
The dealer wasn’t pleased. There I was, sitting on a 9 and a 3, and I wasn’t taking a card. “Are you sure”, he asked. “Yeah, I’m cool.” His up card was a queen. He shook his head and continued around the table. Finally, it was his turn. He flipped over his down card, a six, and then busted on another face card. The pit boss came over and gave our table a new dealer. I told my friends that it was time to go and collected my chips. They resisted, lost the next two hands, and then agreed to shift tables.
The House always wins. You may not know how or why, but it does.
Since this is Health Insurance Issues With Dave, the House is the federal government and the cards are The Patient Protection and Affordable Care Act (PPACA). The dealers and bit bosses? That would be the regulators who dole out the ever-changing rules and regs.
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This blog has contended that the passage of the PPACA began a ten year transformation of our health care payment system. How we get there may either be by accident and reaction, or it may be entirely by design. I’m not privy to that information. This blog can only report on the status of our payment system and leave it for the readers to determine whether there is a pattern or just a random collection of factoids and moments.
We have just ended the first phase of this year’s Open Enrollment Period. Here are a few things I’ve learned between November 15, 2014 and December 15, 2014.
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- Individuals and families saw a large price increase on subsidized health insurance policies.
- The government aggressively pushed Americans to shop on the Exchange for cheaper policies. They weren’t lying. There really were cheaper policies.
- More Ohioans were told that they shouldn’t buy insurance. They should be covered by Medicaid.
- Doctors who accept Medicaid are facing a significant fee cut.
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DAVE
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