A Tale of Two Bakeries
This is a tale of two bakeries, both tasked with baking a new cake. There are many options and as you will see, they have very different methods of working together (or not).
Ideal Bakery: Everyone works hard to advance the interests of the company; everyone has their say but then supports the decision made by the whole, working to implement it as best as possible.
Actual Bakery: Each person works to advance their own personal agenda, regardless of how it affects the company or its individual products; everyone has their say but if their position isn’t chosen, they work to undermine the group decision and use every tactic possible to still obtain their own goals.
The Cake: Both bakeries agree there is a desperate need for a new cake.
The Ideal Bakery deliberates respectfully and agrees on a chocolate cake. Not everyone likes this choice but everyone works together to make it the best chocolate cake possible. Some of those who wanted lemon cake are even the ones to make a crucial adjustment to the icing that vastly improves the quality of the cake. The cake is finished ahead of schedule and everyone shares the credit for a delicious cake.
The Actual Bakery employees spend most of their deliberation time screaming at each other, accusing each other of various false and truly awful motives for their cake choices. They also deliberately produce false information about each other’s cake choices. Eventually, a chocolate cake is chosen. Those who voted for chocolate cake begin the process of assembling ingredients. Those who wanted other cakes continually replace the sugar with salt and the flour with baking soda. Finally, the cake is assembled and put into the oven for baking, but again the ‘other cake’ advocates take turns shutting off the oven and cutting into the cake while it bakes.
The cake tastes horrible and is not ready on time. Those who wanted other cakes point to the end product as proof that their choices were superior. They feel justified in destroying the chocolate cake because it was really doomed from the start. There is simply no way a chocolate cake could ever be worthwhile in their view.
The cake in this story is, of course, health care reform. I am hopeful that the Actual Bakery has not ruined our ACA cake and that it will be good enough. The ACA is not as good as it could have been and it will not be completely ready as early as it might have been. However, the early data is promising regarding the number of insurers in the marketplaces, the average cost of premiums, and the various benefits to consumers (no more pre-existing conditions, minimum coverage requirements, etc).
Let’s not judge the ACA by how it looks October 1. This new law is going to need some additional baking time before it comes together fully. My hope is that the ACA will be good enough on October 1 and terrific on January 1.