There is no disagreement about the meaning of the expression, which is to seize an opportunity by beginning at full speed. However, Dictionary.com says the origin is disputed. “It may come from combat troops dropped into a combat zone, from stowaways jumping off a freight train as it nears the station, or from Pony Express riders avoiding delay when they changed mounts.” All create a vivid mental image, so I don’t have a favorite.
The commentary posted last week was about the financial burden being placed on States by Obamacare. The article titled “Electronic care: Why doctors quit,” by Charles Krauthammer describes an even more important unintended consequence. Doctors who have small practices, often the doctors in rural communities, don’t have the financial resources or technology support to comply with the law. They are retiring because the law requires so much of their time is used for regulatory compliance rather than providing health care. According to the article, the law has created “…a deep erosion of their autonomy and authority, a transformation from physician to ‘provider’.”
The article says virtually every doctor expresses bitterness about the electronic health records (EHR) mandate that produces “…nothing more than ‘billing and legal documents’—and degraded medicine.” One doctor observed that “…introduction of the electronic medical record into our office has created so much more need for documentation that I only see about three-quarters of the patients I could before, and has prompted me to seriously consider leaving for the first time.” Medical practices that hadn’t gone electronic by January 1st have had their Medicare payments cut by one percent. That penalty increases to three to five percent in future years.
What has Obamacare accomplished? Many more people have Medicaid, and that means it takes weeks or months to get an appointment at one of the few places that still accept it. Fifty year old women had their health insurance declared “non-compliant” because they didn’t have maternity coverage. Obamacare has accomplished spending $27 billion on “going paperless,” although the promised $77 billion in savings is nowhere to be found. None of this will make an impression on those who believe government should be in charge of our lives because we and those who have the archaic attitude that they want to own a profitable business can’t be trusted.
A review was posted last week of Vol. 13 in the series of books edited by Steven T. Ross and David Alan Rosenberg. That book evaluated the military plan called “OFFTACKLE,” which called for being prepared to engage in war with the Soviet Union in the late 1940s to early 1950s with 220 atomic bombs dropped on Soviet targets followed by conventional bombing. Volume 14 carries the plan into the future with the Soviet attack into Europe expected to occur in 1957. The extra time allowed the planners to produce the war plan with the code name “DROPSHOT,” which expanded the scale of the attacks. DROPSHOT was being prepared when NSC-68 was written, which was a planning document calling for an extensive U.S. rearmament plan. The Korean War and the fall of China to the Communists reinforced belief that World War III with the Soviets was inevitable. This volume1 contains the declassified (from top secret) facsimiles of the Joint Chiefs of Staff document JCS 1950/5 prepared in three sections. The basic assumption is that “…war against the USSR has been forced upon the United States by an act of aggression of the USSR and/or her satellites.”
It was believed that the massive Soviet conventional forces would sweep into and through Europe when the Soviet leaders decided that war would be to their advantage. Their armies were expected to be in control of Western Europe in twenty days. The report indicates that there was more confidence in intelligence about Soviet capabilities that in previous war plans. For example, “The committee is now informed that the Joint Intelligence Committee has available a revised estimate of the 1957 Soviet atomic bomb stock pile.” One aspect of planning that didn’t change was that it was considered strategically important to hold the oil producing areas of the Near and Middle East. Continue reading
Dictionary.com gives the logical explanation that this expression had its origin from two dogs fighting over a single bone. “In a slightly different guise, bone of dissension, it was used figuratively in the 16th century and took its present form in the early 1700s.” It is used to describe an “…issue of disagreement; something to quarrel about.”
This posting only focuses on one unintended consequence, but it is certainly important to the budgets of state governments. According to an article by Carala K. Johnson of the Associated Press, “A tax on health insurers is helping pay for President Barrack Obama’s health care law, but it’s proving costly to state governments—as much as $13 billion in less than a decade.” The Health Insurance Provider’s Fee was supposed be covered by insurance companies because they would earn a windfall from Obamacare. Those who wrote the law believed those companies should pay for the expansion of coverage, but they apparently didn’t know how business works. The insurance companies raised prices to cover the costs of the new tax instead of just absorbing the cost. Businesses tend to continue to stay in business by making profits from their activities. Expecting the insurance companies to simply absorb additional costs was, to be kind, both naïve and silly.
The price increases passed on by the insurers affected state Medicaid programs, and they have had a huge impact. “State governments pay insurers for the tax; the insurers then pay the tax to the federal government. The federal government then reimburses part of the costs to the state. It might sound absurd, but it’s not amusing to state governments, which lose 54 cents for each dollar of insurance tax.” Another strange and detrimental impact of the law is that the health care tax is not deductible for insurance companies, so state governments must provide additional funds to cover that additional cost.
I find the false economics isn’t the saddest part of the story. One of my doctors made the comment that insurance provided by Medicaid “is a myth.” He explained that people think they have Medicaid insurance, but find that a limited and shrinking number of medical practices accept Medicaid patients. The result is that a person with Medicaid coverage must wait many weeks or even months for an appointment. Not a good thing if you have a medical need. The outcome is that people who have Medicaid aren’t getting health care and the States are paying penalties. Maybe we should be thinking about a better way of solving the problem. Maybe businesses that have a reputation for finding competitive solutions to problems could be lured in by the promise of profits.
As an aside, I’ve heard one of the best parts of Obamacare is the allowing children to remain on their parent’s plans until age 26. If that’s such a great idea, why not 36, 56, or until the parents are no longer around? (Just kidding, maybe?)
This book 1, edited by Stephen R. Ross and David Alan Rosenberg, is an unusual book to be reviewed this web site. The book is listed as unavailable and out of print on Amazon. I obtained a copy on interlibrary loan from the “Center for Naval Analysis” in Arlington, VA. For those who might wonder why I would be interested in such an obscure book, I worked at the Rocky Flats nuclear weapons plant in Colorado, and have been researching why the nation believed we needed such a facility to be built in the early 1950s. I had motivation to obtain the book, but I’ll warn others that the book is very large. It has in excess of 400 8 ½ X 11 pages, even though it only contains the declassified information from the original top secret report. A quick summary is that the report describes an evaluation of “War Plan OFFTACKLE,” which called for a strike with atomic bombs on 220 Soviet industrial site followed by massive conventional bombing.
I’ve read much about the negative effects on military planning created by the competition between the military services in the late 1940s. There was also a lack of cooperation between the civilian Atomic Energy Commission (AEC) and the military planners. The AEC felt they were prevented by the Atomic Energy Act from revealing physical characteristics of the atomic bombs (which was crucial to determining how the weapons could be carried and delivered) or even the number of weapons in the stockpile. This report discusses the stark fact that the military didn’t have the capability to carry out the full war plan and also clearly emphasizes the even more depressing reality of the nearly complete lack of effective intelligence about the Soviet Union, its military capabilities, and its intentions. The only thing that seemed a certainty to the planners was that a World War with the Soviet Union was inevitable. Continue reading