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12:33 PM

Why the House of Representatives Failed to Pass the American Health Care Act

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Why the House of Representatives Failed to Pass the American Health Care Act

Passing the AHCA would have overturned the status quo, ObamaCare, just as ObamaCare overturned the prior status quo, healthcare is an individual, not a government, responsibility. 

Tim Riesterer, instructor in the art of corporate storytelling, in his storytelling framework, explains that human beings have an innate bias to maintaining the status quo.

There is a good reason for this. It is called fear.  We are hard-wired to avoid danger.

We think the status quo protects us against danger in 4 ways.

1.     We prefer stability and see change as a threat to that stability.

2.     We believe the status quo is free and that there is a cost to change.  We generally like to avoid higher costs.

3.     Information overload. Too much information makes selection difficult. Staying with the status quo is easier than sorting through all of the options.

4.     We don’t change because we anticipate we will regret our decision to give up on the status quo.  We project that what we talked our colleagues in to won’t be as successful as we led them to believe it would be.

We can eliminate status quo bias in 4 ways.

1.     Weaken the status quo preference by introducing hidden challenges that make the status quo a less safe (more dangerous) course

2.     Showing the cost of inaction. Unfortunately, we tend to make decisions more often to avoid loss than to realize a gain.

3.     Contrast the status quo with the benefits of taking action to solve a problem. Paint side-by-side pictures of the current situation and the new and improved situation in order to make the case for change.

4.     Personalize the need for change.

Back to the AHCA, the Republicans who favored the proposed law failed to show that the real health care danger was not in changing the law but in not changing it.

 The GOP also failed to speak directly to the voters who were motivating the proposal’s opponents, by failing to personalize that the status quo ObamaCare would be more expensive to voters than the new American Health Care Act.

The Republican policy wonks also overwhelmed voters with statistical information, focusing on billions and trillions of federal dollars rather than thousands of dollars in personal health care outlays. Congressmen who favored the AHCA failed to convince their colleagues that failing to vote for the new healthcare bill was a vote for the status quo, which was the vote that would fraught with regret.

Republicans could have turned the situation around by undermining their colleagues’ apparent preference for the status quo. They could have accomplished this by projecting the future anger of their constituents when they saw their premiums continue to skyrocket and their health care choices dwindle.

The AHCA’s supporters should have focused their messaging like a LASER on the personal costs of not changing to the proposed new law and less on the legislative and policy nuances of the changes.

The bill’s supporters lead by Speaker of the House, Paul Ryan, should have driven home the personal cost issue with a side-by-side comparison of a family’s cost under ObamaCare and under the proposed AHCA. They should have learned the effectiveness of visual imagery from the Democrats’ “Paul Ryan wants to push Granny off the cliff” video ad attacking the then Republican vice presidential candidate Paul Ryan.

In the scare-tactic video, a man who appears to be Paul Ryan pushes an elderly woman in a wheelchair over a cliff in order to make the Democrats’ point that election of Republican Mitt Romney and his running mate Paul Ryan would result in the death of senior citizens who are dependent on Medicare for healthcare. Ryan blamed the Granny ads for turning the country against him thus clearing the way for the election of Barack Obama, the father of ObamaCare.

Again, the ACHA supporters should have spent more time and money personalizing the advantages of change and the dangers of the status quo, by putting a face on the health care debate rather than building the messaging around dry policy issues most voters don’t pay attention to. This is something President Obama himself recognized when he trotted out little Marcelas Owens front and center at the signing ceremony for the ObamaCare legislation in March 2010.

8:13 AM

Abraham Lincoln and Healthcare Reform

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Abraham Lincoln is reported to have said in 1856 that “you can fool all the people some of the time, and some of the people all the time, but you cannot fool all the people all the time." 

Change “fool” to “please” and you have the essence of the current stalemate over the bill under consideration in Congress to replace the Affordable Care Act, known informally as ObamaCare. Congress is currently considering a Republican-crafted replacement bill dubbed the American Healthcare Act.

On one side of the divide are the congressional Republicans who have sworn for 7 years that upon assuming the majority in Congress and capturing the White House they would immediate dismantle the ACA and replace it with a more free market-oriented healthcare system.

On the other side are the Democrats, still smarting from 7 years of withering criticism of the failing ACA, which was passed and signed into law without any effort to engage Republicans on a bi-partisan healthcare solution. The Democrats are divided into establishment Dems and a more liberal bloc built around supporters of socialist Vermont Senator Bernie Sanders.

This bloc largely favors a European-style Democrat Socialist, single-payer healthcare system that would eliminate private insurance companies from the healthcare market making the government the only health insurer. Establishment Democrats see this as a losing political hand in the same way they saw Sen. Sanders as a losing candidate vs Hillary Clinton is the 2016 Democrat primary

Back on the Republican side. We have a further split. The Republican caucus is divided into the mainstream Republicans and more conservative Republicans. These conservatives are themselves split into one group calling itself The Freedom Caucus and the other, known as the Republican Study Committee. 

Back to Mr. Lincoln. The parliamentary maneuvering to either pass the bill into law or block its passage continues as the bill’s sponsors look for ways to entice recalcitrant Members to support the measure. This effort involves amending the legislation to make it more pleasing to the various factions. 

The issue is whether the Republican House leadership can please enough Members to cobble together the required votes to pass a bill that has been promised for 7 years. 

Earlier this week, the bill was amended to allow states the flexibility to impose work requirements on Medicaid recipients and to block-grant Federal Medicaid funding to the states, which would then decide the best way to spend the grant in each state. 

This more Federalist approach to Medicaid seem to have gotten Republican Study Group members seats on the American Healthcare Act train, but do not appear at this late hour to have been enough to get the Freedom Caucus on board. And liberals and some moderates do not favor allowing states set the administrative rules of the program.

We may be at a point where House leadership in order to please enough Members to pass the bill is facing the prospect of having to fool enough Members in order to get their votes. Also, changing the bill to please one faction may make it less likely that an opposing faction will sign on. 

Pleasing, fooling, it’s all the same in politics. Trying to fool or please all the people all the time is a zero sum game. Every vote you win may cost you a vote you lose from another faction.
6:47 AM

International Day of Happiness

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Today, March 20, by fiat of the United Nations, is the International Day of Happiness. Let’s share some happiness. First, some kudos to the girls and boys at Turtle Bay for finally taking a break from Israel-bashing and getting something valuable done. 

Next, let’s work on de-nuking North Korea. Then, how about solving that whole ISIS puzzle. Not to minimize happiness but when the UN sets itself up as the arbiter of the world, it has a lot to arbitrate.

Having one less nuclear power in the world, especially that one, and getting rid of a rabble of homicidal maniacs would make a lot of people happy.

International Happiness Day started with that UN declaration in 2012. But in 2014 the happiness movement was kicked to a new level when Zoe Morris and some colleagues erected an orange happiness wall at the University of Pittsburgh. They invited passers-by to write down how they shared happiness. That was the first year of happiness walls constructed as part of the Live Happy initiative. 

Eventually there would be 30 happiness walls including Pittsburgh. 

But back to Zoe. A year after launching the groundbreaking Pittsburgh happiness wall, her mom passed away March 19, 2015. Before she passed, she told Zoe that she wanted her to be at the happiness wall.  

Two days after her mom’s passing, on March 21, 2015, Zoe was back at a happiness wall. Zoe said that her mother lived her life in service to others and to make them happy. And that she was still caring for Zoe the day the she passed. 

Deborah K. Heisz, co-founder, CEO and editorial director of Live Happy says Zoe’s spirt is what International Day of Happiness is all about.

The International Day of Happiness, she says encourages us to set aside the turmoil of daily life and come together at a common touchstone in the form of a big orange wall and share happiness.

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5:20 PM

March Madness and the Best College Basketball Fans

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March Madness and the Best College Basketball Fans

Our good friends at WalletHub who often supply The Lobster with topical subject matter, bring you the following tidbits related to college basketball’s  annual tournament of champions which rolls off this week.

It’s doubtful any of this will help you build a winning bracket although it will amuse you while you are building that bracket.

According to WalletHub the best city in the U.S. for college basketball fans is Chapel Hill, NC home to the University of North Carolina, a school that has seen its share of college hoops success.

UNC is followed in the WalletHub ranking by Los Angeles, home to the University of California at Los Angeles, which in the 1960s began captivated basketball fans with a series of teams coached by the legendary John Wooden and featuring great  players like Kareem Abdul-Jabbar.

Thanks to Coach Wooden and his seemingly never-ending parade of stars at UCLA, Los Angeles owns the most NCAA national championship banners. This may help explain its second-ranked fan base. It’s easy to be a fan when you sit in Pauley Pavilion and stare up at 11 banners hanging from the rafters.

Number 3 on the WalletHub Hit Parade is Durham, NC, home of Duke University usually a perennial contender to take home the championship hardware but not this year.

Fourth on the rundown is Bloomington, Indiana in the basketball-crazy state of Indiana and home to Indiana University of the Big Ten Conference.

Number Five on the list of the best college basketball fans is Philadelphia, Pennsylvania, take that Philly sports fans haters.  This city sports a multitude of successful big time basketball programs, lead by the Owls of Temple University, and followed by St. Joseph University, La Salle University, and Penn of the Ivy League.

And throw in nearby Villanova University, which by virtue of its gaudy record this season will lead the field of 64 on to the hardwood this tournament. Nova also has the highest winning percentage among men’s college basketball teams. Their 88 percent is 6 times that of the school with the lowest win rate, the Tigers of Grambling State, which has won about 16 percent of its contests.

All totaled, Philadelphia has 116 regular season titles, the most among major college teams.

Following Philadelphia is East Lansing, Michigan, home of the Big Ten’s Michigan State University.

Clocking in at seventh place is Lawrence, Kansas, home to perennial roundball power, the University of Kansas.

Following Lawrence is Lexington, Kentucky, home of the University of Kentucky, another annual championship contender. Lexington’s fan base may have ranked a lowly 8 in the best fans poll, but its fans did lead in one key area, the price they are willing pay for season tickets. Season passes to see the Kentucky Wildcats play start at 950 dollars, which is 21 times the starting price for a season of hoops in Hamilton, NY,  home of the Colgate University Raiders.

Kentucky. Colgate. Sounds like a 1-16 bracket match-up to The Lobster

Next up is beautiful Storrs, Connecticut, home of the perennial woman’s basketball champion team.

Number 10 on the WalletHub list of the best college basketball fans is Cullowhee NC, home of the Catamounts of the Southern League.

The survey crunched the numbers on 291 cities. The 7 criteria by which the cities were evaluated included the number of teams per city, the winning percentage of each team to arena capacity, and social-media engagement.

To enjoy the full report and check out where your city ranks, visit

11:46 AM

Still Building the Foundation of EBT the Next Generation

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Still building the foundation of EBT the Next Generation government payments conference. Working this week on developing the conference theme, as well as the subject of my annual Front Page Focus plenary session.

My choice for both is "Adjusting to the New Realities of Government."

For years money poured into programs like SNAP (nee' Food Stamps) and WIC, its smaller sister. But with a new sheriff holding court at 1600 Pennsylvania Avenue the question of whether such largess continues is a matter of conjecture, fit for an interactive plenary session.

Front Page Focus I control. The conference theme is a collaborative decision by the eGovernment Payments Council, the trade group behind the conference, now in its 20th year. Whether or not the Council adopts this theme or not is a choice by many disparate parties.

This collegial methodology may seem inefficient, but has worked well for 2 decades, while other shows have come and gone.

EBT NextGen is scheduled for November 5th through 8th at the Hilton Clearwater Beach Resort and Spa (