I had an interesting visit in my cubicle this week. My CEO stopped into my occupational man-cave to tell me that my blog posting content was good lately. He’s a very busy man, so I appreciated the visit and the input.

There was one part that I left out when discussing this and other issues with him. There are some days when I really have a hard time trying to explain the ins and outs of the American health care system. There’s a part of me that believes that with regard to this topic, the ability to write about it is some type of penance for something I did in a past life. What sick and depraved part of my being keeps getting excited about attempting to explain chaos? I’d rather talk about things that make sense to me, such as the purity of the perfect sandwich, economy cars or ice hockey. Instead, I am entrusted with medical delivery in the United States.

This past week, it became clear that this chaos is about to get worse.

On the legal front, The Supreme Court, which at one time in the distant past was concerned much less about the rights of corporations, announced that it will hear legal challenges to the Affordable Care Act in the opening weeks of November. The thrust of the challenge goes to the Act’s mandate to individuals to purchase health insurance coverage. The ruling, which will more than likely occur in the Spring (just in time to become a Presidential campaign issue) should be interesting. The Court, in its current ideological construct, is pro-business and anti-government. So, how do they rule against a government mandate when the biggest financial beneficiary of the Act is the insurance industry, which we can all agree represents a big business? Get ready for some of the most twisted logic ever committed to paper when the Court releases its ruling. I recommend some type of release valve be installed in your skull prior to that time to prevent the sudden explosion of your head.

PPACA’s life span is a good lead-in topic to the next bit of news that’s slowly coming forth. In the current budget crunch, individual states are beginning to restrict the number of total days per year that Medicaid recipients can be hospitalized. The latest state to vote for such a restriction is Hawaii, which beginning in April 2012 will restrict the number of days to 10. This is the lowest number yet enacted on the state level.

Here’s where policies like this lead. The sickest Medicaid patients, who also double as the poorest residents of the states in which there is a cap, are billed for the unpaid portion of their hospital stay. These bills goes unpaid because the problem isn’t solved by the patients cancelling their country club memberships or selling their cars, as they don’t possess these things. At the end of the process, the hospital eats the bill because they are in the business of admitting people to their facilities who are sick. Hospitals will turn around and shift costs to private health plans, which in turn pass off the costs to insured patients in the form of premium increases. Depending on the dent the new premium places on the healthy privately insured patient, the healthy person may decide to let his or her coverage lapse, which increases the premiums that much more for those who keep their coverage. If the hospital can’t shift the costs, especially a hospital in a rural area, the hospital faces closure.

Remember that at the root of PPACA is an expansion of state Medicaid programs to a higher percentage of the population. On the brink of millions more qualifying for this type of coverage, Medicaid will stop paying for your care after a pre-determined utilization threshold is reached. You barely qualified for your new coverage based on economic factors and now, your coverage stops. This Bill’s for You!

I’m what I would consider a fairly sentient being. I can make sense out of virtually anything. If I can’t make sense of something, such as artichokes, speed limits or baseball’s balk rule, I’ll at least make the attempt. With regard to America’s health care system, I’ve come to a decision. If the world is ever invaded by aliens, in the absence of enough advanced weaponry, I’ll fight off the invasion by explaining the American health care system to them in detail. All it really takes to destroy someone is to introduce an idea too complex to be comprehended and then watch their will and spirit collapse from within in an attempt to understand. Our health care system provides that opportunity amply.

Now, where did I put that skull valve……