BLOG: PPACA Resolution? Think Again

Is the question of the PPACA settled? The best laid plans......

The 2010 Patient Protection and Affordable Care Act (PPACA, aka. Obamacare) was enacted over the  objections of many who called it a "takeover" and "socialized medicine".  Since then, those in opposition have been working to derail, defund, and  repeal this federalized-health-insurance train.  They may get some unexpected, but welcome help from the inevitable inertia and bickering that accompanies the birth of every large bureaucratic empire.

With the election last Tuesday, pundits have been proclaiming that the issue is finally put to rest.  With Obama firmly in office, and the senate in Democrat hands the prospect of repeal is remote.  The recent US Supreme Court decision upholding the constitutionality of the "mandate" swept away major doubts about whether the law could move forward. The public perception today is that the matter is settled. "Obamacare" is a done deal.

Nothing could be further from the truth.

In our country, where politics is driven largely by public opinion, that opinion will play a major role in the fate of the PPACA.  In this case, a majority of Americans want the PPACA repealed.

Even if the PPACA had broad support, and no focused opposition, the normal process of a "rollout" would encounter institutional roadblocks, and would have to satisfy political interests that would be affected.  The bigger the program, the bigger the issues that must be resolved, and this all takes time.

With the PPACA, the stakes are huge, so the institutional resistance will be massive. Because many of the actual rules have not even been issued (also read about delays here), real resistance has not yet appeared.  "The secretary" (HHS Secretary Sibelius) is working hard to turn 2700 pages of legislation into detailed rules - an enormous undertaking.  Many of the rules will have huge financial and political consequences.  Rulemaking may happen, but it will not go smoothly.  I will be shocked if Ms. Sibelius issues the PPACA rules anywhere near the required schedule to get everything ready for Jan, 2014.

In the next year, we will see citizens, hospitals, insurance companies, and corporations wrestle with these changes.  Contrary to the promises of Mr. Obama that "if you like your insurance plan, you can keep it", thousands of businesses, and millions of Americans  will see major changes in their insurance and medical care, and they will not stay silent about the changes they don't like.  Corporations that spend hundreds of billions on insurance must come to terms with the many requirements and burdens that will be imposed by the PPACA.  They won't go quietly, either.

As usual, others say this better than I do.  A list of additional issues can be found here: Obamacare is Still Vulnerable.

Those who got this legislation through Congress are convinced that they are doing the right thing, and have little patience with opposition.  They are determined to prevail. Their supporters often think of the PPACA as more of a crusade than a program.  Proponents don't speak of costs and tradeoffs, but of rights and dire consequences.  Debate often has flavor of a jihad, so I do not expect the PPACA's proponents to "see the light" when things come up in rulemaking that reasonable people might see as a reason to change direction.

On the contrary, I fully expect these "normal" implementation issues to be significant, but not sufficient to stop the PPACA.  What I do expect is that all these factors will force the "rollout" of the PPACA to take much longer than expected, and every issue raised and overcome will highlight the inherent contradictions of the PPACA.  Throughout the process, the implicit question will be: Do we really want the federal government running our health care?

November 6th, 2012 was a beginning, not and ending.  I look forward to November, 2014.

This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.

Al Tate November 14, 2012 at 08:19 PM
That's all fine and dandy if Don posts, it's his right, even if I think it's garbage. But what about Patch coming up with it's own topics and reporting on local people, events, news, sports, features? Patch has just turned into a political pipeline with jibberish like Don's blog front and center. It no longer is a place to go for local news, people, places, business info, sports and so on and on. Why not?
Susan November 23, 2012 at 09:27 PM
Being a moderate Democrat, I disagree with Mr Lee on most things related to politics, but I greatly appreciate his input and courage in writing about his political positions and the reasons for those positions. In the often toxic world of online political discussions, I find Mr Lee to be informative and he remains civil even when those disagreeing get nasty. Even though I disagree with him on many things, I have learned a lot from what Donald has written. Many times he will write something that I find "wrong" (in my opinion), and this will force me to research a subject. This is a fantastic way to learn, and find out if you are as strong in your position as you think you are. Over the last few months I have told many people that you must engage with people who have different political positions than your own. You can never be taken seriously or hold any credibility if you don't understand the "other side" and simply say they are wrong. This process is much easier when you can find someone strong in their convictions who remains civil AND is informative at the same time. I greatly appreciate Donald’s input for these reasons. He has even swayed my opinion a time or two, but I would never tell him which issues specifically… ;->
Donald Lee November 24, 2012 at 07:12 PM
When I ran for Mn House in 2010, I frequently told people I wanted them to get involved, regardless of whether they were supporting me, or opposing me. Engagement and civil discourse are essential. Agreement is optional. ;-> Thank you for your engagement, and kind words.
Susan November 25, 2012 at 01:02 AM
You're welcome. I've become fond of our little Patch group. Peter (above) linked the Kaiser poll, but here is a summary by a political editor and director of ABC News: "A record low number of American voters want to see the Affordable Care Act – Obamacare – repealed, according to a new post-election poll conducted by the Kaiser Family Foundation." "But only 33 percent of Americans now want to see the law repealed. 43 percent of Americans view the law favorably and 39 percent view it unfavorably, according to the poll." "National exit polls conducted on election day found 26 percent of voters wanted the law expanded, 18 percent want it left as-is, 27 percent wanted to repeal some of the law and 25 percent wanted to repeal all of it." http://abcnews.go.com/blogs/politics/2012/11/poll-fewer-support-obamacare-repeal/ I question if the shift in thinking is because people, after learning more details, are increasingly thinking this is the right approach, or if they simply don't want "the fight" to continue in D.C. Something MUST be done to stop the rapidly increasing costs of health care and health insurance in this country. If these increases continue, no one (other than the 1%) will be able to afford either. I think you know that I don't find ObamaCare, in it's entirety, to be a "good" thing, but I still believe it is a step in the right direction for getting everyone insured, and 'hopefully' slowing the pace at which prices are increasing.
Donald Lee November 25, 2012 at 05:00 AM
A resource for those who are interested: http://healthreformquestions.com/quiz/ The facts presented here are sourced and easily followed. Draw your own conclusions.


More »
Got a question? Something on your mind? Talk to your community, directly.
Note Article
Just a short thought to get the word out quickly about anything in your neighborhood.
Share something with your neighbors.What's on your mind?What's on your mind?Make an announcement, speak your mind, or sell somethingPost something
See more »