Imagine going into a
new restaurant in which you are a part owner and ordering a meal.
Every few minutes the manager comes over and says it will be ready in
another few minutes, but the meal doesn't come.
Finally, he apologizes and says that they hired a third party vendor to
run their kitchen, and while they've tried their best to ensure that the vendor
fulfilled the contract it just isn't getting done. In order to be served the manager suggests
you,
- Go to a food fair where there will be other chefs to prepare a meal
- Hire your own chef
- Do your own cooking and buy direct from grocers.
There are a lot of
ways people might respond to that. One
might swear never to eat there again.
One might tolerate the problems in the short term, hoping for eventual
improvement. One might want to fire the
manager, telling him and his cowboy boots to take a walk. And one might try to shut down the whole
restaurant, though that is a bad idea for reasons that don't fit into the
analogy.
But what I don't
think people would do, what appears to me highly counter-intuitive, is to
conclude that we should shut down every alternative kind of food distribution
and trust this manager whose incompetence is proven to oversee delivery of all
food to everyone for every meal.
I'm glad the
Medicaid rollout and CCO's are going strong, but lets be honest. It's relatively easy to get buy-in from
people whose only option is nothing.
More than three quarters of Oregonians not already on Medicaid and
Medicare had insurance in 2011. They
have options, and the state's handling of Cover Oregon provides little reason
to give them up.
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