affect every American personally. It  will send ripples  throughout  the healthcare and general economy.  It will  hit medical device makers with excise taxes on profits,  high income individuals and families with $400 billion of new taxes,   young people with higher premiums,  businesses with penalties for not insuring workers,  and doctors and other health professionals with a paperwork blizzard of  2000 pages of  new regulations. It will, on the other hand, provide new  benefits to 30 million Americans.
In his book Obamacare Survival Guide,  journalist Nick J. Tate says Obamacare contains good news and bad news for Medicare recipients, individuals with employer-based insurance,  individuals with private health insurance, the uninsured, Medicaid recipients, and health professionals.  The big winners will be the uninsured, those with pre-existing conditions, and young adults under 26 covered under their parent’s plans. The big losers will be Medicare recipients,  small businesses,  health care innovators,  physicians,  unions,  and individuals and small group members  who will pay higher health care premiums.
When talking of Obamacare and its implementation, critics are fond of telling the story of boiling a frog as a metaphor.    If you drop a frog into boiling water, it will frantically clamor to jump out of the pot.    But if you place the frog in tepid water and turn the heat on low, say for 4 years as is the case of Obamacare, it  will tranquilly float in the water  and will allow itself to suffer a slow death, to stew in  its own juice until  government takes over.  That, at least, was the theory before Obamacare remained unpopular.  Obama supporters will counter by saying, “ It’s about time we had a government-run system, just like other advanced societies.”
Maybe so,  but it will take a every bit of the $684 million devoted to themarketing effort to sell Obamacare to the “young invincibles” for services they do not think they need and do not think they can afford to pay, given their low incomes and rate of uenployment.
But make no mistake about it. If Obamacare is carried out as planned over a ten year span,  it will transform American society by making it more  dependent on government.  It will entail  a massive government overhaul  that will affect us all:  the insured, the uninsured, senior citizens, taxpayers, the affluent, working families, the poor, the unemployed, children under 18, young adults 18 -29, illegal aliens, large and small businesses, unions, doctors,  health care professionals, nursing homes, insurance  companies, and drug companies.  
Because of its vast scope and its gradual introduction over a ten year period, Obamacare will spread into every corner of American society with a  mixture of consequences including  hidden taxes, penalties, and fees,  access for care and protections for the uninsured , and rising costs for the rest of us.  It may be worth it.   That is up to voters to decide.  Once implemented, however, the Obamacare hodgepodge  will be hard to dislodge.
Tweet:   Obamacare is a ten year hodgepodge of mandates, public insurance expansions, and government regulations that will affect every American.

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