Because I’ve had a hectic week, it has taken me a while to catch up on all the internets. This has allowed me to consume an entire week’s worth of dismay and panic over the healthcare.gov rollout (with New Improved Square Wheels!). It’s a bit ridiculous, since the real problem is that healthcare is still too damn expensive. Nonetheless, it has been incredible, in a car crash kind of way, to watch the Technobrat Pundits® suddenly castigate the Obama administration for an incompetent rollout (looking at you, Ezra Klein).
Maybe there was no way in hell a public option–giving people the option to buy into Medicare and CHIP–or expanding Medicare to all was ever going to happen. But the idea that the insurance companies–some of the most miserable bastards in the long, sordid history of capitalism–were going to be ‘partners’ or team players in all of this was patently absurd. In terms of implementation–getting it done–Obamacare was about as non-pragmatic as can be (and it’s worth noting that the only reason the insurance companies in Massachusetts went along and still go along with Romneycare is that they know a credible alternative is a state-wide single payer system. As is the case with many sociopaths, fear is the operational effector).
Not only did we reinvent the wheel, we did so poorly.
Pragmatism, my ass.
Legislative negotiations (reviewed yearly) should determine the fee for every medical procedure and medication, and fees should be identical across the country. Of course, insurance/pharmaceutical companies parasitize on an inverse relation between regulation and “negotiation.” A lack of transparency will continue to be an issue with any proposed changes in healthcare law — causing even more problems with rollout. It’s Nigerian Airways Flight 2120, writ large.