Why Is It So Complicated?

OK - so here I sit reading articles on how Paul Ryan's plan cut Medicaid. And while on the surface I don't disagree, once one starts to dig down further into what is really going to happen the answer isn't quite so simple. So this has caused me to come up with some questions of my own.

First question: Why is Medicaid so complicated to understand?

Medicaid, is a safety net. But finding out that deep in the bowels of the legislation on page umpty-whatever, one can discover that his parents, who worked hard all their lives and did what was right, can easily become dependent on Medicaid if nursing or assisted-living homes become involved. Why would a program that was designed to help those down on their luck be used to help those who did the "right" thing? What makes me more upset is why does someone who worked so hard through-out their lives have to become destitute before this help is offered?

After talking with Medicaid (and Medicare, for that matter) I discovered that the same question can be posed to two individuals and two entirely different answers can be received. (Sounds like that bastion of civility we call the IRS.) Meanwhile, I can call my health insurance provider and talk to two different people and get the same answer. Now I know the health insurance provider is not as big as Medicaid or Medicare but it is BCBS, and they are no small potatoes. What this tells me is the regulations controlling Medicaid and Medicare do not make sense to those who are paid to interpret them. If it doesn't make sense to them (and in turn, to us) how is anyone to get a direct and consistent answer?

Second Question: What is the best way to clean this up?

I don't believe there is a good answer because the human condition is involved. Mr. Ryan's plan tried to remove this condition but if it were to be placed into practical use there would be many influences trying to save their own butts. I can't really blame them. I do not want to be unemployed either. As I learned, way back in the day while attending university, what is not said is just as, if not more, important than what is said. If I knew my job was on the line I am sure I could come up with some reason (not declared in any rule or legislation) why I would still be needed and the system would not function efficiently without me.

Here is where I believe the same individual who is endangered is the most useful. Who better to find waste than the people who see it every day? I know many federal workers who are very conscious of waste. While they do not necessarily see their own waste, they see others. What a great place to start. Peer groups could be a way to begin cleaning up what is perceived as waste. I am sure there are many other ideas out there. Start with something AND there needn't be a government oversight committee created to do this. Offer an incentive, private sector companies do this all the time.

Third Question: Is efficiency too much to ask?

My line of work takes me many places. Most of these places are private enterprises, but a good portion are at various levels of government, from local to federal. There is not a single place in any of these enterprises that some waste can not be found. I have see, though, the government tends to be more wasteful than the private sector. I would like to see more government departments work together. Let me give an example. In order to get benefits from "Agency A" all the paperwork has to be done properly. (So far, no problem.) But let's say that some of the paperwork needs to come from "Agency B". (For the sake of argument, both agencies are federal agencies, although we have all seen or heard stories from all levels of government.) Now, if Agency B supplies paperwork and Agency A does not have all the information needed would it not be more efficient for the two agencies to communicate with each other rather than reject what has been done forcing the client to begin the process again? This is not the service that is expected and if it isn't expected then it is money wasted. If a shopping center or service supplier does not deliver, do you return for the same bad product or service?

I hear about all the money the corporations make and how it isn't right for them to make it. Last time I looked, controlling the income of private companies is a mild form of fascism. Do we really want to go down that road? Private sector companies are forced to be as efficient as possible because they answer to their shareholders. As a shareholder in the stake of the government I do not feel I am being served to the best of the ability of the government. Bureaucracy? Don't know. Apathy? Again, still don't know.

What I do know is if it was not so "durn" hard to interpret what the government was saying then people would understand what was needed, required or expected. Clean up the way we do things. Laws, if proactive, should be written as such and thought out, without rushing, before being put to a vote and then placed on the back of the bureaucrats who have to implement them. If a law is written that is reactive, then take some time to look for unintended consequences BEFORE implementing them. All this should be done before a law is passed, not afterwards in an attempt to clean up what should have been obvious had it not been for rushing.

An ounce of prevention is worth a pound of cure.