Saturday, June 29, 2013

Libraries and the PPACA

Seems Like a Good Idea, But...
Today, this came across the AP newswire:

Before librarians get their knickers in a twist, let me make this clear:
1. I presume that librarians are well-intentioned
2. I presume that librarians are intellectually, internally consistent
3. I presume that librarians are open to the notion that they may need to accept new concepts
In short, don't put words into my mouth by confabulating facts, which are iron-clad and irrefutable, with your individual frame of mind/opinion.

This Type of Program Exists for Seniors
There are senior centers and Commission on Aging offices throughout the country. Those people are trained in Medicare. They are not authorized to make recommendations. Senior centers and local Commission on Aging offices should not be making specific recommendations. I am 100% certain that this is violated.
The unintended consequence of this is that when an error is made, or misunderstanding occurs, the senior has no recourse for the advice received. If a licensed person makes the same mistake, the senior has recourse. The licensed person can lose his/her license if intentionally misleading a person. There is something called Errors and Omissions insurance if a licensed person makes an error.  Seniors wrongly understand the people at senior centers and Commission on Aging offices to be similarly permissioned. I am also certain that some directors at senior centers don't know understand this distinction. Now, you see why I am writing this.

Librarians Face This Dilemma Frequently (I Presume)
As a fellow tweeter pointed out, Law Librarians are almost all lawyers and are reluctant to give legal advice. They have good reason to be leery. So now, an uninformed person is coming to the library and attempting to find guidance on health insurance? There are health and financial ramifications to the selection of health insurance. The choices will be more clear on the statewide exchange: that doesn't make it obvious or even simple. That libraries frequently have access to the internet doesn't make the institution the expert on the best choice

PPACA Execution Stinks So Far
Let's leave politics at the doorstep. The PPACA is the law of the land and has survived for three years, a Supreme Court case, and a presidential election. The President's academic specialty? Consititutional Law, where he was a lecturer at the University of Chicago on the matter, after graduating from Harvard Law School. I won't bore you with finance-speak here: the pricing will be worse for some and better for others. It is my opinion that this will cause problems in 2015, when insurance companies find out that not enough young people have enrolled, and only the older, non-Medicare eligible have enrolled, leaving losses not discounted by the equity market at the current time. More on that in another post.
There are supposed to be "navigators," who will help people. They are not licensed. Neither will librarians (unless there is a coincidence).  These navigators have not yet been trained. In the Medicare case, the same people have been doing this for years. To say this is a bit late would be a massive understatement.

Libraries to Choose Individually
Let's just say it will be very interesting to see how libraries handle this situation. Having an open computer workstation for this explicit purpose is quite a bit different than answering questions and explaining the ramifications of available alternatives. By the way, there are income tax ramifications as well. I know these subtleties as a part of a professional specialty. I wouldn't suggest that I know library science. The president hasn't stated that librarians are PPACA experts: we will see if library patrons understand that. I doubt it, and libraries would do well to think carefully about their approach over the remainder of the year.

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