I have a few serious issues with the Affordable Care Act.
For example I have this belief that an American should be able to, through choice of lifestyle, avoid taxes. I have no doubt that will be taken out of context, so I will explain it in plain terms with an easy example: driving is, in effect, taxed. We pay drivers license fees, registration fees, and probably taxes on insurance – and since it is mandated in many places one could even make an argument car insurance is a tax. However you could choose not to drive, and avoid all of these taxes. I choose to drive, I happily pay those taxes – they improve the roads we travel, and it creates jobs. But I have that choice.
The ACA is a tax you pay as long as you are alive. I think this is wrong. There is a way to opt-out, but most people are more opposed to suicide than taxes.
I also have a problem with the name of the law. Mind you we were told it was about health care. It is absolutely not, as many people are finding out. It is simply about insurance. Insurance is nice to have…if there are doctors and nurses in facilities that accept it. Some places in America are finding out that their tax/insurance is worthless. Their local hospitals do not take the insurance, and the hospitals that do are a 4 hour car ride away.
There were no provisions to encourage the development of the medical profession. No educational assistance for low income Americans to attend medical and nursing colleges, which is such an all-around win-win for the nation it astounding this was over looked. There was no medical equivalent to the G.I. bill, where a medical college education could be paid for through service: either military or by serving communities with medical care shortages. There are communities in America with a serious shortage of medical professionals – pair that with all the brilliant young Americans who would make excellent medical professionals if they could afford the education and you have a piece of law I would support.
The worst part, the most irresponsible part, was the way the law was deployed.
You will have to excuse me, I am an Information Technology professional. Every good IT pro knows how to do a deployment of a major change. No IT pro with even a bit of experience would roll out a major change to production without testing it, or even better testing it and putting out a pilot program.
I know, your thinking ‘An IT guy, he must be talking about the web site’. 100% wrong! I will agree that was absolutely pathetic – but that is just a piece of it.
If you are going to put a program in place, affecting 1/10th of the economy, the worst thing you could do is present it nation-wide with no real idea how it will work. This is so typical of politicians – people who talk about it, argue about it, but never do it. All 50 states, all at once. No test in one or two states for a year with an expansion plan based on lessoned learn. No carefully choosing a few counties across the nation that would present a good cross section: skewing older, skewing younger, dense population, sparse population – used as a test environment. They just flew blindly with a strong faith that the ‘right’ choice would over come everything.
This would have made the web site roll out much less of a hot news item. The flaws would have been exposed and corrected before the entire nation put their social security number, health care information, and credit card number in the database*. It would have impacted those in the pilot program, and that is bad of course, but it would have been a much smaller user base exposed. The web site also would have had a pretty decent idea of the load it had to handle, and been able to extrapolate what an expansion of the plan would require. Better security, but traffic management, all with a pilot roll-out.
One more thing could have been accomplished: if it was obvious it was not working it could have been stopped! Now too many politicians have either hitched their proverbial cart to the law being a success, or to it being a failure.
If someone had asked me, a typical American citizen, how I would have done health care the law would have been much different. It would have focused on increasing minority and poverty stricken, but smart and talented, youth entry into the medical field. I would have created programs to relieve the debt of those in these programs through service in communities with medical shortages or in the armed forces. In effect your intern years would be given to serve your fellow Americans, and as payment for that those who you served would pick up your education tab.
I would have tried to work on replacing the current government medical programs with one that does more for those with less. I don’t think anyone in the nation thinks we should not take care of our fellow Americans who are truly down on their luck. That is not what America is about. We help, we give, we protect, we do not turn away and spurn our fellow Americans.
I would not have made the collective insurance industry drool by mandating every person in the nation must buy (expensive, though it was not supposed to be) insurance or be heavily taxed. I would not have incentivized medical professionals to retire by not making their job worth it through reducing their income. One positive side effect is with medical school not being seen as a viable choice by many talented brilliant young Americans we should see an uptick in the engineering profession.
I would have tried to find a state to pilot the program and provided an incentive for whatever state dedicated themselves to test out the program. I would have had a plan to expand it, or in the case the failure of the program, to eliminate it. I would have had criteria for what entails success or failure before hand, so that could not be left to emotion or political winds of change.
Expand the medical profession, reduce the risk of a nation-wide roll out, reduce the bureaucracy of multiple inefficient government programs, and a definition of success or failure. Why is that so hard to do?
Also, as an IT professional, I think I would have hired David Kennedy’s security firm, not attacked him on Capital Hill because he was able to prove the ease with which the web site could be breached. If he was able to declare it secure after he exposed its initial flaws that would have made the public faith stronger. Because, as it stands now, again as an IT professional, I would rather pay the tax than put my data on the ACA web site. And my specialty in IT is information security.
I think David Kennedy would be my CISO if I ever was trusted by the people of America to be their President.