The Lakota Sioux are a confederation of American Indians of the great plains of North America. In the 1730s, the Cheyenne introduced the Lakota to horses, and the Lakota became proficient buffalo hunters while developing a highly advanced horse culture.
My first exposure to Lakota culture was reading John G. Neihardt's superb book "Black Elk Speaks" when I was in high school. I haven't thought much about the Lakota since then, but recent events have reminded me of a phrase often attributed to those accomplished Lakota horsemen: "If you discover you are riding a dead horse, the best strategy is to dismount."
Business pundits and others have used the phrase to create characterizations of executives who can't ever seem to let go of an idea, even well after its demise is apparent to everyone else. Watching the quagmire that PPACA has become, it is clear the Lakota's wisdom has not made its way to Washington.
In fairness, some of the same dead horse strategies (DHS) now being attempted by PPACA champions were attempted by our component of the industry over the past couple of decades, even as the traditional non-consumer-directed, fee-for-service scheme was dying of a thousand cuts.
But today, it is the government's mount that is deceased, and they are attempting all of the tortuous methodology others have used when attempting to continue riding a long-deceased horse. Let's examine just a few of the PPACA DHS.
Buy a stronger whip
Surprisingly, this was attempted early on in the process, albeit in a rather clumsy manner.
When all of the pirates of the Potomac (also known as Congress) couldn't convince skeptics of what a great thing PPACA would be and how we would all reap manifold benefits from its passage, Rep. Nancy Pelosi suggested we shouldn't just take her colleagues' word for it.
We should read the law ourselves to find out all of the good things it contained.
At the time, it reminded me of that great Groucho Marx line: "Who are you going to believe? Me, or your own lying eyes?" The problem was that when we read it, we found out our eyes weren't lying!
Provide additional funding to increase the dead horse's performance
It is difficult to conjure a single government program that has cost less than its original estimates — or even come in on budget. Jetter's First Law of Economics states that bad ideas in the private sector go out of business, while bad ideas in the public sector get more funding.
Projected Medicare costs in 1965 — the year it was passed — were $12 billion. Actual costs were $110 billion.
From early reports, PPACA appears to be following in older brother Medicare's footsteps.
In early April of this year, the U.S. Department of Health and Human Services (HHS) released budget documents indicating it expects to spend $4.4 billion by the end of this year in grants to help states set up exchanges. The original estimate was $2 billion.
In addition, HHS has asked Congress for another $1.5 billion to help set up federally run exchanges in those states that will not be establishing their own.
