Saturday, November 30, 2013

If It Ain't Broke, Don't Fix It

I spent a part of my Thanksgiving in a conversation with my daughter discussing the steps involved with repairing a leaky toilet in their home.  (What, this isn't the normal holiday conversation you have with your kids?  Really?)  Now that you're riveted to your seats by what's about to come next .... 

 (12/5/13:  An updated version of this effort was just posted to the TFP Website.)

I could do this because I was fortunate enough to have a father who while I was growing up (OK, growing older) was able to instruct me in the basic 'Harry the handyman' skills involved with maintaining a homeIn fact, he went on to instruct me in an apprenticeship program that he had taught at R R Donnelley and Sons that included basic mechanical, electrical, and hydraulic / pneumatic principles when I began my career in the printing industry.  One of the first things he stressed in those lessons was that since maintaining any complex system would be difficult enough for even the most conscientious maintenance staff: 'if it ain't broke, don't fix it'.  This is apparently something that the Congress and the President either never learned, or forgot about when creating the 'Patient Protection and Affordable Care Act' or 'ACA'.  
Oh I know that politicians often like to simplify subjects that they either don't understand themselves or don't think that 'the voters' will, in order to sell us something (usually a bill of goods); but the simple truth of the matter is that when all of this began, the US had a level of health care that was the envy of the world. That's why other world leaders and that pesky '1%' with the cash often came to this country for treatment of their ailments. This is not to say that there weren't things that needed improvement, but most of that seemed to be greater "access" to this wonderful system through minor modifications of health insurance coverage.

While even those who had no insurance or couldn't pay had access to some level of medical care, they needed more. Those with pre-existing medical conditions also needed the ability to obtain or retain insurance (especially when changing jobs). Doctors needed tort reform to reduce the amount of defensive (and expensive) medical procedures being performed for no better reason than to protect themselves from frivolous malpractice lawsuits, without removing the patient's right to seek redress from poor practitioners. Patients and doctors alike needed protection from the crony-capitalism in an insurance industry riddled with restrictive choices mandated by individual state insurance regulators.

In its normal ham-fisted approach to almost every issue however, our federal legislators chose a 'throw the baby out with the bath water' approach, without considering the ramifications of another 'never-ending gobstopper omnibus' effort, as well as the laws of unintended consequences. Far too concerned about winning points for their respective parties that they could store up like nuts for the next election (like there aren't enough nuts around in every election), our legislators allowed themselves to be caught up in the momentum of a 'sweeping reform' which only seem to clean out sound judgment, and good law. Sadly now, the nation is left with a result that even many of those who originally voted for it are less than pleased with.

This is not to say that the ACA doesn't positively address some of the issues that it intended to. Those with pre-existing conditions now have the access to insurance that they deserve. Unfortunately, this came with the cost that far too many of those who had pre-existing insurance plans lost them. Many who needed access to health insurance will finally get it, but in spite of all the back-slapping after its passage, 30 million will remain without it. Instead of freeing up the insurance market between states to make it cheaper, the ACA instead further restricted it to four 'government-approved' plans that make it even more expensive (and, contrary to the law's title, less affordable). Perhaps worst of all is that politicians who touted the necessity of this sweeping change and the fairness of their effort granted themselves their staffs an exemption from the rules that they insist the rest of us follow.

Not surprisingly, those seeking electoral credit for their legislative efforts are instead contracting incurable levels displeasure, disapproval, and disrepute that may cost them the privilege of the jobs they sought to protect with its passage. Curiously, it's only the distraction of the temporary collapse of the website used for enrolling in this monstrosity that's offering any protection to these wayward legislators from the greater ruin and future recrimination that awaits them. Tragically (if not perhaps fatally), the CYA and CYP (Cover Your Party) nature of the entrenched politics involved precludes even the most honorable of members of either party from doing what they know in their hearts probably now needs to be done.

So it's time for many to learn a hard lesson that apparently their fathers couldn't or didn't pass on to them. You don't fix a simple leaky toilet by ripping out the entire bathroom. You don't remodel a house by demolishing it and rezoning the neighborhood for commercial. In fact, with anything that needs repair, the first rule must always be: 

"If it ain't broke, don't fix it!"    


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