Ham the Space Monkey and the Affordable Care Act

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January 5  |  Blog, York ENT Blog  |   Dr James Rejowski

I spent my grammar school years from the late 1950s to the mid-1960s, and as such grew up during the development of the American space program. Rocket ships and astronauts were of great interest to young boys like me. My brother and I received a Kenner slide show for Christmas one year. It had a small projector with some slides and came with a record that we played while we watched them and signaled when we should advance the slides. I’m dating myself but people my age will remember things like this.
We had a presentation on dinosaurs and another on the Alamo, but one of our favorites involved a trip into suborbital space by a chimpanzee named Ham.

Leaving the earth seems almost routine now but at that time that it was not a given that Ham the Space Monkeyone could survive in space, and if they did, would be able to perform any tasks related to piloting a space craft. Ham was trained to respond to simple commands and he was launched in a predecessor to the Mercury capsules to see whether this could be done. His mission was successful. He returned safely and spent his remaining years at the zoo in Washington DC.

His successful venture was ultimately followed by Alan Shepherd in Freedom 7, built in part upon the knowledge gained during Ham’s earlier flight.
The continued accumulation of knowledge and technology obtained during the Mercury, Gemini, and early Apollo programs allowed the Apollo mission to be successful in 1969 when Neil Armstrong and Buzz Aldrin were able to land on the moon. Each step along the way contributed substantial building blocks to the final outcome. Even taking the greatest minds of that generation, it would not have been possible for scientists to sit down and develop a Saturn V rocket and a lunar module in one step.
And that little story reflects my concerns regarding the Affordable Care Act.

The healthcare system in the United States was not going in a good direction. Changes needed to be made. Coverage was becoming increasingly expensive and increasingly unpredictable. Rationing by economics prevailed. People either got excellent care or too frequently, no care.

Unfortunately, by trying to do things in one fell swoop, I don’t think the ACA is going to have much to offer over the previous system. Its website rollout has been inauspicious to say the least. I think it’s going to be a challenge to get healthy people to buy policies with high monthly premiums when the penalty for not doing this is minimal. There will be an incentive for businesses to drop employer sponsored coverage altogether and direct their employees into the exchanges, which may well offer Medicaid type of programs, not accepted by many providers. Maybe there is no reason to obtain insurance at all, since there are no pre-existing condition exclusions. One could make the argument that you should wait until you get sick and then purchase it.

It probably would have been better, in retrospect, to do things in steps, as the space program did. Perhaps the politics and the partisanship would not have allowed it. It is now 2014, however, and the ACA is here to stay. It’s going to be an interesting ride.

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