The Missing Link in the Affordable Care Act

President Obama signs the Patient Protection and Affordable Care Act into law on March 23, 2010, surrounded by Democratic supporters (except, perhaps, for the boy in the front, who seems a bit too young to have a definitive political ideology). White House photo by Pete Souza.

President Obama signs the Patient Protection and Affordable Care Act into law on March 23, 2010, surrounded by Democratic supporters (except, perhaps, for the boy in the front, who seems a bit too young to have a definitive political ideology). White House photo by Pete Souza.

The creators of the Affordable Care Act (a.k.a. Obamacare) overlooked one essential link in the unbroken chain of historical health care service in America: the important role of the insurance salesperson. Call him/her what you will, but here we will use the term salesperson or sales representative.

For the purposes of this article, let us think of the health care chain as containing five main links: 1) patient, 2) sales representative, 3) insurance company (or other payer), 4) health service provider, and 5) patient care.

In the Affordable Care Act (hereafter “ACA”), the second link is either weak or missing. The creators of the ACA have made a fatal mistake by trying to go around the sometimes maligned and unappreciated lowly insurance salesperson. To their credit, they have made lame attempts to furnish substitutes — namely the website (which is a joke), the Navigators, and others. Continue reading

L’affaire du Président, or President Hollande is a Naughty Boy

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French actress Julie Gayet, the latest object of President Hollande’s affection, is shown here at the 2007 Deauville American Film Festival. Wikipedia photo by Mireille Ampilhac

Today I am going to write about something taking place in France.  Have I lost you already?  I only ask because I know that many Americans are either thoroughly apathique or completely hostile when it comes to our French collègues.  I’ve heard the usual complaints: they live in a nanny state, they don’t believe in working, they hate Américains, they are complete cowards in all their military campagnes, and they have a preference for the kind of cheese that looks like a science experiment gone wrong.

Perhaps the thought of reading an entire article about France fills you with disgust.  Perhaps you are still unwilling to give the French credit for “freedom fries” more than a decade after the fact. (There is actually an ongoing dispute about whether deep fried potato strips originated in France or modern day Belgium.) Perhaps you think that the term “Francophile” is synonymous with “socialist”.

Allow me to reassure you by insisting that this is not really a French story at all: it is an age old tale about a politician caught in a sex scandal, full of the kind of details that are sure to reinforce your cynicism, while at the same time making you feel superior to other members of the human race.  Are you interested now?  I hope so, because that is about the best sales pitch I can give. Continue reading

For Japan and China, a Dispute Worthy of Voldemort

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The Yasukuni Shrine in Tokyo on a rainy day. Photo by Wikipedia user Fg2

I had a nice post prepared for today that was going to deal with a controversial issue in the religious world, but I have decided to put it aside and instead address a controversy that is currently brewing in the world of international relations.  One might even say it takes place in the fantasy world.

Let me first state a well known fact: China and Japan do not get along.  Subjects of disagreement between them include the fact that one is Communist and the other is a Western-style democracy, one is a major U.S. ally and the other more of a U.S. competitor, both are economic powers going after some of the same markets, a controversial chain of islands is claimed by both of them, they each have capable and expanding military forces, and one of them has a bunch of cute pandas while the other does not. (Ok, that last one isn’t really a source of tension.) Yet, all of these factors tend to take a backseat to a list of historical grievances that have proved to be infinitely hard to forget. Continue reading

Fixing American Government in 2014

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The White House, October 2013

As we begin the year 2014, I find myself reflecting on the political situation in the United States, and I must say that it is a bit depressing.  Our political parties cannot seem to agree on much of anything, our bureaucracy is a model of inefficiency, and there does not seem to be much positive change on the horizon.  Is there anything that could really fix this situation?

Well, with a new year, hope springs eternal, and though I have no expectation that any of the following suggestions will be implemented this year (or any other year), I am going to go ahead and make them anyway in the hope that it might spur some positive discussion.  Love them or hate them, here are five things that I think would help to improve our federal government. Continue reading

Iran’s Deal With The Devil

Iran and the United States finally reached an agreement regarding Iran’s nuclear program, but it seems this time the devil is in the details.

Over the weekend, the U.S., its allies, and Iran managed to work out a deal in which some of the international sanctions Iran has been experiencing will be lifted in exchange for certain reductions in Iran’s nuclear development.  This is a six-month agreement that the Obama administration hopes will lead to a more permanent solution after further talks take place.  I know what you’re thinking: “What an amazing diplomatic breakthrough!”  Well…

“Last night is not a historic agreement – it’s a historic mistake.  It’s not made the world a safer place…This agreement has made the world a much more dangerous place,” argued Israeli Prime Minister Binyamin Netanyahu.  Ok, so we’ll put him down as “still on the fence”: not surprising, since Netanyahu has never gotten along that well with President Obama.  He probably is just upset that Barack (the U.S. president, not Netanyahu’s Israeli political rival, Ehud Barak) is going to get all the glory for this one, right? Continue reading

The JFK Assassination: Where Are They Now?

Jacqueline Kennedy leads her children out from her husband's funeral on November 25, 1963, followed by other members of the Kennedy family.  White House photo by Abbie Rowe

Jacqueline Kennedy leads her children out from her husband’s funeral on November 25, 1963, followed by other members of the Kennedy family. White House photo by Abbie Rowe

 

As you have probably heard, today marks the 50th anniversary of the assassination of U.S. President John F. Kennedy in Dallas, TX.  There has been no shortage of material commemorating the event, perhaps most notably the film “Killing Kennedy” which appeared on the National Geographic Channel and was based on the book by Bill O’Reilly (and Martin Dugard, who likely is responsible for more than 50% of the end product, but inevitably gets 5% of the credit).  I watched the program, and it made me wonder, whatever happened to some of those people?

Obviously, we all know what happened to President Kennedy. (The clue is in the title.) Lee Harvey Oswald also failed to make it out of that week alive, thanks to Jack Ruby.  The rest of the characters in this story went on living their lives, some fading into anonymity and others becoming high-ranking officials.  Here now is a review of what happened to a few of the people caught up in the JFK assassination. Continue reading

A Day to Honor our Veterans

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The Korean War Veterans Memorial in Washington, D.C.

Guest blogger Shelley Watkins talks about how her life experiences have shaped her views of the U.S. military and her appreciation of our veterans.

Two days ago, I found myself making an unplanned stop at the Korean War Veterans Memorial in Washington, D.C.  It was a beautiful fall day, colorful leaves swirling midst the verdigris soldiers, frozen mid-step as they walked across the field of battle. There was an unexpected flash of burnt sienna as an anxious fox scurried through the statues, desperate for sanctuary and finally disappearing under a bush. Does he really have a den in this crowded place, the only being allowed to walk among the statues? Continue reading

Mayors Gone Wild: Canuck Edition

800px-Skyline_of_Toronto_viewed_from_Harbour, Flickr John Vetterli

The lovely city of Toronto, now home to a truly embarrassing mayor. Flickr photo by John Vetterli

There are increasing calls for Toronto Mayor Rob Ford to get ouuuwwwwt of city hall.  (“Ouuuwwwwt” is how people from Ontario tend to say “out”.)

Here in the United States, we know all about mayoral scandals.  In the ‘90s, there was D.C. Mayor Marion Barry, who was sentenced to six months in prison after being convicted on drug charges.  In the ‘00s, we had Detroit Mayor Kwame Kilpatrick, whose offenses made Barry’s seem rather trivial: he was recently sentenced to 28 years in prison for a laundry list of crimes that included “taking bribes, steering contracts to his friend, extorting businessmen, deceiving donors to his nonprofit, living lavishly on the public’s dime and loading the city’s payroll with friends and family.” Continue reading

Trouble in the Kingdom: Saudi Criticisms of U.S. Policy

800px-Arrival_ceremony_welcoming_King_Faisal_of_Saudi_Arabia_05-27-1971, National Archives Robert L Nudsen

Former Saudi King Faisal is greeted by President Richard Nixon at the White House in 1971. The U.S.-Saudi relationship is one of long standing. National Archives photo by Robert L. Nudsen

With Syria in flames and Iran continuing its nuclear development, two Saudi princes have grabbed headlines criticizing Obama administration policies in the Middle East. What does this mean for the future of the bilateral relationship?

In the Middle East, events seem to shift as often as the Arabian sands. Rulers rise and fall, wars come and go, and firm alliances are often hard to achieve. Thus, the longstanding relationship between the United States and Saudi Arabia has been one of the key driving forces in the region, an alliance based more on common interests than common ideals or ways of life.

The course of this relationship has not always run smooth. The presence of American troops and contractors on Saudi soil has been a source of consternation for those who frown on such things happening on holy Islamic land. The OPEC embargo in the 1970s revealed some distance between the two allies, while the Persian Gulf War opened the door for enhanced military cooperation in defense of the Kingdom and neighboring Kuwait. Another low was reached after the 9/11 terrorist attacks: 15 of the 19 hijackers were from Saudi Arabia. Continue reading

America is the New Egypt

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Photo by Wikipedia user Kallerna

America’s politicians are not much better than Egypt’s these days, squabbling and refusing to deal with big issues.  What must be done to fix the situation?

Apparently, when Americans think about Egypt, the first word that comes to mind is “pyramids”; at least, that’s what I heard at one of the many D.C. think tank events I attended during my time working on Egypt.  I get it: the pyramids are pretty awesome.  However, when I think of Egypt, I am sad to say that one of the first words that pops into my head is “dysfunctional”.

When I say dysfunctional, I am referring to the government, which since the 2011 revolution has gone from an interim military regime, to a mostly democratic one dominated by Islamists, and then back to an interim military regime.  If you like lots of plot twists, then Egypt is the place for you these days.  What the country really needs is a unity government full of technocrats who can put it back on track politically and economically, but that is easier said than done. Continue reading