Watch Where You Step

I admit that I was a bit confused.  The key employee of a local not-for-profit was about to give us the “30 Thousand Foot View” on a particular issue.  My confusion?  I had always thought that it was easier to find bullshit in a cow pasture.  Our guy proved me wrong. 

I was reminded of our captain of the shovel brigade Wednesday afternoon when I had the opportunity to take part in a special government sponsored online seminar on the Patient Protection and Affordable Care Act (PPACA).  The facilitator promised a High Level Overview of the new law.  What we got was a cheerleader who attempted to substitute PowerPoint for back flips and the ubiquitous can-can line.  If one-sided hyperbole is your favorite way to spend an hour, you would have been in heaven. 

Though this briefing was by invitation, only, there were no requests to keep the contents secret.  Reporters were supposedly on the line.  We were even provided a link to the presentation.  I would include it, but It Doesn’t Work! 

I knew we were in for an informative webinar when the first slides told us why we had to have the PPACA.  “Insurance companies could take advantage of you and turn away 129 million Americans with preexisting conditions”.  We learned that the law was built on everything that worked in our system and fixed everything that didn’t.  I turned away for a moment, but I’m sure that one of the bullet points was that the President and the PPACA guaranteed that the sun would forever rise in the east and set in the west. 

The twenty-eight page presentation covered little substantive ground.  The slides extolled the virtues of the yet to be created exchanges and the new heroes of healthcare, the Navigators.  Our facilitator mentioned a new class of participants, Certified Application Counselors, but her screen presentation failed to note or define them. 

For someone who has spent almost 34 years in the business, it was an hour of total frustration.  How do you unlearn what you know to be true?  Can you pretend that up is down or that black is white? 

I didn’t have time to dwell on the seminar.  Dinner Wednesday night was to be downtown with friends.  Flipping through the stations as I was driving on I 90 into town, I happened on to Neil Cavuto on FOX.  He was interviewing Dr. Ben Carson, a noted pediatric surgeon from Johns Hopkins and a FOX favorite. 

Dr. Carson is a really, really smart guy.  And if I was looking for a surgeon to separate conjoined twins, he would be at the top of my list.  But his political rants aren’t in that same class.  I’ve included the link.  While his voice went high and shaky, his argument sunk to the level of your average FOX talking head.  The segment ended with Cavuto and Carson delivering what they hoped to be the fatal dagger to the heart of the PPACA – IRS involvement. 


There is no reason to expect more than this from FOX, but we need more from someone.  We are months from the real start of the PPACA, the opening of the exchanges, and the wholesale upheaval of our current payment system.  Businesses have already spent millions of dollars in an effort to be in compliance with regulations that are still being drafted and changed.  Neither one-sided cheerleading sessions nor silly rants will help us efficiently pay for the medical services of over 300 million Americans. 

There is still time to modify the Patient Protection and Affordable Care Act to make it more effective.  All we need is a Congress more interested in fixing problems than scoring political points.  We don’t need more grandstanding.  We need action.  But I’m not holding my breath.  I am, however, watching where I step.

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5 Responses to Watch Where You Step

  1. from the original blog site says:

    RNNN June 21, 2013 at 4:58 PM
    scary and stupid stuff. I remember when I had my Dad with us — it was the first year to pick a Medicare plan for meds. It was crazy, so many plans to wade thru with so many companies. I only listened to a salesmen where he already had his Medicare supplementary healthcare insurance just to simplify things. After just reading what all was out there, this was the easiest way to go. I know Dad trusted that company since he already had life insurance with them as well. But what about the older couple who doesn’t have an RN or knowledgeable son or daughter to help with these decisions?? I am sure it is worse now, which will get even worse with the PPACA. God help all who have to deal with all of this. Whenever the government becomes more involved in healthcare, the waters just get murkier

  2. Susie Sharp says:

    Dave, thanks for the humor and insight. You’ve been my ‘go-to’ guy for years when it comes to insurance matters and have been a proven straight shooter for the folks I’ve sent to you for guidance and advice.

    I’ve always thought it a shame that the richest nation in the world couldn’t find a way to provide medical care for its own people. The U.S. stands almost entirely alone among developed nations lacking universal health care. (Map:

    Who would have thought just a few short decades ago, that the words “homeless” and “veteran” would be commonly used in the same sentence in the grand old US of A? (Same with “homeless/hungry” and “child.”) US politicians are seemingly obsessed with sending rice, chocolate and MREs off to 3rd world countries lest those countries look to Russia, China or the Taliban for support – all the while our own citizens go without, sleeping under bridges, in back alleys and in city streets.

    While insurance executives consistantly manage to eke out livings on meager 7 figure compensation packages, I love to hear how they begrudge food assistance, early child care assistance and ‘Obama phones’ for the unemployed and struggling (Note: To be factual, they should be called “Woodrow Wilson phones” – see history:

    There needs to be basic dignity associated with life – and death. The folly of ‘trickle down economics’ has long been exposed as a mere ruse to make the rich richer and the poor poorer. Fool me once, shame on you. Fool me twice….

    I was 13 in 1968 and worked the summer at minimum wage – at a grand $2.30/hour. After 3 months of working/hoarding, I was able to take my summer savings and buy myself a cherished Yashica D 120 TLR 2.25″ economy box camera. (Picture and stats: At 13, I was living at home with my parents, fully supported/fed/clothed and housed. My only real worldly concern was the increasing awareness of an untenable military situation in Vietnam. My only financial concern was acquiring that camera before school started in the fall. My hands still remember the feel of that familiar and well-loved brown leather case.

    Flash forward to 2013. The consumer price indexing site shows that 1968’s $2.30 minimum wage translates to $15.40 in today’s dollars. ( And what, you wonder, is Ohio’s current minimum wage? $7.85. So all who want to argue that minimum wage keeps pace with inflation can now suppress that nonsense before it dribbles out of your mouths in an undoubtedly alcohol fueled conversation.

    There’s a difference between a minimum wage and a living wage. In 1968 three months of labor (while living at home) provided me with the means to afford one inexpensive camera. If I’d worked an entire year, I would have been able to buy a total of 4 cameras. – IF I lived at home.

    Today, at HALF that 1968 dollar’s value, people who live in the US are expected to be able to pay rent, buy food and medicine, feed and clothe their families, pay electricity, gas and water and educate their children. Where’s the disconnect?

    The disconnect lies in a lot of places. The most glaring example in recent history that stands out in my mind is when the American auto company executives wanted to beg for their bail outs and all flew to Washington in their own separate private jets with their own separate private pilots in the cockpits. FAIL.

    But I digress…

    Health care for the masses is a massive responsibility – one that only a massive authority can resolve and govern. For the ‘Obama phone’, it was the telecommunications industry that stepped up to the plate to serve the underserved (see link above). Who in the health care industry has stepped up to the plate to partner in a solution to the health care problem? Let’s hear it from the drug and medical device industries! Let’s hear it from the leading hospitals! The resounding response brings an old familiar song to mind:

    So… without an industry leader willing to come to the forefront, the only massive authority left is the Federal Government. Please do not blame the President for trying to bring into an effect a needed solution to a problem that industry leaders consider a hot potato and will not tackle.

    The only pet peeve I have is the government’s seeming need to reinvent the wheel. I would have hoped that it would have studied nationalized health insurance in other developed countries and adopted the best practices of each, but that is not apparent.

    Thanks for yet another great article, Dave.

  3. Toms shoes says:

    I love it when folks come together and share ideas. Great website, stick with it!

  4. […] on two phone conference / webinars with the Centers for Medicare and Medicaid Services (CMS).  As previously noted, the government employees hosting the meetings were woefully unprepared.  Cheerleading permeated […]

  5. […] today we have Ben Carson and Donald Trump. And for a moment of sanity, Joe […]

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