Unstoppable, Immovable

A long time ago, an enterprising arms dealer was peddling his goods, looking to sell both a spear and a shield.  He was a boisterous hawker, given occasionally to the stereotypical sales hyperbole.  His spear was so good, he claimed, that it could penetrate any shield.  Spear sales soared, but his inventory of shields was growing.  Since the pitch worked the first time, he reprised it for the shields…so good they could stop any spear.

Inevitably, a buyer, holding both in hand, asked what would happen if this spear were chucked against this shield.  And thus the age old paradox was born – What happens when the unstoppable force meets the immovable object?

We ponder this question today because waxing philosophical is easier on a beautiful early spring Colorado Friday morning than is trying to make sense of the fluid healthcare policy situation in Washington.

Side note.  In case you needed to be reminded of your blessings, on Thursday, the House Ways and Means Committee had an 18 hour ‘mark-up’ session of the Republican bill.  That was followed by a 28 hour version of the same thing by the Energy and Commerce Committee.  The material changes from that process were effectively zero.  You did not have to endure that, so give thanks.

As we watch this process unfold, regardless of where you sit on the political spectrum or where you stand on specific issues, it is worth remembering that we live our version of the old paradox.  Healthcare in this country, regardless of how it is delivered or who pays or the method for doing so, is really expensive.  And at the same time, no one, especially if they or their grandma is sick, wants to give up one iota of service or care.

Piercing spears meet impenetrable shields.

Public payment, even a single payer system (that group has gone underground, I think), would explode the national debt and spiral us into a major economic depression.  Private payment only would leave the vulnerable only more so and unravel the fabric of our society.

So of course, we’ll land somewhere in the middle, neither fully public nor exclusively market.  Politics and policy is trying to make it all the math work, both economic math and vote counting math.

But keep front of mind, the opposing forces in this debate are each virtually irresistible to one another.  This stuff is hard.  Who knew?


two × 5 =


Tim Coan, ALN’s CEO, writes an insightful and witty blog three times a week about a variety of topics relevant to independent physician practices.

Yes, I'd like to get Tim's blog.