As the open enrollment period for 2014 approaches, premiums on individual plans in the Obamacare exchanges for California will double, and will increase 80 percent or more in Ohio. At the end of its first decade in force, the ACA will leave more than 30 million Americans without insurance – the driving issue behind health-care reform for at least the last twenty years.
The problem with all of the health-care industry reforms has been that precise goal: expanding insurance. The widespread use of comprehensive insurance policies insulates end users in the system from price signals, especially on routine care. That eliminates competition on price as insurers use their economic weight to pre-negotiate pricing on every kind of service and product under their coverage, from blood tests to setting broken bones. Providers locked into a specific schedule of reimbursements have no reason to innovate to either lower costs or increase value, and end up having to spend money and time dealing with insurance companies for delayed payments rather than focusing on the patients seeking treatment in their clinics.
Ironically, the multiplication of mandates and other regulations in the ACA on both private insurers and government-run programs like Medicare and Medicaid have more doctors opting out of the third-party-payer system altogether. Earlier this week, CNN Money reported on the migration to cash-only services among health-care providers, driven by poor reimbursements, increasing regulation, and high overhead.
ObamaCare has taken a terrible system and made it much worse.
Rather than an offense against art, a properly structured sale would represent a public-spirited update of how the art came to Detroit and other U.S. cities in the first place: as a way of providing liquidity to Europeans in need of cash. “The second world war has opened up an opportunity such as may never come again,” the DIA’s director wrote unabashedly in 1948. “Great private collections which have been held intact for a hundred years or more are being broken up.” Detroit is like an aristocratic estate forced to adjust to changing times. It can’t marry an heiress, but it might find some lucratively appreciative new homes for some of its heirlooms.
This is the just consequence of terrible voters’ decision and awful city management.
Stewart Money has some thoughts on the implications of the culmination of the courtship.
I’ve never really believed that the true goal of this program was a significant cost reduction. I think that the only requirement for which it makes sense is rapid-response single-orbit rendezvous.
But one other point that Stewart doesn’t mention. In the original rollout, they declared that the goal was (at least eventually) human missions. I don’t know how many people are going to be willing to go to orbit on a two-stage solid, particularly given OSC’s record. I know that I wouldn’t be, particularly given the more attractive alternatives (SpaceX/Dragon and perhaps whatever XCOR eventually comes up with). I wonder if this is the final nail in the coffin of the original cover story.
Clark Lindsey has collected the tweets from this morning’s session at the #NSRC2013.
Bottom line — they still won’t announce anything resembling a schedule. “We will fly when we are ready.” As opposed to everyone else, who will fly before they are…