cur-mud-geon: anyone who hates hypocrisy and pretense and has the temerity to say so; anyone with the habit of pointing out unpleasant facts in an engaging and humorous manner
The world of health care is changing rapidly and we’re all in the middle of that change. Health care in many areas is becoming more and more decentralized. Remote medicine is practiced more and more across many states. The Mayo system and the Cleveland Clinic system are made available for consultation in many areas of the country. A local low cost MRI system relies upon the Cleveland Clinic to read its MRIs.
Against this backdrop, we have the implementation of the Affordable Care Act (a/k/a ObamaCare) progressing. That is driving some new approaches such as that of private exchanges that are beginning to appear. These exchanges are offered by private firms and use the aggregation of numbers of subscribers to achieve plan flexibility and cost competitiveness.
More and more, employers are struggling with the cost implications of future health plans. They are limited by law from charging the employee more than 9.5% of single coverage cost as the employee’s contribution for its health plan. Employers are turning to brokers and consulting firms seeking alternatives that will keep them attractive as employers while not damaging the profitability of the company.
More and more, we hear about companies either enacting or threatening to enact changes to their definitions of full time as the ‘new normal’ of 30 hours per week or 130 hours per month begins to take root.
As with any change of this magnitude, there are bound to be those whom we’d classify as winners and those whom we’d classify as losers. The odd thing about this change, at least to me, is that our President has used any number of Executive Orders to alter the law to his liking when that is the domain of Congress. Even odder is the lack of any real pushback from either Congress or the Supreme Court, the other two branches of our form of government that ought to be jealously guarding the Constitution. It is almost as if those branches do not want anything to do with the Affordable Care Act that has been defined as a tax in order that it could be declared constitutional.
Democrats are bracing for re-election amidst low approval numbers and Republicans are hoping they don’t self-destruct again as they work to move their ‘further-right’ closer to their ‘middle-right’ in order to achieve some form of compromise.
Elected members of both parties could be described as their party’s own worst enemies and yet they persist in their attempts to win more acclaim for themselves. Of course, with acclaim theoretically come more campaign contributions. We tend to forget that political outcomes are often, maybe even most often, defined by the amount of money spent establishing positions and muddying the opponent in the process of buying votes. It is bad to define politics in those terms but that seemingly has become the new reality.
It is difficult to see that changing now that we have decidedly begun our societal trip down that dreaded ‘slippery slope’.