Television historians date the beginning of the decline of "Happy Days" to the episode in which the Fonz water skiied over a shark.
Clearly, if you're anywhere on the spectrum from being angrily opposed to the Patient Protection and Affordable Care Act (PPACA) to warmly supportive in a nervous way, the U.S. Department of Health and Human Services (HHS), the Urban Institute, the Kaiser Family Foundation and Commonwealth Fund analysts have jumped the shark when it comes to creating projections about how wonderful PPACA will be in 2014 and later years, or how great it would be today, if only it were already gloriously in full effect right at this exact moment.
Shining projections about how great PPACA Universe will be do nothing but make HHS and the various think analysts seem creepy. Maybe PPPACA will be great or maybe it won't, but, except maybe when it comes to concrete efforts to draw up state and federal budgets and impact studies, the time for theoretical PPACA projections is over. The time for seeing how the actual law and the actual implementing regulations work is here.
Similarly, I think the time for fulminating furiously about how every last sentence in PPACA is hair from Satan's foul nose has jumped the shark.
Some readers here believe that just about every tax, and certainly every tax imposed to fund social welfare programs other than disaster relief and epidemic prevention programs, is a form of theft.
I sincerely wish I could give you readers a country, and I think it's likely that your country would be a fair, prosperous country. In the long run, I assume that every dire prediction you make about how the United States will implode will probably turn out to be true.
But, honestly: I just don't have any moral problems with taxes myself. I don't think Medicare, Medicaid, income taxes, payroll taxes, the existence of HHS, the mere concept of the existence of PPACA, or anything along those lines is immoral. For me, the question is just whether those things work, or whether they're so complicated, inefficient, bad for people, plain crazy, etc. that the costs outweigh the benefits.
So, arguments that PPACA is Satanic in and of itself, or that an individual health insurance ownership mandate is inherently the work of the devil, or anything along those lines tend to make my mind wander.
One of the programs that PPACA haters really have been hating for the past few months is the Medicare quality bonus program.
The bonus program is tied in with PPACA-related cuts to Medicare Advantage funding.
Medicare program managers are trying to use the program to reward Medicare Advantage plans that do a good job on metrics such as enrollee satisfaction and the percentage of enrollees who've gotten their blood pressure checked in the past year.
PPACA haters in the House have been holding hearings about horrible and unauthorized the quality bonus program is, saying it's just an HHS trick to distract plans' attention away from the overall PPACA Medicare Advantage funding cuts, etc. etc.
But one thing that's interesting is that the program seems to be forcing Medicare Advantage plan managers to think about health care indicators that someone out there in the universe probably ought to be thinking about. Maybe it's good for health care costs, and for people's health and quality of life, if a health plan manager knows a little cash depends on whether enrollees are getting their blood pressure checked.
Analysts at Avalere Health looked at the actual ratings and found that the plans actually improved their performance a whole bunch between last year and this year.
