This last week marked the one-year anniversary of the Patient Protection and Affordable Care Act (PPACA), also known colloquially as Obamacare. Depending on who you are and where you stand, you might not be sure whether to celebrate or mourn the occasion.
I looked up what gift one is supposed to give on such an occasion and discovered that the official traditional gift one bestows at the one-year anniversary is paper. The official modern day gift is clocks. I couldn’t think of a more appropriate set of gifts for Obamacare.
If you have seen the bill itself, PPACA covers 2409 pages, so it obviously loves paper. Whole forests have been felled to support the thousands of articles, pro and con that have been written about this law. Paper is the perfect gift to enable the 3-ring circus of election flyers, academic papers, letters by constituents to their representatives and government regulations that have swirled around PPACA. Left unchecked, this law may result in the consumption of every last tree on earth as our politicians extol the virtues of their own particular arguments.
As for the gift of a timepiece, it will come in handy so we can watch how time is running out for our economy as we let our healthcare system continue to fiddle while Rome burns. We can count the clicks of the ticking time bomb as our nation’s economic health self-destructs over unchecked healthcare spending and the likelihood that the average family will have to spend $20,000 to buy a health insurance policy by the end of this decade if something doesn’t change the trajectory of healthcare inflation.
It is disturbing to sit here in California, a microcosm of the healthcare crisis we are facing, and watch the budget cuts that will eviscerate important healthcare programs for seniors and others because it is too difficult and time-consuming to take another road: that of forcing efficiency on the system through aggressive care management, comprehensive telemedicine programs and the alignment of provider payments with the delivery of high quality care, among other things. Hopefully California will ultimately be able to restore funding for programs such as adult day-care, which helps to avoid hospitalization for those with chronic illnesses by giving caregivers the ability to see the oncoming complications of disease that might land people in the hospital if they are left unattended and unaided at home.
In 2014, on the 4th anniversary of PPACA when most of its significant provisions are slated to go into effect, etiquette suggests that the proper gifts to give will be linen or silk (traditional) or appliances (modern). If the nation has not made strides to come together towards a unifying set of solutions to our healthcare cost crisis by 2014, we are going to have to take our linen in the form of bandages to hold our economy together. We will not need an appliance—we will already be toast.
Late breaking news the morning after I wrote this: some funding restored for CA adult day care programs. I wonder what goes in its stead?
