Opening Day

This might not be the opening day you were thinking of, but today, October 1st 2013, marks the opening day of open enrollment for the Health Insurance Marketplace (e.g. Healthcare exchanges). These provisions fall under the Patient Protection and Affordable Care Act, also known as Obamacare, and are recognized as the largest extension of government in United States history.

As I understand it, and with the help of a pretty good article titled Obamacare 101, it explains in laments terms that the basic pillars of Obamacare are grounded in

(1) shared risk, 

In other words, by increasing the number of people that have health insurance, there are more people to share in both the costs and the benefits.

(2) individual mandates, and

Every individual is required to purchase health insurance or will pay a penalty.  All individuals will have access to health insurance, either through their employer or through the exchanges. And those that cannot afford insurance will be eligible for federal subsidy. 

(3) employer mandates. 

Companies with more than 50 full-time employees will be required to provide health care insurance plans that meet some standard, basic coverage.

Last night we saw the government turn its lights out to the rest of the country: an official government shutdown.  There hasn't been a government shutdown since 1995. What's on the table though? - - from the desire to defund Obamacare by House Republicans, the delay of Obamacare for one year, removal of taxes on medical devices, and many other criticisms of the program. It is a big program and has some inherent flaws, but we will only see the value of it if we can get to some agreement in the next couple days...we shall see what the future will hold from both the perspective of the American public and from the physician. We ARE making history today.