Obamacare Exchange: The People or the Insurers?
False urgency heads for an immovable object.
At a hearing Thursday of the Michigan House Health Policy Committee, Blue Cross Blue Shield and other insurance industry lobbyists pleaded for fast action on creating a state Obamacare “exchange.” Given their point of view, their desire for an accelerated timetable is understandable: As businesspeople, they hope to gain some certainty over Obamacare's endless details. The haste of employees at the Michigan Department of Community Health is similarly understandable, and at this time, they have the ear of Gov. Rick Snyder.
But many — even most — of the committee members' constituents have a more compelling priority: seeing the federal Patient Protection and Affordable Care Act swept onto the ash heap of history. From their point of view, creating an exchange now would only help entrench the big-government mistake known as Obamacare (six reasons why are listed here).
The insurance spokespersons' testimony tried to feed a sense of urgency, but free-market health care policy experts have demonstrated that the case for urgency is just not plausible. The “do-it-or-else” threat is that if Michigan is not well-advanced toward an operational exchange by 2013, the federal government will create its own exchange for the state, supposedly leading to a loss of state control.
Both parts of the threat are questionable. “Control” isn't really an option to begin with: The Wall Street Journal reviewed the federal health care regulations released last July and found: “The word ‘require’ appears 811 times in the 244-page rule and its 103-page supplement. ‘Must’ shows up 580 times — and this is merely [Health and Human Services'] first batch of exchange mandates.”
Moreover, Heritage Foundation health policy expert Ed Haislmaier recently described how these regulations evaporate the "state control" mirage even more definitively:
Initially, while HHS was still deciding how to implement the legislation, a narrow window of opportunity existed for states to pursue a “pushback” strategy of creating a restricted exchange and requiring it to contract with the state’s Medicaid program and insurance department to perform the eligibility, enrollment, and insurance regulation functions that state lawmakers seek to retain control of. HHS effectively closed that window in its proposed exchange regulations issued in July. …
The combined effect of these regulations and grant requirements [is] that a state would have to agree to surrender any last vestiges of meaningful control over how Obamacare is implemented. Thus, a state would now have no more real control over an exchange it set up than over one HHS established. … (Emphasis added.)
Nor will the feds be eager to step in with their own exchanges. Not only do they lack the capacity; due to goof-ups in the law, they lack even the authority to create and operate the exchanges. Specifically, the PPACA fails to provide funding for federal exchanges, and even more seriously, it doesn’t authorize payment through them of the insurance subsidies at the heart of Obamacare. In addition, it’s extremely unlikely that more than a few states will have working exchanges by then.
In 2012, Obamacare faces two mortal threats: A ruling by the U.S. Supreme Court, expected in June, and the judgment of an even higher court on Nov. 6 — the presidential election. If Obamacare survives both SCOTUS and VOTUS, there will then be time enough to create a state exchange, and the arguments for doing so will carry more weight. Michigan will have plenty of company, too, with many other states also taking a wait-and-see approach.
Given this, prudent state lawmakers should ignore the false sense of urgency being generated by exchange supporters now.
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Time to reject Satan...
and all his works and empty promises.
The PPACA aka Obamacare will drive health care costs up, by eliminating free market competition in health care. Demand will be skewed upward, forcing prices up, which is exactly what happened due to Medicare since 1965. And given it's unprecedented complexity, it's ripe for the law of unintended consequences to kick in, as it always does. If allowed to stand, it will increase our annual deficits and national debt burden.
History teaches us, at least some of us, that free market competition delivers higher quality and lower prices than the government can deliver. Every major government program is failing and bankrupt, and a huge burden on future taxpayers. People can solve any healthcare issues, not the government.
The devil is in ...
"they hope to gain some certainty over Obamacare's endless details"
It amazes me that the people making these laws actually believe that what they do will make things better. They either have a) good intentions but are bvery stu[id, or, b) they are evil and are trying to wreak havoc.
Anymore, with the decline in morality of our society, I am leaning more and more toward the latter.
Howling idiots in ascendancy
The Heritage Foundation is a right-wing think tank funded by Joseph Coors, the beer magnate, the Koch brothers (http://www.greenpeace.org/usa/en/campaigns/global-warming-and-energy/polluterwatch/koch-industries/the-heritage-foundation/), and other millionaires with no interest in protecting the public's health.
Health care exchanges are a compromise that allows insurance companies to still remain in the game of profiting from people's illnesses; however under the exchange system, they have to compete on a level playing field and, therefore hopefully, not obtain excessive profits. The alternative, to which Obama did not subscribe and which is used in many contries like Canada, is a single payer system that would control costs. If Canada is a good example, such a system would deliver excellent health care for half as much as we pay for it in the United States. There is no wonder that insurance companies using the Cato institute as a mouthpiece would not like this. It would eliminate all the profits they get from people who are afraid of getting sick.
Ordinary people, not millionaires, should look into the advantages that health care exchanges offer people. Among other things, they will allow people rejected as unprofitable by insurance companies to find insurance at market prices. Obamacare isn't the best solution, but it is a solution. "Pushback" is just stupid. It is just a way that the Michigan Republican legislature can further damage the state and its people during its brief unfortunate ascendancy created by angry voters who had nowhere to turn except to the howling idiots that were pushed up into the last election by well organized corporate funding.
This is so foolish, it is difficult to know where to begin. First, the source of funding is not relevant to the wisdom of ideas. Second, the reference to "excessive profits" betrays a profound misunderstanding of how the world works. Profits are a residual that is left over after all inputs have been paid for, and are thus a powerful incentive to do things efficiently. Profits, certainly "excessive profits", are competed away.The reference to Canada fails to acknowledge the many shortcomings of that system. Canada does not control costs, they control prices. The negative consequences of price controls have been abundantly demonstrated over and over again, but some people are so dazzled by the illusion of their short term benefits that they fall for them. And I don't recall the author complaining when the Stryker family bought the Michigan House for the Democrats in the previous election.
well said. And pricing fixing will hurt medical field and produce less competition as more doctors refuse to take medicare because of the penalty they pay for referring clients to a specialist for whatever reason! 1 out of 6 hospitals could close as medicare reimbursements are cut by 20%. So you have a spike in demand, with 30-50 million more Americans "entitled" to healthcare, but fewer doctors and hospitals to care for them. Can you say rationing?