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December 17, 2018

The Fruitcake Continues Around

TIt was a 1995 episode of Seinfeld that popularized the term ‘regifting,’ but just because it took Jerry and Elaine to give us the vocabulary, the practice is not that new at all.

For example, take the famous holiday fruitcake.

I know that when I was a kid, we got one from someone most every year.  I know for certain that we NEVER took a bite of one.  I know that my parents, both raised by Depression-era, dirt-under-their-nails farmers, would not allow a perfectly good anything to be tossed in the trash.  So, though I cannot prove it in court, I am fairly certain that my mother was a ‘regifter.’ 

The fruitcake just keeps coming back around, never quite accomplishing what the giver intended, but doing enough to stay alive to come back again next year.

Just like Obamacare.

Yes, we still have a small quota of bad analogies left over for 2017 and we’re trying to use them all up before yearend.

As you likely know by now, last Friday a federal judge in Texas ruled that the Affordable Care Act’s individual coverage mandate is unconstitutional.  He also took the next step and said that the individual mandate is so essential to the whole Act that it cannot be severed from it, thus the entire ACA is rejected.

Here are the essential, and inseverable, bullet points that go with that news:

  • This was a lawsuit brought by 20 red state attorneys general, heard by a Bush appointee in Texas.  This is the Red team. The appeal will be led by California and other like-minded states.  This is the Blue team.
  • Though the judge ruled the ACA unconstitutional, he did not block its continued operation, so it is all business as usual for now.  Is this now an actual zombie law?
  • The appeal will likely head back to the Supreme Court, where Chief Justice John Roberts broke conservative hearts in 2012 when he voted to uphold the law.  Gorsuch and Kavanaugh now sit in the seats then occupied by Scalia and Kennedy.
  • The appeal will not likely be heard by the Court before the 2020 election, which means that if we thought healthcare would be a big issue in the next vote, then it just get amped up by a factor of ten. 
  • Be assured of one bi-partisan point of agreement we will hear during this mind-numbing cacophony coming our way: everyone is against people getting denied coverage for pre-existing conditions. We’ll get lots of swearing allegiance to this idea; just don’t press for the underlying economics of it all.
  • This all prompted a flurry of tweets from the President.  Shocking, I know.  As a sign of the coming times, one shouted, ‘Mitch and Nancy, get it done!’

And with that, we’ll come back to that tweet Wednesday to explore an optimistic idea for those of us who still believe in Santa Claus.

Tim Coan
Tim Coan

CEO and founder

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