By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 01/23/2011
IF THE ongoing ... ongoing ... and ongoing debates about repealing the Obama administration's new health care law causes you to feel weary or disoriented, a quick visit to "The Winchester Mystery House" could set you straight. This popular tourist attraction in San Jose is just the ticket for an invigorating education about the American health care system. It can make anyone feel more confident about surviving the deadening clamor of the current disputes.
The first thing to appreciate about the Winchester Mystery House is that it continues to stand despite its original owner's obsession with constant architectural renovations. Legend claims that Mrs. Winchester conducted nightly séances to divine home-remodeling tips that would allow her to elude and confuse "bad spirits." Her compulsive need for self-protection meant constant and unwieldy revisions to her home.
Consequently, at one point the Winchester home contained at least 500 separate rooms of varied shapes and sizes. Stairways that bluntly ended at ceilings. Chimneys that ascended short of the roof. Doors that opened to nowhere. As the home's official website describes: "The miles of twisting hallways are made even more intriguing by secret passageways in the walls. Mrs. Winchester traveled through her house in a roundabout fashion, supposedly to confuse any mischievous ghosts that might be following her."
We are kin to Mrs. Winchester as we continuously amass disconnected health care policies under one old roof and choose to think of our ramshackle construction as a unitary "system."
We never get the foundation right because we always listen to the loudest political spirits of the day and take their piecemeal advice. We pass innumerable health care laws and regulations that are so mind-boggling and labyrinthine to navigate, that we often give up the ghost trying. Meanwhile, as individuals and as a nation, we pay a hefty premium for the thrill of it all.
In other words, the Winchester Mystery House looks a lot like our American health care system.
But the Winchester house uniquely offers visitors the opportunity to experience chaos and structural anarchy without suffering apoplectic fits. In fact, many tourists leave the house feeling awed and intrigued, rather than frustrated. For those invigorated folks, a trip to the Winchester Mystery House provides a preparatory course from which they can graduate -- newly heartened -- and take on the health care debates.
So, how to interpret last Wednesday's vote in the Republican-led House to remove the floorboards under the Obama administration's 2010 health care legislation?
How to understand what would happen even if a repeal of the Affordable Care Act were to succeed?
First, it's important to know that absolutely nothing in the new health law has been repealed by Wednesday's vote. Repeal can occur only if the Senate subsequently votes in its favor and the president signs the repeal into law -- neither of which stands a ghost of a chance.
And, in theory, even if the House, Senate, and president were all on board to dismantle the Affordable Care Act, it may be comforting to realize that the entire health care system would not come crashing down upon us. That's one of the few benefits from having such a disjointed system -- removing one floor or one room can occur in isolation without destabilizing the whole.
Next, it is useful to conceive of the new health law as a suite of distinct rooms in various stages of construction. To lump those rooms together and collectivize them as some monolithic "ObamaCare" is as much an intellectual error as it is a political mistake. That's because Americans have actually begun to inhabit the disparate rooms newly constructed by the health law. Many like what those rooms offer, and many now fear eviction if a blunt repeal of "ObamaCare" ever proceeded.
For example, a tour of the new suite brings us to several such rooms in current operation. In one room, thousands of young adults have been included on their parents' insurance policies through age 26. Residing next door are relieved families with children who can no longer be denied coverage based on pre-existing medical conditions.
Another room shelters millions of seniors who've received financial assistance to help pay for prescription drugs. Down the hall, accountants monitor premium hikes by insurance companies and demand reasoned justifications.
In yet another room, analysts are planning to sort out which research findings and medical therapies offer the best evidence for good patient care.
In other words, we need to understand precisely who and what gets hurt when we start swinging sledgehammers against a system we've all created. We need to be specific and discerning about which rooms require a handyman and paint job, and which require a repeal or overhaul.
In all, more than 90 new rooms are planned by the Affordable Care Act. Most reforms remain under construction, with expected completion dates through 2014. To review them all is to be made aware of their wide-ranging scope and ultimate reach into every American's life.
And it is to be fully reminded about the patchwork nature of our enormous, sprawling health care system which is still in need of a solid enduring foundation, a coherent internal logic, a more sizeable welcome mat, and the wise counsel of a few good spirits.
––––––––––––––––––––––––––––––––––––––––––––––––––––––––-
© Copyright 2011, Kate Scannell
Kate Scannell is a Bay Area physician, syndicated columnist and the author of "Flood Stage."
Dr. Kate Scannell highly recommends a 10-minute cartoon: "Health Reform Hits Main Street" presented by the Kaiser Family Foundation and can be linked from her column online at www.contracostatimes.com
or through
http://healthreform.kff.org/The-Basics.aspx
First Published in Print: 01/23/2011
IF THE ongoing ... ongoing ... and ongoing debates about repealing the Obama administration's new health care law causes you to feel weary or disoriented, a quick visit to "The Winchester Mystery House" could set you straight. This popular tourist attraction in San Jose is just the ticket for an invigorating education about the American health care system. It can make anyone feel more confident about surviving the deadening clamor of the current disputes.
The first thing to appreciate about the Winchester Mystery House is that it continues to stand despite its original owner's obsession with constant architectural renovations. Legend claims that Mrs. Winchester conducted nightly séances to divine home-remodeling tips that would allow her to elude and confuse "bad spirits." Her compulsive need for self-protection meant constant and unwieldy revisions to her home.
Consequently, at one point the Winchester home contained at least 500 separate rooms of varied shapes and sizes. Stairways that bluntly ended at ceilings. Chimneys that ascended short of the roof. Doors that opened to nowhere. As the home's official website describes: "The miles of twisting hallways are made even more intriguing by secret passageways in the walls. Mrs. Winchester traveled through her house in a roundabout fashion, supposedly to confuse any mischievous ghosts that might be following her."
We are kin to Mrs. Winchester as we continuously amass disconnected health care policies under one old roof and choose to think of our ramshackle construction as a unitary "system."
We never get the foundation right because we always listen to the loudest political spirits of the day and take their piecemeal advice. We pass innumerable health care laws and regulations that are so mind-boggling and labyrinthine to navigate, that we often give up the ghost trying. Meanwhile, as individuals and as a nation, we pay a hefty premium for the thrill of it all.
In other words, the Winchester Mystery House looks a lot like our American health care system.
But the Winchester house uniquely offers visitors the opportunity to experience chaos and structural anarchy without suffering apoplectic fits. In fact, many tourists leave the house feeling awed and intrigued, rather than frustrated. For those invigorated folks, a trip to the Winchester Mystery House provides a preparatory course from which they can graduate -- newly heartened -- and take on the health care debates.
So, how to interpret last Wednesday's vote in the Republican-led House to remove the floorboards under the Obama administration's 2010 health care legislation?
How to understand what would happen even if a repeal of the Affordable Care Act were to succeed?
First, it's important to know that absolutely nothing in the new health law has been repealed by Wednesday's vote. Repeal can occur only if the Senate subsequently votes in its favor and the president signs the repeal into law -- neither of which stands a ghost of a chance.
And, in theory, even if the House, Senate, and president were all on board to dismantle the Affordable Care Act, it may be comforting to realize that the entire health care system would not come crashing down upon us. That's one of the few benefits from having such a disjointed system -- removing one floor or one room can occur in isolation without destabilizing the whole.
Next, it is useful to conceive of the new health law as a suite of distinct rooms in various stages of construction. To lump those rooms together and collectivize them as some monolithic "ObamaCare" is as much an intellectual error as it is a political mistake. That's because Americans have actually begun to inhabit the disparate rooms newly constructed by the health law. Many like what those rooms offer, and many now fear eviction if a blunt repeal of "ObamaCare" ever proceeded.
For example, a tour of the new suite brings us to several such rooms in current operation. In one room, thousands of young adults have been included on their parents' insurance policies through age 26. Residing next door are relieved families with children who can no longer be denied coverage based on pre-existing medical conditions.
Another room shelters millions of seniors who've received financial assistance to help pay for prescription drugs. Down the hall, accountants monitor premium hikes by insurance companies and demand reasoned justifications.
In yet another room, analysts are planning to sort out which research findings and medical therapies offer the best evidence for good patient care.
In other words, we need to understand precisely who and what gets hurt when we start swinging sledgehammers against a system we've all created. We need to be specific and discerning about which rooms require a handyman and paint job, and which require a repeal or overhaul.
In all, more than 90 new rooms are planned by the Affordable Care Act. Most reforms remain under construction, with expected completion dates through 2014. To review them all is to be made aware of their wide-ranging scope and ultimate reach into every American's life.
And it is to be fully reminded about the patchwork nature of our enormous, sprawling health care system which is still in need of a solid enduring foundation, a coherent internal logic, a more sizeable welcome mat, and the wise counsel of a few good spirits.
––––––––––––––––––––––––––––––––––––––––––––––––––––––––-
© Copyright 2011, Kate Scannell
Kate Scannell is a Bay Area physician, syndicated columnist and the author of "Flood Stage."
Dr. Kate Scannell highly recommends a 10-minute cartoon: "Health Reform Hits Main Street" presented by the Kaiser Family Foundation and can be linked from her column online at www.contracostatimes.com
or through
http://healthreform.kff.org/The-Basics.aspx