A Realistic View of the ACA – Part 4

In Part 1 of this series, I introduced the series and covered the first part, Repeal.  In Part 2, Transition, I focused on a relatively simple transition plan for people currently covered under the ACA, including some of the financial math that would be associated with such a plan. In this Part 3, Replace, I focused on essential elements that would need to be included in a system to permanently replace the ACA.  In this Part 4, Looking Forward, I’ll get into 1) how repeal and replacement of the ACA could potentially be the main determinant of the outcome of the 2018 mid-term elections and/or the 2020 presidential election, and 2) what the future will probably look like under the replacement law if it is successful.

2018 and 2020 Elections Could Swing On Success Or Failure of the ACA Repeal/Replace Scenario

If repeal and replacement of the ACA is viewed as highly successful, that will favor continued and potentially even heavier Republican dominance. If is viewed as a total flop, that will favor at least some swing of the pendulum back toward Democrats.  Whether the outcomes of those elections are “sweeps” in either direction will depend on the perceived success or failure in other areas [immigration, terrorism, etc., but probably mostly the economy].

Note. Although the preceding paragraph assumes that the Current Paradigm will not fully “die” in another 2, maybe even 4 years, we must keep that factor in our thinking. A major acceleration in the paradigm shift underway, which I think is likely because of Mr Trump’s leadership style, would essentially erase the Republican/Democrat domination and change future elections dramatically [see the page A Major Paradigm Shift Well Underway at this site for a more in-depth description of this paradigm shift, and my blog post Election Aftermath – 1 for a confirmation that such a shift is underway].

It will be very interesting to see how the media characterizes both repeal and replacement. The extreme liberal bias in the media will no doubt result in second-guessing Trump and his administration at every point. The media’s strong supportive tone in reporting on Obama for the past eight years will turn into resistance and skepticism in its reporting on Trump. This will make Trump’s task in repeal and replacement much more difficult than Obama’s task in getting the ACA pushed through [i.e., Trump will have to not only produce a successful transition, but also counter negative press about it — much more challenging than having a press that is essentially a cheer-leading squad].

The Unfolding Of Healthcare From Here

There are two trends that I believe are imminent and will consume an increasing share of both financial and “mainstream” media coverage about Healthcare over the next few years.  Both would no doubt have occurred regardless of the presence or absence of the ACA or its replacement, for one simple reason: in 1960, Healthcare costs were 6% of the GDP; at the end of 2015 [most recent finalized data available], they were 17.8% and still rising. You don’t have to be a mathematician to understand that this is an exponential trend that not only will not, but cannot continue. Any component of the economy exhibiting that kind of exponential increase in the percentage of the GDP is headed for massive change, because continuation of that trend would ultimately result in that component completely dominating the economy and, over time, literally shutting down all other components.

Home Health And Other Alternate [Non-Hospital] Service Delivery Venues

One of these trends has to do with a major shift in how Healthcare services are delivered — specifically, a shift toward a substantially higher percentage of care that is delivered in venues other than hospitals. I believe hospital care will become more and more associated with very complex surgeries and other conditions that require intensive care and highly expensive equipment, that smaller hospitals will ultimately become more like networks of “remote emergency rooms” associated with large tertiary care hospitals, and that home-based care will become much more prevalent than it is today.

The trend toward alternate-venue delivery of healthcare services has actually been underway for well upwards of a decade [one evidence being the proliferation during that time of Urgent Care Centers, often staffed by Physician Assistants and Nurse Practitioners], but it is accelerating much more rapidly now. Also, more in-home service [Home Health] agencies are starting up, and existing ones are experiencing exponential growth.

The reason for this trend is no more complicated than cost containment. Hospitals have extremely high fixed costs when compared with those of alternate venues [particularly patients’ homes], and per-service costs in the alternate venues do not include allocations to cover those high fixed costs. Variable [labor and materials] costs are also higher in tertiary hospitals because of specialty staff and materials that have to always be available in them [this staff and those materials are not actually needed for many, many procedures].  Even when transportation costs [e.g., of medical professionals to patient homes] are accounted for, overall costs are still lower. As icing on the cake, it is quite possible that the quality of some alternate-venue services, all things considered, could actually be higher than the quality of services delivered in hospitals.

Massive Re-Engineering of the Healthcare Industry

The other trend I see on the horizon might actually be several different trends that could be viewed separately. I am grouping them into one because they will all be fueled by one main driver — the huge and rapidly growing need for improved overall effectiveness, a term I like to use to describe the ratio of quality divided by cost. Since there is no single number that reflects quality, this ratio does not exist, but referring to it conceptually is a concise way to define overall effectiveness — i.e.: if quality improves and cost remains constant, overall effectiveness [OE] increases; if quality remains constant and cost is reduced, OE increases; and [the ideal scenario] if quality improves and cost is reduced, OE increases dramatically.  This trend, then, can be thought of as a massive re-engineering of the Healthcare industry, not unlike what we have seen over the past few decades in other industries — notably manufacturing and mining.

Although considerable progress has been made in the past decade or so, Healthcare, in comparison to other industries, is still extremely inefficient. With all that technology has done to increase the OE of other industries, Healthcare is still a very “manual”, labor-intensive industry.  Granted, barriers to progress in Healthcare are probably more intense than in other industries [information security, for example], and risks of failure are more severe [loss of life from system failures rather than just recovery costs and/or lost revenue from outages in other industries], but the biggest barrier is burdensome regulation.  Getting into the details of that is beyond the scope of this blog post, but believe me, I wrestled with the Healthcare regulatory environment for decades. It’s like putting a boxer in the ring with one arm tied behind his back.

On the positive side, I believe the stage is now set for huge leaps in OE in Healthcare. Technology [telemedicine, more sophisticated yet less expensive testing methods, smartphones and smart watches and other “wearables”, smart homes and the “Internet of Things”, emerging standards for information interchange, more non-invasive “surgical” procedures …] is poised to facilitate massive functional changes, and the current leadership mindset of reducing government regulations, although mostly articulated in terms of environmental and financial regulations, will hopefully extend to Healthcare.

And Finally … Actually Dealing With Fraud and Abuse

Another factor that would contribute substantially to OE is virtual elimination of — not just reduction in — fraud and abuse [one notable example being providers who obtain reimbursements from Medicare and Medicaid based on fraudulently reported diagnoses and/or procedures]. This has become a standard claim of both Republican and Democrat candidates for at least the last six presidential election campaigns, and it has even been quantified by DHHS at $60 billion [that’s BILLION, with a “b”] in 2015. In my years as a senior executive in large regional healthcare systems, if I had told my Board that I had become aware of $16 million in unnecessary and avoidable expenses [about the same percent of annual budgets in those organizations as $60 billion is of the $3.8 trillion federal budget], particularly if they were related to fraud, it would have been OK if I had simultaneously articulated my plan for eliminating them in the current quarter. If I had said I just wanted them to be aware, and that I had formed a task force to look into the matter and fully quantify the problem and give me recommendations by the end of the current quarter to completely eliminate that waste in the next quarter, that might have been OK, too.  Had I then said in the next quarter that we were still researching the matter without simultaneously reporting at least some progress toward fixing the problem, I would have been fired on the spot. Only in government can a $60 billion [that we know of] problem be allowed to exist for decades and still be talked about by politicians as something that “we need to look into”.

Series Conclusion / Upcoming Plans For This Website

This post concludes this 4-part series that I entitled A Realistic View of the ACA.  Since this topic is so critical to the success of the Trump administration, I have decided to include the main content of Parts 2 [Transition] and 3 [Replace] in a new section of pages at this website that will focus on the future [Healthcare being only one of those areas of focus]. When that section’s content is ready for publication [which I’m currently targeting for sometime in January 2017], I will announce it in a blog post.  I have already drafted quite a few additions to the page that was originally the content of the Replace plan in Part 3 [some of those additions stemmed from reader comments].  Stay tuned!


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Charles M. Jones

A Realistic View of the ACA – Part 3

In Part 1 of this series, I introduced the series and covered the first part, Repeal.  In Part 2, Transition, I focused on a relatively simple transition plan for people currently covered under the ACA, including some of the financial math that would be associated with such a plan. In this Part 3, Replace, I’ll focus on essential elements that would need to be included in a system to permanently replace the ACA [trying to provide decent coverage of such a broad topic in an average-length post was impossible, so this one is a little longer].  In Part 4, Looking Forward, I’ll get into 1) how repeal and replacement of the ACA could potentially be the main determinant of the outcome of the 2018 mid-term elections and/or the 2020 presidential election, and 2) what the future will probably look like under the replacement law if it is successful.


Keep This In Mind …

To be meaningful and useful, outlining the essential elements that would need to be included in a system to permanently replace the ACA must be done in context with the Some Basics First section at the beginning of Part 2 of this series [A Realistic View of the ACA – Part 2]. If you review that section and overlay its conceptual framework on what I’ll be writing here, you’ll see that this post reflects my philosophy on the guiding principles I mentioned in that section. In a nutshell, I don’t believe that all Americans are entitled to some kind of “standard” level of health insurance [any more than I believe that all Americans are entitled to own a home, or to have a job they want, or to have an automobile, a telephone, …]. I do believe, however, that some government-mandated elements of a national healthcare system need to be in place, the main purposes of which would be: a) to ensure that all citizens are protected from financial ruin brought about by health problems; and b) to minimize the overall cost of providing all healthcare services, whether through government facilities and employees or through private sector providers. Under that basic philosophy, I will now list what I believe are the essential elements of an effective system that will not be the financial train wreck that the ACA is.

Essential Elements

NOTE. I am not asserting here that this simple outline fully defines the entire replacement system that would be needed. However, I do believe that it summarizes a conceptual approach that will work.

  • (1) All insurance policies must cover the same time period [January 1 to December 31, or some other twelve-month period — calendar year will be assumed here], and all deadlines for signup must be the same.
  • (2) By the same date each year, all insurance companies must submit electronically to DHHS a database of policies they will offer in the upcoming year, and those lists must contain a small amount of key information such as monthly premium, deductibles that must be met before any reimbursement begins, average co-pay ratio (e.g., 80% / 20%) for all situations where such ratios apply, primary physician visit co-pay, specialist visit co-pay, drug co-pays by “tier”, etc. [all of this would be very easy for any company to provide].
  • (3) No insurance company can refuse to issue a policy to anyone based on their health status [e.g., pre-existing conditions].  This would clearly result in most insurance companies attaching astronomically high premiums to some of their policies, putting them out of financial reach for the vast majority of people who would need them. This issue will be addressed in subsequent items in this list. NOTE. Even Medicare is denied to people with end-stage renal failure at the time of their initial qualification for coverage. Allowing that criterion for this ACA replacement system should be investigated if elimination of those cases would have a material impact on overall costs.
  • (4) If there are to be any mandated coverages [maternity, children under 26 can remain as dependents under their parents’ policies, abortion, gender change, etc.], all insurers who offer those kinds of benefits to any policyholders must offer optional riders in all policies they offer to anyone. One mandated coverage I believe would solve many problems and simplify this [or any] program greatly would be policies that provide catastrophic coverage only. For example: a much-lower-than-average premium; no coverage for anything up to $X, 80% insurance coverage / 20% patient copay from there to $Y, and 100% insurance coverage above $Y [the values of X and Y would have to be worked out, but I expect that values like $2,000 to $3,000 for X and somewhere between $10,000 and $20,000 for Y would result in premiums substantially lower than average and “maximum out of pocket” amounts at least as low as any current ACA-enabled policies, maybe lower].
  • (5) Using statistical techniques [simple “bell curve” logic, standard deviations, etc. — far less sophisticated than techniques many government agencies use every day], DHHS will identify two groups of “outliers” in the policy database [i.e., policies that fall outside affordability limits set in the preceding year — see Ongoing Refinement section below].  One group of outliers will be called the Mandated Coverage Special Handling Pool [MCSHP], and will consist of people who are cost outliers and have applied for mandated coverage. The other group of outliers will be called the Cost Outlier Special Handling Pool [COSHP], and will consist of all other people classified as outliers.  For all of these outlier applicants [both groups], the following steps would be taken:
    1. The applicable insurance companies would be issued letters of authorization to approve those policies at the average rate of all policies to be issued by that company in that year, with DHHS’ guarantee that it will reimburse them for all costs for those policies that are over and above their average costs for all other claims paid during that year.
    2. All SHP applicants will be issued letters from DHHS [or from the companies to which they applied if that is more practical] outlining their options: 1) proceed with enrollment [which would put them in the same status as anyone else who was not put in the SHP, including determination of their qualification for any other governmental financial assistance that may apply to them]; or 2) refuse this offer of government assistance over and above any other assistance for which they may otherwise qualify.
    3. Through dialog with each SHP policyholder who elected to go ahead and enroll, DHHS would: 1) determine whether or not they qualify for any other governmental financial assistance that may apply to them; 2) attempt to identify other coverage options that would provide equivalent or better benefits while lowering the government’s projected costs to support their policy; and 3) implement any decisions resulting from this interaction.
  • (6) A determination will be made as to income levels [and/or other criteria] at which government assistance should be offered, and what that assistance will be.  If such an assistance program is included, it will be implemented through income tax credits [not just deductions from income] and a mechanism for providing those credits through payroll withholding credits for employed people or through additions to any unemployment or other [disability, etc.] payments for others. NOTE. The details of this would have to be worked out in conjunction with changes in the Tax Code that will likely be underway at the same time.
  • (7) All insurers will submit an annual report to DHHS to include total revenues from policyholders, total reimbursements from government, other revenues, total cost of claims paid [and maybe expenses “incurred but not reported”, or IBNR, depending on how long after year-end the report is due], etc. Data for these reports would be readily-available within these organizations, so the reporting [which should be common-format electronic data, not paper] would not be burdensome. A similar reporting requirement for providers might also be advisable if that information would enhance the usefulness of the information obtained from insurers.
  • (8) At some point in the future, when more viable measures of quality are available and more effective ways to incorporate them into insurance policy comparisons have been developed, quality parameters should be integrated into this entire process [attempting to do this now could actually be detrimental without better measures than we have at this time].
  • (9) The above items are operational in nature. Other possibilities for reducing overall healthcare costs that should be investigated would include but not be limited to the following [some of these are controversial; to the extent those controversies are simply driven by “wars among lobbyists”, that more fundamental issue will need to be dealt with before meaningful progress can be made]:
    1. Imposition of maximum increases or mandated reductions in a given year.  This would have to be purely data-driven, not fully controlled by politicians, and some “appeal” process would be necessary.
    2. Removal of state-level boundaries for insurers. Allow the sale of national policies, regional multi-state policies, etc.
    3. Promulgation of Tort Reform. Curb sometimes ridiculous jury awards, but in a way that does not adversely affect accountability. This is much more costly than the awards themselves — the bigger cost is in “defensive medicine” [tests ordered and procedures performed by providers to avoid potential lawsuits even when they would not, absent the threat of litigation, consider those tests and procedures medically necessary].
    4. Identification of ways to curb “blockbuster” drug costs without thwarting innovation within companies that develop them.
    5. Improvement of capabilities to curb fraud and abuse in all entitlement programs as well as in this new ACA replacement system.

Program Administration

On the administrative side, the massive organization put in place under the ACA would be dismantled as soon as possible, leaving a much-reduced, very streamlined management structure and a much smaller staff consisting of current employees having skills most applicable to administration of the new law, plus any new hires required to ensure an appropriately skilled workforce.

Ongoing Refinement

Certain elements of this program would require an ongoing effort to adjust various parameters each year to ensure that they remain current. One example would be computation of the “outlier” definition mentioned in #5 in the Essential Elements section above.  In the first year, the information in the ACA database for the 2017 enrollment period would be used to establish a baseline database for the new law [see #2 in the Essential Elements section above for a description of the kinds of information that database would contain].

Another area that needs more focused research right now as well as ongoing refinement over time is identification of more viable measures of quality and development of ways to incorporate use of these measures into insurance policy comparisons. Despite much time and effort along these lines over many years, the truth is that current measures simply do not adequately account for variations in patient conditions and other factors that can grossly skew current measures like mortality rates, unexpected returns to surgery, patient satisfaction scores, etc.

Potential Roadblocks

To repeal, and to replace, the ACA will require “lock-step” solidarity among almost all Republicans in the House and at least 50 of the 52 in the Senate [just as initial passage of the ACA required that of all Democrats at that time]. Assuming that all Democrats will be in solidarity with their opposition, this may be tougher than some legislators think at this time.  Also, there may be certain provisions that may raise the specter of a presidential veto even though a Republican will be in the White House. This may turn out to be a textbook example of Mr. Trump’s deal-making ability — or an example of lack thereof as it could potentially apply to this situation.

On the prospect of filibusters as a blocking mechanism … Minority-party threats of filibusters have become so commonplace over the past two years that many people probably think that a less-than-60-seat majority in the Senate enables the minority party to block forever [by threatening filibusters] any bill they oppose, rendering the majority party completely powerless to drive its agenda. That is not the case, however, and the first two years of the Trump administration could produce a major breakthrough in the gridlock of recent years if Republicans are as unified in their agenda as Democrats have been in blocking it. The decision by a majority leader to bow to the threat of a minority-party filibuster is a simple practical matter — avoiding an actual filibuster, which can consume many days, perhaps longer, before the majority leader can bring “cloture” about [the last step that results in the bill being brought before the full Senate for a vote], frees up time for passage of other more bipartisan bills which have greater prospects of being passed.  With a minority-party President who would likely veto narrowly-passed controversial bills, that decision is probably a wise one.   If there has ever been a time when the majority needs to stand up to filibuster threats and do whatever it takes to drive key pieces of its agenda through, this is it!  If a bill is particularly important to the Senate majority and its legislative agenda [and/or the president’s agenda], then going through a filibuster would be worth it and would expose very publicly that it’s the minority that’s causing the logjam.

Note. For anyone interested in gaining a more in-depth understanding of Senate rules and operations as they relate to filibusters and cloture, the document at this link would be a good start: Senate Filabuster & Cloture Rules.

Why This Replacement Approach?

The main advantages in taking this general approach are not that difficult to figure out:

  • Rather than micromanaging every citizen’s healthcare coverage, it focuses the government’s attention [and expenditures] on problem situations [a) all citizens who cannot obtain any coverage, and b) all citizens whose coverage options are financially out of their reach and who qualify — based on all applicable criteria, not just those associated with healthcare — for government assistance].
  • It allows for mandated coverage items that will probably be required to get the law passed in both houses of the Legislature, particularly the Senate, and it keeps the direct costs of those mandates visible every year.
  • It keeps cost outlier criteria current every year, providing a) a more efficient and more expeditious method of adjusting them to changing conditions and b) better information for identifying the actual cost to the program of egregious pricing for certain items like “blockbuster” drugs, “exotic” prostheses, etc. [currently, these situations become visible through media coverage of specific situations, and the resulting politicization (politicians continuously engaged in “issue-hunting”)].
  • The overall cost, the administrative complexity, and the size of the bureaucracy required to administer the program, would be dramatically lower [largely because of the previous items in this list].

There are probably other advantages, but those listed above are enough to warrant taking this approach.

In Part 4 …

In Part 4, Looking Forward, I’ll get into 1) how repeal and replacement of the ACA could potentially be the main determinant of the outcome of the 2018 mid-term elections and/or the 2020 presidential election, and 2) what the future will probably look like under the replacement law if it is successful.


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Charles M. Jones

A Realistic View of the ACA – Part 2

In Part 1 of this series, I introduced the series and covered the first part, Repeal.  After writing this Part 2 and realizing that discussion of a Transition Plan required a few more words than I originally thought it would, I decided to expand the series to four parts instead of three. So, this Part 2 will focus mainly on a relatively simple Transition Plan for people currently covered under the ACA, and some of the financial math that would be associated with such a plan.  Part 3, Replace, will focus on the essential elements that would need to be included in a new plan defined by a law replacing the ACA, and Part 4 will focus on Looking Ahead [after passage of a law replacing the ACA].

Some Basics First

In the process leading to proposed law being voted on in both houses of the Legislature, there is an unfortunate reality we have to face — that bills get to this point only after huge amounts of political bargaining among Representatives and Senators whose primary focus is not on what is best for America, but on what most likely leads to their reelection. For that reason, the most important part of the process is bypassed — determining first what guiding principles can be agreed upon up front before hashing out of the details even begins. In the case of coming up with what became the ACA, or of coming up with a law to replace all or parts of it after its repeal, that would mean addressing fundamental questions like the following:

    • Is every American citizen entitled to insurance to cover their healthcare needs, or is it simply a product/service that some people can afford and others can’t?
    • If healthcare insurance is an entitlement, which products/services are considered entitlements, and should the government provide them directly through government-run facilities or pay private providers for their costs and reasonable profits to provide them [and in the latter case, how will guaranteed access and affordability be ensured for people private insurers deem unprofitable to cover]?
    • If healthcare insurance is not an entitlement, should there be regulations that require access to healthcare services under certain conditions by people who cannot afford to pay for those services [and if so, what are those conditions, and is government required to either pay for that access (through tax revenues) or require providers to absorb the unreimbursed costs they incur in providing them (a form of indirect taxation)]?
    • In either case, for any financial assistance that may be available under certain conditions, do people who do not manage their own health well [eating habits, exercise, etc.] receive the same assistance as those who do [and if not, on what basis is the granting of assistance made, and who makes that decision]?

Although most legislators would probably say they did address or are addressing fundamental questions like these, they haven’t done so in the way and to the depth I’m saying they should have.


Given this caveat, we’ll look at two things that replacement legislation needs to address: 1) a transition plan for people currently covered under plans obtained through the ACA; and 2) essential elements of a replacement law. As mentioned above, I’ll focus on the latter in Part 3, Replace.  In this Part 2, I’ll focus on a plan for Transition.

Transition Plan

This isn’t rocket science — a lot of what is needed is simply common sense.  Politicians have a tendency to get bogged down in peripheral arguments, particularly when they perceive that a decision they are about to make will affect large numbers of people and/or when they recognize the risks involved and the possibility that they and/or their party will be blamed [and punished in the next election] if things don’t go well.  I call this the Mesmerization Syndrome.  A good example is what has already become a headline item — “Repealing the ACA will kick 20 million people off their health plans”.  Something I said in Part 1 of this series is worth repeating in this context. … Although there are, in fact, about 20 million people now enrolled through the exchanges set up under the ACA, nobody knows how many of these people have coverage through the ACA because they could not obtain coverage without the ACA.  It would not surprise me if it turns out that only half, maybe even less, would not be able to obtain more or less comparable coverage — i.e., many enrollees probably bought through the exchanges for other reasons [e.g., they found it easier to navigate through their options once the initial glitches were ironed out]. Whatever the actual number of people affected turns out to be, all that is needed initially to avoid this “kicking off” is a simple set of transition rules built around a common-sense “grandfather clause” something like the following:

Grandfather Clause  Any existing policy obtained under provisions of the ACA cannot be terminated by the insurer, nor can its renewal be refused until the replacement law is in effect, except for 1) non-payment of premiums; 2) or non-payment of co-pays, deductibles, etc. within “x” days of due dates [unless disputed — with a defined process for resolving disputes].

According to www.healthcare.gov [the site where people can “shop” for and sign up for plans under the ACA], the average 2017 cost of a “gold” plan [the best plans available] will be $9,167. Even if all 20 million enrollees were grandfathered in for all of 2017 and all 20 million qualified for 100% government-subsidized coverage [an extremely exaggerated, almost facetious assumption], the cost of this transition would only be 183.34 billion [in the general range of what would be spent under an unmodified ACA] .  Realistically, the cost would be less than that because based on the highest estimate I’ve seen, only about 83% of people enrolled under the ACA qualify for government subsidies [the average amount of individual subsidies is a difficult number to find, but it is certainly nowhere near 100%]. Also, as mentioned above, it is only people who otherwise would not be able to obtain coverage [i.e., not the whole 20 million] who would need to be included in this calculation. It would not surprise me at all if the actual cost of this “grandfather clause” transition turned out to be considerably less than $100 billion.

Essential Elements of a Replacement Law

I’ll get into this in Part 3, Replace. Then, in Part 4 of this series, which will be focused on Looking Forward, I’ll get into 1) how repeal and replacement of the ACA could potentially be the main determinant of the outcome of the 2018 mid-term elections and/or the 2020 presidential election, and 2) what the future will probably look like under the replacement law if it is successful.


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Charles M. Jones

A Realistic View of the ACA – Part 1

Judging by his cabinet appointments so far, it is clear that President-Elect Trump is focused on doing the things he said he’d do, getting those things done expeditiously, and [as usual for him] not letting himself get sidetracked by political correctness, criticism, and fear of opposition. One of the most visible “to do” items is “repealing and replacing” the Affordable Care Act [ACA, aka “Obamacare”] — one of the major themes of his campaign, and part of the Republican mantra practically since passage of the Act through some political “shenanigans” [i.e., designed loopholes to enable “reconciliation” to be used to get the bill to a floor vote, which assured passage since the Democrats narrowly controlled both houses of Congress at the time].

I was a “C-Suite” Healthcare executive for most of three decades, and after that I was a Healthcare consultant for about seven years. Among my executive oversight responsibilities for several of the “C-Suite” years was a centralized business office for a ten-hospital, seventy-clinic integrated healthcare delivery system that also included an insurance subsidiary. I say that to say that I have direct knowledge and experience that I believe enable me to write with at least some degree of authority on this subject.

This post is the first of what I currently envision as three parts: Repeal; Replace; and Looking Forward. I’ll begin this first post with an introduction of the series.


It’s not exactly rocket science to figure out that the ACA will ultimately collapse under its own weight. The evidence of that has been building almost since its passage, but the accelerating problems of the past two years, capped off with upcoming 2017 options that include not only both massive premium increases and markedly higher deductibles, but an increasing number of failed exchanges and more major providers pulling out of the exchanges that remain, make it obvious that “something has to give” — soon.  The Caduceus image above is a cartoon-style version of the symbol often used for healing and medicine, and it tells the story fairly succinctly — the tails of the two snakes are labeled “Good Intentions” and “Reality”, and at the top, the latter has its fangs in the head of the former.

The unfortunate truth is that this situation was predicted by many people, some within our elected leadership, when the ACA was first passed. In retrospect, anybody should be able to see the wisdom of those predictions.   Just think about the initial promises during the legislative process that resulted in passage of the ACA.  In effect, it was:

I have deal for you … Pass this into law, and within a few years everybody will have quality healthcare coverage, with the average family saving $2,500 per year.  Those who currently have health plans that they like will be able to keep those plans, and their current relationships with doctors and other providers will not need to change unless they want to choose from among the many other options that will be available to them through State and National exchanges. All people who need financial assistance in order to afford a reasonable health plan will obtain that assistance in the form of government subsidies that will partially or fully offset their premiums.  In the long run, this “won’t cost taxpayers a dime” because of the savings that will be achieved through better access [thereby preventing a large percentage of emergency care costs and costs for procedures that can be avoided with better primary care], “elimination of fraud and abuse”, and more competition [which will drive down prices].

Anyone who bought that line is a classic example of proof that P. T. Barnum was right — “There’s a sucker born every minute”.  You don’t need to be a healthcare or finance expert to figure out that you cannot promise unlimited service from providers over whose costs to provide those services you have no control, and at the same time promise that this unlimited service will be “affordable” without risking huge taxpayer costs that the country simply cannot afford.


Politically, Mr. Trump will have to get this part done, because any attempts to simply modify the existing ACA to make it fiscally sustainable [which it currently is not] would be throwing logs onto the fire of Democrat Party “See, we told you so” rhetoric. Politics is not the only reason why a repeal is necessary, however. This law’s original 2,300-page version, since expanded through operational policies and additional regulations promulgated under its auspices to the equivalent of tens of thousands of pages, is a bureaucratic nightmare, and its fundamental financial and operational design flaws will ultimately result in it collapsing under its own weight as described in the Introduction above [and “ultimately” is now, with descriptions like “death spiral” already circulating long before the November 8 election].

It is extremely disappointing to me that people in our leadership [all Republicans, of course] who constantly expressed warnings about the situation the ACA is now in were never able to articulate their concerns in a way that “connected” with people.  Had they been able to do that, it is quite possible that the bill would never have become law in the first place — and if politics had pushed it through anyway [which is what happened], it would have been repealed with bipartisan support very early during its implementation. And by now, we would probably already have a better system in place instead of having a replacement process still ahead of us.

It will be interesting to see how this repeal process unfolds — whether Democrats will have the good sense to refrain from filibusters and other tactics [which will only delay, not prevent, repeal], and whether Republicans will at least try [hopefully successfully] to gain bipartisan support for a transition plan to avoid sudden loss of coverage for people currently enrolled in plans obtained through the ACA [such a transition plan will be absolutely essential — I doubt that a repeal will otherwise be possible because I expect that even our Republican President-Elect might veto a repeal bill that does not include such a transition plan or at least a concomitant bill dealing with transition].

An Important Note About “Millions Losing Coverage”

One thing to keep in mind since there are already rumblings [almost exclusively from Democrats] about “kicking 20 million people off their healthcare plans” if the ACA is repealed … Millions of people will believe these claims simply because they don’t understand how the ACA works.  Although there are, in fact, about 20 million people now enrolled through the exchanges set up under the ACA, nobody knows how many of these people have coverage through the ACA because they could not obtain coverage without the ACA.  It would not surprise me if it turns out that only half, maybe less, would not be able to obtain more or less comparable coverage — i.e., they bought through the exchanges for other reasons [e.g., they found it easier to navigate through their options once the initial glitches were ironed out].

In Part 2 …

In Part 2 of this series, I’ll focus on two main points: 1) some of the financial math that would be associated with a relatively simple transition plan for people currently covered under the ACA; and 2) options that are under discussion about a system to replace the ACA.


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Charles M. Jones

One Picture Is Worth A Thousand Words

img_7262Depending on whether you end up reading a section that will not apply to all readers of this post, the text here is only about 400-700 words [about the length of a typical newspaper editorial], but according to the old adage “one picture is worth a thousand words”, two pictures [actually one diagram and one U. S. map] make it equivalent to about 2,400 to 2,700 words [about the length of a comprehensive newspaper cover story]. Enjoy! …

Regarding the diagram, I honestly believe that if every person who could potentially be eligible to vote in 2018, and particularly in 2020, would view it and conduct himself/herself accordingly between now and 2018 [and particularly 2020], many of this country’s problems would be greatly diminished if not completely eliminated because the result would be that 1) every resident who could potentially vote would do so, 2) nobody would vote more than once in a single election, 3) no ballots would be cast by dead or otherwise ineligible people, and 4) every resident would be a more active participant in our process for identifying candidates for office [perhaps including themselves] and gaining support for election of those candidates.

So to that end, please share this with everybody you know — on FaceBook and Twitter, through email lists, etc. Think about it … you could be a part of getting America back onto a more sustainable path!

The brief remainder of this post assumes that the reader has viewed the diagram. All diagram viewers will be referred to Referenced Paragraph 2 at the end of its “flow”; some will also be referred to Referenced Paragraph 1 — so first, please view the diagram at this link: Post-Election Guide For U.S. Residents.

Referenced Section 1

[NOTE: This section will only be meaningful to a person who has viewed the diagram (above link) and been referred here from there]

fullsizerender-7You were referred to this section because you said you are either openly gloating over the election outcome or protesting against it, and that directed you to the diagram block at the left.  If you are engaged in either of these activities, please stop immediately! What you are doing is not only unproductive and disruptive, it is actually counterproductive — working against the effective functioning of our government. Whether the candidate who won the election won it through the Electoral College or the popular vote, or both, doesn’t matter “at this point”, as Hillary Clinton would say. The Electoral College exists for the very purpose of ensuring that the votes of all Americans carry at least some weight. Like it or not, it is what it is. Americans who think the election system should change need to move on “at this point” by 1) supporting their new duly-elected President and 2) engaging in legal and constructive ways to gain enough support to change the system to their liking.

One final picture for anyone who is protesting with “Not My President” or “Trump Lost the Popular Vote”. The county-level map below shows that the counties in America voted overwhelmingly [98.2%] for Trump [more justification for the underlying purpose of the Electoral College]. Just think of the county in which you live. The environment there is what impacts your life most on a day-to-day basis. … And one word [OK, sentence] of advice: be careful what you advocate; you may get it [or put in the form of a question, if the result had been the opposite — Clinton won the election via an Electoral College margin of 15.4%, but Trump won the popular vote by a margin of 1.0% — would you still be saying the system is bad?].

County-level 2016 election results map [red Republican/Trump, blue Democrat/Clinton]:


Referenced Section 2

[NOTE: This section will only be meaningful to a person who has viewed the diagram (above link) and been referred here in the box shown at left]

fullsizerender-8Everybody following the diagram was ultimately referred to this section because it applies to everybody, regardless of their attitude about the election outcome [all paths in the diagram lead to this point, the diagram block at the left].  Because we are so divided ideologically [as the campaign just ended clearly showed], our election system will always result in approximately half our citizens being happy with an election outcome and half being unhappy with it. That is exactly why we have specific terms for elected officials, and why both the lengths and end points of those terms vary. The time between term expirations for various offices is when we should move on, working in legal and constructive ways with like-minded people in our individual “happy or sad camps” to identify candidates for future elections and develop plans to gain support for them.

So there you have it — and you heard it first right here at www.USAparadigm.com. Please share this with everybody you know — on FaceBook and Twitter, through email lists, etc. Think about it … you could be a part of getting America back onto a more sustainable path!


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Charles M. Jones

An Alarming Development

Not a time for resting on “assumptions”

In the physical world, Newton’s First Law of Motion is pretty straightforward and easy for non-scientists to understand: “An object will remain at rest or in uniform motion in a straight line unless acted upon by an external force”. That’s basically the definition of inertia.  A parallel concept in the broader world in which we live is that we humans have a tendency to assume that, absent a major crisis of some kind [like Newton’s “external force”], things that seem okay today will remain okay.

Unfortunately, in these times, that is not a safe assumption. In America, the overall sociopolitical climate has been changing exponentially over the past few years, and we would be well-advised to view each of the components of this change with more scrutiny. Any one of these components could be a harbinger of a trend that, if amplified over time, could be looked back upon in the future as something that should have been fervently resisted.

Changes in human perceptions tend to occur over years, decades or even longer before they become highly noticeable when viewed in context with the past. As one decades-long example, the Civil Rights Movement itself changed [for the better, in my opinion] perceptions of both blacks and whites toward each other. Although there appears to be bitter hatred toward each other at both extremes today [Black Panthers at one extreme, White Supremacists at the other], general perceptions of each other in the much larger “center” are starkly different [and better] than they were decades ago.

A Harbinger?

One of the things I’m noticing lately [since the election] that is very disturbing to me is the attention being paid in the media to what some call “fake news”.  The recent presidential election campaign provided numerous examples, with total fiction flowing from both sides about underhanded things the other side was doing. Anybody can post anything on FaceBook or Twitter, or send a “broadcast email” to lists he/she can access — and if they want to, they can even include logos of companies or organizations that make these posts look like forwards from reputable sources.

The way Liberals are talking about this, there is a need for “screening”, and there is considerable pressure on Google, FaceBook and Twitter [because they are very large companies, and companies of their ilk are quickly overtaking traditional media as the principal source of news for more and more millions of people] to come up with ways to do that. This is very disturbing.

The First Amendment has been used to justify such things as publication of what almost any reasonable person would call pornography, very derogatory and hateful remarks some people make about others, etc.  The justification in court cases is, in so many words, what one person considers distasteful another considers “art” or “freedom of expression”. By that logic, what basis would a liberal kid like Mark Zuckerberg [FaceBook CEO] use for deciding what “news” items being posted on FaceBook are “appropriate” — or even “accurate”, for that matter?

We have laws against slander, and to the extent one person or organization posts something that is provable as untrue in Social Media [or publishes or broadcasts it in traditional media] that is derogatory toward another person or organization, the offended person or organization can sue for damages. In purchasing decisions, caveat emptor [let the buyer beware] should always be a consideration.  Absent slander, everything that comes into a person’s email inbox, FaceBook News Feed or Twitter Feed should fall under whatever the equivalent Latin phrase would be for “let the reader/listener/viewer beware”.

Big Brother?

Underlying something in the calls to “do something about this” is an interesting mindset — that Joe Citizen is either a) incapable of discerning for himself which pieces of media “news” he consumes are true and which aren’t or b) unwilling to do the research to sort all that out and just lets it all “soak in”. The extension of that thinking is that people who are in a better position to make that decision than Joe need to to make it for him and screen out “inappropriate” content so he doesn’t see it in the first place.

The environment depicted in George Orwell’s 1949 book 1984, though possibly off [depending on one’s point of view!] in its projected year of realization, was exactly what the near future could hold for us if this train of thought “catches on” politically and gains some traction that results in legislation and/or executive actions [or even in “collaborative agreements” among key media moguls].

The technology in the 1954 movie version of Orwell’s book might look “clunky” by today’s standards, but the underlying conceptual framework was remarkably accurate in predicting today’s technological capabilities — ubiquitous devices for viewing everything going on everywhere [even within private homes], centralized surveillance by authorities using that technology, the ability for those doing the surveillance to have dialog with individual people … sound familiar today?

Just think about today’s technology: smartphones; the Internet; Internet-connected TV content delivery devices [the newer cable TV boxes, Roku, AppleTV, Google Chromecast, etc.]; video devices used [ostensibly only] for traffic management, building security, etc.; home automation devices; automobile electronics; the “Internet of Things”; drones; etc.  … now, think about that technological environment in context with recently-uncovered  “goings on” in the CIA and the FBI, and it’s not very hard to see Orwell’s “future” being more like the present than we’d like to believe is possible.

A recent TV series, Person of Interest, is not as much science fiction as one might think. Most if not all of that technology already exists as components, and the degree to which it is [or could be] all tied together and usable in the way depicted in the TV series [very much like Orwell’s 1984, but in an ostensibly more altruistic setting] is much more plausible than we might assume when watching the show as entertainment.

Learn from the frog in the pot of boiling water

The issue I’ve tried to shine some light on in this post [pressure on Google, FaceBook and Twitter now, but potentially any company with an “audience”, to find ways to screen out “fake news”] is something we should all follow and understand — particularly if any screening methods these companies come up with move in the direction of promulgating government regulations or even “collaborative agreements”. This is a classic example of something that could become a “frog in the pot of water slowly coming to a boil” situation — we are apathetic about it until it is apparent that it has become a danger, at which time we can’t prevent the highly undesirable outcome [in the case of the frog, leg muscles “cooked” to the point of being too weak to enable him to jump out of the pot; in ours, Orwell’s 1984].

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Charles M. Jones

Election Aftermath – 7

map-resultsTime To Move On

Some of the text in this post were taken directly from letters to the editor published in the Opinion section of the 11/14/16 Tennessean [Page A12].  As I read those letters and considered not only their content but their overall tone relative to letters published in that and other publications in the days since the election, I felt a level of confirmation of my plan for this last of seven daily post in the series I entitled The Aftermath. This post is also the last in what could be viewed as a fifteen-day series that included a seven-post “countdown-style” series [Down the Stretch] leading up to the election followed by a post on Election Day and then by this “count-up-style” Aftermath series. My plan for this post is to indicate where, on balance, we appear to be at this point after the most bizarre presidential campaign in my memory and possibly in our nation’s history.

The general tone of these opinion letters tracked pretty closely with the general tone I’ve been seeing in my week-long intentionally-more-than-average daily consumption of media content for several days now — less loser temper tantrums and winner gloats and more “get a grip” and “time to move on” content. It’ll take at least some display of maturity in the media [a very big uphill climb, I admit!], with less headline chasing for newspapers and “This just in …” for radio and television, but I expect that will happen as a little more time goes by.

A good thing about letters to editor is that they have to be short, so there’s less bloviating and more to-the-point content in them. This one would be ballyhooed by some who’d label me as a dogmatic bigot for quoting it, but it captured pretty well how I think most Americans who voted for Trump feel: “America is angry and sick and tired of being misrepresented by the press and career politicians. Instead of protesting in the streets and burning buildings, we elected a new President. Hopefully, we can … rebuild respect for our nation and reset our moral compass. By this, I mean that not everything is okay as long as I don’t hurt anyone. There is right and wrong. If you get your feelings hurt every now and then, get over it. The media and politicians need to stop stoking the flames of racism as well. Stop dividing the nation as Latinos or African Americans or the new one: uneducated white men. We are all Americans! … There will have to be change in all parts and not everyone will be happy”.

Here’s another: “President-elect Donald Trump used a coalition of Democrats, Independents and Republicans, along with a well-organized, comprehensive ground game to win the presidency. Trump was a non-PC candidate who promised to protect our national borders, vet immigrants coming from nations with militant Islamic problems, bring businesses and manufacturing back to our country, and uphold the Constitution.  He spoke to the many millions of individuals who feel they were being ignored. But, just as important, the Democrats have for the last eight years contributed to their own collapse. Barack Obama’s legacy is one of divisiveness and an ultra-left-wing agenda achieved in part through over-reaching, unconstitutional executive orders. Under his watch, they have seen their loss of both the U.S. House and Senate, most governors and a large majority of state legislatures. The president’s signature socialist achievement, Obamacare, is falling apart. Hillary Clinton was seen as an uninspiring continuation of the failed Obama legacy. But worse for her, her many scandals and lies came back to haunt her. Finally, the elitists in the media attempted to cover up the Obama/Clinton train wreck and it was obvious. Overt partisanship in the left-wing media only served to backfire on the very Democrats for whom they were cheer-leading”.

In all, there were nine letters, eight of which were election-related. Four of those expressed what could be called the “winners’ view” and four expressed what could be called the “losers’ view”. I didn’t quote the latter category here because they were still “in the weeds” and didn’t show the same level of perspective as the ones I quoted. They did, however, use less divisive and derogatory terminology than letters the first day or two after Election Day, and they had more of a “Let’s pick up the pieces and figure out how to <get back into power, in so many words>” tone.

On the Opinion page [A12] in today’s Tennessean, one letter lamented the ills of the Electoral college, but this one seemed to me to be the best argument for it [partial quote, after the writer briefly reviewed some 1770s history]: “There was intense debate over what was fair representation for the people of each state. That’s how we came up with the two senators for each State and varying numbers of representatives in the House. This way, no one state or small group of states that have the largest population can impose their will on the rest of the States. The Electoral College is the same concept. If we only used the popular vote to determine the Presidential election, you might as well let the 10 or 12 most populated states on the East and West coasts hold the election. The rest of the states would rarely if ever have a say in the outcome of the election. Donald Trump won the Electoral College and he also won 30 out of 50 States. The majority of States voted yes to Donald Trump. We are a union of states in a democracy and each state had its vote represented in the election”. The county-level [rather than state-level, which is misleading] map at the top of this post says pretty clearly that we don’t have a “minority-elected” President.

I should also point out that the Tennessean is an extremely liberal newspaper, but I thought the editorial about the election in the 11/13/16 edition [page H1] was very balanced and well-written. I’ll close with some of the text from that editorial, with which I wholeheartedly agree:

The road to healing begins by accepting reality. Donald Trump won the 2016 presidential election and will be the 45th president of the United States of America on Jan. 20, 2017. Americans can rejoice that the 219-year-old tradition of peaceful transition of power in the U.S. will occur anew. President-elect Trump showed graciousness and humility in victory and Secretary Hillary Clinton did so in defeat. … Now, it is up to citizens in their communities to begin the process of healing and coming together. This can be done by reaffirming our commitment to the values and freedoms endowed by [our] state and national constitutions, by facing each other even if we voted differently, and by having difficult, respectful conversations about how to move ahead. … We heal by listening first to one another.  We should focus on what we have in common.  [We need] prayer [and] positive activism, [and we need to] think globally [and] act locally.  This last one is very important and calls on Americans to be more engaged than ever in civic life, from decisions on where to build sidewalks to what happens to our health care system. The elected officials at all levels, from president to mayor, are not our masters; they are the people’s servants. Now is the time for courage, for unity of purpose and for summoning the intentionality to sustain and strengthen our democracy. We Americans are capable of this and so much more. We are all the United States of America.”

I’ll go back now to posting more or less weekly, with my first post next week offering some “where, if anywhere, to go from here” thoughts.


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Charles M. Jones

Election Aftermath – 6

question-mark-faceToo Many People Don’t Vote!

Of all the statistics one can glean from exit polls and from the voting statistics stemming from this election, probably the most alarming is the fact that around 90 million people in this country who are eligible to vote don’t vote. That’s more than 27 times the average popular vote difference in the last 5 presidential elections, and over 148 times the average popular vote difference in 2000 and 2016 [the two closest races in that time period]. Of those, 13 million don’t even bother to REGISTER to vote. That’s more than 4 times the average popular vote difference in the last 5 presidential elections, and over 20 times the average popular vote difference in 2000 and 2016.

Just think about those numbers for a moment.  The people who don’t even vote could literally seize control of America if they could do three things very well in the year or so leading up to a presidential election: 1) develop a common cause [or a small, easy-to-communicate set of causes] around which they could rally themselves and either an Extreme Left or an Extreme Right “base”; 2) put together an effective Social Media campaign strategy [which would require only a fraction of the money traditional campaigns spend on media advertising]; and 3) execute that strategy as effectively as the Trump campaign just did and the Sanders campaign almost did.

In a way, that’s encouraging, and in another way, it’s scary.  It’s encouraging because, as the Trump campaign just demonstrated [and as the campaign that defeated Senator Eric Cantor did in 2014, and as the Sanders campaign almost did this year], there is clearly a paradigm shift underway, and traditional views of what wins elections no longer “rule”.  It’s scary because how the 90 million non-voters think, and what causes they might develop to rally around, is a huge unknown — i.e., other than demographic information [age, sex, race, marital status, etc.], there are no election statistics, exit polls, etc., to give any insight into who they are and how they think, and assuming that they could simply be lumped into “buckets” based on demographics alone would be a very risky basis for making predictions.

Something that would be most interesting to know, but which is probably impossible to accurately measure, is the percentage of the people involved in all the demonstrations going on who actually voted in this election.  If most of them voted and they’re just frustrated because they lost or elated because they won, I guess demonstrations are fine as long as they don’t turn violent [as some have] — and as long as they don’t simply throw back to Trump supporters or Clinton supporters the same kind of hate speech that both of these candidates used in their campaigns [which at this point is totally unproductive and even counterproductive].  But if they didn’t vote and they’re involved in demonstrations, shame on them!  I’ve quoted President Garfield before, but what he said is wise counsel to anybody who is demonstrating but didn’t vote: “The people are responsible for the character of their [leaders]. If [they] be ignorant, reckless, and corrupt, it is because the people tolerate ignorance, recklessness, and corruption.  If [they] be intelligent, brave, and pure, it is because the people demand these high qualities [in the people who] represent them”. In other words, “they” didn’t bring this situation about; you did!

People considering running for office in the future, as well as those now in office and having a desire to remain there, would be wise to take the dynamic I’m referring to here into account as they continue in their current roles and/or aspire to other roles.

Moving on to a different and more currently significant subject. …

In looking at key appointments Mr. Trump is already making, I am even more encouraged that he is a man who will ultimately overcome the negative impressions many people have of him and rise to the challenges of the office. Some of his appointments are “establishment” people — a recognition on his part that although he campaigned as — and in large part was elected because he is — an “outsider”, he will need more “political savvy” than he personally has to be successful.  I believe he is a man who has keen insight into “goings on”, and that this insight, maybe even intuition, gives him a unique ability to “know what he doesn’t know” and fill in the gaps with people who do know those things.

Our President Elect has two other qualities which I believe, when combined with that mentioned in the preceding paragraph, will make him a successful President.  He is a proven leader and decision-maker, something that has been grossly missing during the current administration. Also, he clearly has a love for his country and thinks of it as exceptional.  Whether he will be as good a President as I believe he has the capacity to be remains to be seen, but at this point, I am encouraged, and will pray to that end.


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Charles M. Jones

Election Aftermath – 5

b0a7ee87-8f4c-423f-ae98-d26b389ada68-2060x1236I mentioned in my second post in this seven-day The Aftermath series that I had purposely been consuming a bit more than my usual amount of daily media coverage in order to get a good feel for whatever post-election climate was developing. Now, after consuming that higher-than-usual share of media coverage for five post-election days, I’ll mention two more observations/conclusions to add to what I have shared in posts two, three and four.

The “Gimme” Mentality

First, in a conversation a good friend of mine and I had last Friday, he said something that has resonated with me in my daily mental “cataloging” of thoughts about content for upcoming posts to this blog. He said “One thing that stands out to me is how large the ‘gimme’ population is”. That remark has come to my mind several times since then as I’ve since seen pictures and video clips of demonstrators carrying signs and chanting “What do we want? (Whatever)!. When do we want it? Now!”.

Relating these demonstrations to other “anti this” and “pro that” demonstrations that go on all the time amplifies the underlying concept my friend was elucidating — too many people these days seem to believe that when they think something would be a good thing to have, “somebody” should “give” it to them — and that “they” should “give” it to them now. That is a very dangerous mentality, and it is contrary to the fundamental tenets of this country’s founding.

The mechanics of our democratic republic were not designed to provide instant gratification. In fact, they were intentionally designed to avoid changes that might, in the absence of safeguards built into them, fail to allow for the Law of Unintended Consequences — i.e., unforeseen new problems often caused by implementation of the “solution” to an existing problem. One example of these safeguards is the fact that there are two- [for Representatives], four- [for the President], and six- [for Senators] year terms, so there is never a single election in which all incumbents could be removed from office [although many people — at times, I must admit, including me — think that might not be such a bad idea!].  Another example is the President’s authority to veto legislation passed by the Legislature [which in most situations requires only a simple majority vote], and still another is the Legislature’s authority override a Presidential veto with a 2/3 vote in both the House and the Senate.

The mechanics of our democratic republic were designed, however, to empower citizens to do two things: 1) garner enough support among their fellow citizens to bring causes they believe to be important to the attention of their elected Legislators [with the goal of ultimately producing legislation furthering those causes]; and 2) run for office themselves and/or support and vote for candidates whose ideologies and/or modus operandi align with theirs. Neither of these two things provides instant gratification. They both require knowledge of and involvement in the mechanics of our governmental processes — and they both require dedication of time, often years.

Too Many People Have Too Much Time on Their Hands

The second observation/conclusion I’d offer in this post is that we have too many people with too much time on their hands. Although demonstrations are a right stemming from the First Amendment [and in my opinion have at times been a force for good in our history], I believe there is something we should learn from much of that activity going on now. First, and unfortunately, “real” unemployment [including people who have dropped out of the workforce altogether] is at an historically high level. I am among those who believe that the outcome of this election will result in improvement in the employment situation more rapidly than would have been the case under Democrat control, but large-scale improvement will not be immediate.  Essentially, through the election, we have done all we can do at the moment for that segment of people with too much time on their hands.

Another big segment of people with too much time on their hands is college students [many of the current demonstrations are on college campuses or are dominated by college students even though they are occurring in the streets of the cities where those colleges are located].  There has been a huge shift over the past few decades in the general mentality of college students.  When I was in college, we had a “soap box” area where people could voice their opinions about issues of the time. At most times on any given day, somebody was on the “soapbox” doing exactly that, and there was usually a small crowd around whoever was speaking. But most students simply did not have the time to be involved in demonstrations requiring them to be away from their classes most of a day or their study time at night.

I earned about half my college expenses for my first two years, and more than 75% of them during my last two years. I was in an Engineering program, which at that time required 143 semester hours for graduation [fewer than half of Engineering students were getting that done in four years]. I didn’t get it done in four years on my intelligence, but on my perseverance and determination. My wife was a year younger, and with equal perseverance and determination, condensed her academic schedule in Education to three years so we could graduate together.

My point is not an attempt at self-aggrandizement, and I know that there are many college students today who have similar stories, but this kind of focus does not seem to be the dominant mentality on college campuses these days. There seems to be less focus on what college is supposed to be [preparation for a productive career] and more on the social and avocational elements of college life.

It is my sincere hope that changes in the underlying causes of both of these sources of idle time will wane as our economy improves, and that the reasons for the demonstrations will diminish as well. I believe the outcome of this election will result in a climate in which both of these things will happen.


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Charles M. Jones

Election Aftermath – 4

Media coverage of demonstrations [which are fine if peaceful] and riotous tantrums seems to indicate that they are waning.  I hope that is true, and that the orderly transition almost [see below]  all of our leaders, both Democrat and Republican, say is what we need now that the election is behind us.

So why did I say “almost” all leaders? It seems a fitting exit for Harry Reid [who is not seeking re-election] that he would be the exception. I am looking forward to no longer seeing him stand almost completely motionless at podiums as he reads speeches written for him like he’s afraid some of his handlers might chastise him if he misses a single word or makes one minute deviation from the script. Speaking in precise monotones, he interrupts his completely motionless state maybe once or twice, glancing up in an attempt to present the illusion that he is conscious.

I would not cheapen this post by actually providing a link to Reid’s letter, but will simply say that that phraseology used by a United States Senator, particularly the second highest person in its leadership, grossly diminishes the little respect that a small minority of our citizens still have for the Senate as an institution, and confirm my rationale for already thinking that by blocking practically everything Republicans tried to do, he has probably been an even worse Senate minority [previously majority] leader than Barack Obama was a President. He could easily have gotten his points across with less derogatory terminology and at least some respect for the office if not the person.

I sincerely appreciated West Virginia Senator Joe Manchin [technically an Independent, but essentially a Democrat since he caucuses with (and almost 100% of the time votes with) them] denouncing Reid’s remarks. … “Senator Harry Reid’s statement today attacking President-elect Trump is wrong! It is an absolute embarrassment to the Senate as an institution, our Democratic party, and the nation. I want to be very clear, he does not speak for me”.

Most Democrats are about as far removed philosophically from me as would be possible, but I respect all but this one [Reid] of their leaders who [as far as I’m aware] have shown at least perfunctory respect for President Elect Trump by publicly stating their desire for an orderly and peaceful transition.

Shame on Senator Reid, and thanks to Senator Manchin for openly rebuking his Minority Leader for such crass and disrespectful remarks.  … And thanks to other Democrat leaders who have been much more gracious in articulating their thoughts about the events of this week.

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Charles M. Jones

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