Opinion: State-based exchange best option - Coeur d'Alene Press: Local News

Opinion: State-based exchange best option

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Posted: Friday, March 1, 2013 9:33 am

At my request and after careful, deliberate consideration, the Idaho Senate recently approved legislation affirming my choice of a state-based health insurance exchange.

That bill now goes to the Idaho House of Representatives, where debate figures to be just as passionate. That's understandable, since most members of the Idaho Legislature share my intense opposition to the so-called Affordable Care Act, better known as Obamacare.

But the issue before us has nothing to do with how we feel about Obamacare, how we feel about overreaching federal authority and the government's failure in this gargantuan and unworkable piece of law to address the essential goals of more affordable and accessible health care.

It has quite simply to do with our right and responsibility to keep as many options as possible open to the people of Idaho. As much as we might object to the necessity, creating a state-based exchange is the only way to preserve options, oversight and accountability for our citizens.

If we fail to seize this opportunity, if we default to total federal control of this process, the result will be an unresponsive, one-size-fits-all federal exchange wreaking havoc on some of America's most reasonable costs of coverage.

At its core, this is a matter of state and individual rights. A state-based exchange enables us as citizens to be, if not the architect of our own destiny, then at least the general contractor.

Everyone reading this knows how I feel about Obamacare. As I have from the day it was enacted, I will continue encouraging and supporting efforts by our Idaho congressional delegation and many others to repeal and replace the law. But the fact remains that for now and for the foreseeable future it is the law. And as responsible elected officials we're sworn to uphold the rule of law - not just those laws that we support.

So I urge the people of Idaho and members of the Legislature to stay engaged in the important work of changing a misguided federal law, but in the meantime we need to work at preserving for Idaho the option of having a voice in how one element of that law is implemented.

A state-run exchange that works for Idaho is neither a Trojan horse nor a white flag of surrender to Obamacare. Rather, it's an opportunity to positively influence local outcomes under difficult circumstances, but we have to seize it.

Doing nothing leaves us with a federal exchange, administered from Washington, D.C., by unknown bureaucrats making decisions about Idaho citizens under the cover of an all-seeing and all-knowing government. That's simply not acceptable to me or, I believe, to most of you.

More than a decade before Obamacare started giving health insurance exchanges a bad name, they were at work in the private sector, used mostly by large companies seeking to provide affordable group health coverage for their employees. Some states, including Idaho, also have had private exchanges selling small group and individual policies for years.

Then Obamacare started confusing the issue. Its passage and court approval, and the subsequent re-election of its namesake, left those of us seeking a market-based approach to addressing the issue frustrated and disappointed.

But much as we may wish otherwise, resisting Obamacare by simply refusing to act is no remedy at all. It sounds great in principle - even heroic. Yet history tells us it does not effectively influence public policy, change the law of the land or even protect our interests.

That requires relentless, tireless and consistent work to change hearts, minds and votes. Creating a state-based exchange maximizes our flexibility and degree of self-determination while that important process continues.

Make no mistake: Defaulting to a federal exchange is a worst-case scenario for Idaho. While advocates of doing nothing contend there is no substantive difference between a federal exchange and a state-based exchange, their arguments put philosophy and political wishful thinking ahead of facts like these:

* Nobody is required to buy health insurance through an Idaho-based exchange.

* Defaulting to a federal exchange would add extra layers of bureaucracy for Idaho insurance buyers.

* A state-based exchange would conduct all its business publicly and transparently - which would not be the case with a federal exchange.

Designing our own unique plan, having the exchange run by locally chosen Idaho citizens who will meet openly right here at home, gives us the best chance of weathering the Obamacare storm while meeting the needs of Idaho citizens.

As one member of the Idaho Senate so eloquently put it: Given a choice, I choose Idaho.

  • Discuss

Welcome to the discussion.


  • boohoo2U posted at 9:48 pm on Thu, Mar 7, 2013.

    boohoo2U Posts: 406

    sure it isn't SS Dictator? how soon before they experiment on unproductive people. No, they are already doing that! on you as well! YOU JUST DON'T KNOW IT!

  • boohoo2U posted at 9:45 pm on Thu, Mar 7, 2013.

    boohoo2U Posts: 406

    THAT WASN' THE SIDE OF TOWN I WAS THINKING OF. No negatives on the quality of health care in Mexico. My hope is that you reap the benefit of the floors you lay and trust the medical community that serves them.

  • boohoo2U posted at 11:37 pm on Sun, Mar 3, 2013.

    boohoo2U Posts: 406

    may you perpetually stand at the end of the line for health care with illegal immigrants cutting in front of you. May the next floor you lay be Tijuana STD Supreme.

  • boohoo2U posted at 5:26 am on Sun, Mar 3, 2013.

    boohoo2U Posts: 406

    VOTE; NO - NO - NO!

    I attended the meeting on health exchanges today. One 'black and scary' SUV with an Otter sticker was parked adjacent to me. It is unwise to consider a state exchange under the auspices of Yobama Care. It is prudent to resist the Patient Protection and Affordable Care Act (PPACA) that has neither been read by most legislators, is still being written, and is essentially an oxymoronic treatise to prep you for a RoyalScrew.

    PPACA starts with patient protection, with options for those in need of services being pared by death boards. It ends with affordability: Presumably by law, I have access to healthcare. My request for routine labs has been denied. Guess I'm too old and unproductive to waste precious funds on liver enzyme tests. I cannot afford even one lab test through Dirne. So much for affordability.
    As for physician integrity, who holds them accountable? Physicians annually murder more patients through negligence than the combined deaths by autos, guns, and water, and get away with it! The few physicians with integrity and a conscience are being replaced at KMC by third world holders of dubious medical credentials.

    I wish I could draw my own blood and inject it into a machine for testing at my local Walgreen's or Rite Aide. I would be happy to pay a reasonable sum for the results and appropriate medicine. As it is, I must submit to having my arm broken behind my back - COMPLY OR DIE!

    PPACA will not change the reality I endure. Any alternative that does not specifically include Naturopaths and Chiropractors as recognized care providers, establish an ombudsman board to educate Idaho workers and advocate for total restoration after a W/C injury, and eliminate all insurer entities and their associated government bureaucracies, is a waste of time and will prove unproductive.

    As written, I say flush PPACA and Obama at least twice, then start over.

    Is the grass really greener because the Danes don't have as many guns?

    "Guns" or "Butter", you can't have both. ----- Rather snide at that!

    major false assumption greyhound2 as you scurry after the bunny down a dead end trail.
    If only you could get your hands on a gun before that Wabbit vanishes at the finish line.

    Denmark is an excellent place to live. #1 for happiness as a 'quality factor for life'.
    Fall through the cracks and you at least get a small room in what could be considered a commune.

    At just 12 guns per 100 residents and a very homogenous, tight-knit society, they have little to fear.
    What they do fear is judicial activism by the European equivalent of our Supreme court.
    Non-citizen Jews in Denmark fear deportation in conjunction with criminals and gang members.

    The European Court of Justice (ECJ) could easily rule that all immigrants have citizen rights.
    That would reclassify criminal gang violence into 'racial riots' because the desparate races (Muslims) aren't getting their fair share. Sound all too familiar? Some time ago, the muslim Black Cobras held crime in check to prevent police infringement on their criminal enterprise.
    Times have changed!

    In addition to guns, the Danes need to outlaw all crowbars, darts, hammers, knives, screwdrivers, wooden clubs and anything else that a criminal might use to terrorize those who work hard to provide for their families.
    A better, more equitable solution would be to arm all Natural-Born Danish Citizens with ASSault weapons to eliminate ASSoffenders of their laws without trial and with extreme prejudice before it is too late. Criminals deserve only three squares of Wonder Bread daily and a cot to rot on.

    I walked away from an opportunity to emigrate to Denmark. That bridge has washed out for me.


  • greyhound2 posted at 3:13 pm on Sat, Mar 2, 2013.

    greyhound2 Posts: 808

    The United States ranks number one in cost (16% GDP) but ranks number 38th in results, according to the UN WHO (an organization with no axe to grind). Get a clue.

    So who ranks better than the United States? Just about every industrialized First World country on the planet with El Salvador ranking 37th (a banana republic which is just ahead of the US by 1% point).

    Also, who is ranked number one in the world: for quality: France is first at 8% GDP, which is a socialist country that shows better overall results. So how did the US Healthcare Reform effort go down the drain: a secret closed door meeting at the Obama WH with the Insurance Company executives which took the Public Option off the table. No other reason - except that the US government was also prohibited from bidding for drugs like Canada and Mexico from big Pharma. USA number one? Not hardly. Newsweek ranks the US 11th in quality of life with Canada at number 7. The system can be changed, or we can all stampede for Canada (not that they want us and would be abhorded at the onslaught of so many ugly Americans). BTW, in quality of life, Scandivian countries take the one through three spots on the planet. No, you are not number one. "Guns" or "Butter", you can't have both.

  • The Simple Truth posted at 12:17 pm on Sat, Mar 2, 2013.

    The Simple Truth Posts: 563

    well, it's not like the GOP has any ideas or a spine....

  • boohoo2U posted at 11:49 am on Sat, Mar 2, 2013.

    boohoo2U Posts: 406

    no choice matters when workers are crushed through the cracks by physician groups to the benefit of corporations.

  • max power posted at 8:27 am on Sat, Mar 2, 2013.

    max power Posts: 559

    *** Two Great Reads ***

    Obamacare Survival Guide by Nick J. Tate

    Beating Obamacare by Betsy McCaughey

    Both are informative and let you know what you are in store for. Some of the topics addressed are:

    * Medicare cuts & new benefit rules

    * Rising premium cost & new taxes

    * Hidden taxes, levies, fees and penalities

    * Small business requirements

    * Medical professional rule changes you need to know

    * Exchanges & how to buy insurance

    * Prescription drugs & the new changes

    Did You Know?

    * Cuts to Medicare will pay for more than half of Obamacare

    * If you fail to get coverage, IRS can withold your refund

    * Hospitals that spend least per senior get bonus points, starting in Oct 2012

    * Your employer may drop employee health insurance before 2014

    * You could find yourself on Medicaid, where surgery patients have a lower chance of surviving than
    patients with no insurance at all.

    * Medicare officials warn that some hospitals will stop taking Medicare. Where will seniors go?

    * The Secretary of Health & Human Services will dictate how your Doctor treats you, even if you have
    a private plan that you paid for yourself.

    If you don't want to be blindsided by the myraid of new rules, regulations, fees, penalities and taxes that are coming down the pike, and if you want to understand what Obamacare means to you then prepare for it by educating yourself...

  • Why Not posted at 7:17 am on Sat, Mar 2, 2013.

    Why Not Posts: 4524

    EXCELLENT POST Bob from Athol

  • JoeIdaho posted at 6:40 am on Sat, Mar 2, 2013.

    JoeIdaho Posts: 2841

    No; that's the GOP being manipulated by the dictator, boobama.

  • bob-athol posted at 6:34 am on Sat, Mar 2, 2013.

    bob-athol Posts: 192

    I read the PPACA (Obamacare) as it was being debated in 2009. It took me 44 hours to read. I guestimate that 30% of the bill had to do with information and data gathering .... one thing for sure is, the government wants every bit of our medical records. BTW, nothing in the information requirements allows you to view what was written by your doctor or anyone else entering data. PPACA is indeed a hugely costly bureaucratic mess of goo. Idaho should have no part in it.

    While I like Butch, he and our state reps (Malek,Morse, Goode) supporting the state exchange are missing a lot in this. Yet at the end of this article, Butch describes what he is missing and that is this direct quote - - "Designing our own unique plan, having the exchange run by locally chosen Idaho citizens who will meet openly right here at home, gives us the best chance of weathering the Obamacare storm while meeting the needs of Idaho citizens." -- Butch mentions the correct solution, but thinks his comment supports getting in line with a federal state exchange. LOL

    What Butch is missing, is we are not designing our own plan in a state based exchange, we are carrying out the mess that the fed's created. PPACA state exchange rules give hardly any wiggle room to Idaho. We could indeed design a far better plan, and one that does not send huge amounts of profits to the insurance and health care groups who are lobbying like crazy to pass this.

    While this is indeed a complicated regulatory act I've tried to think of how to phrase our current debate and it comes down to this .... go back to Jonestown. The people living there were told drink the poison koolaid or be shot .... and indeed many felt that was their only two options. (Butch's position) However there was a 3rd option .... fight and fight collectively. We know for sure they all died by not fighting. By fighting, some would have lived.

    So what Butch is saying quite simply is, lets determine our own destiny and drink the koolaid. The logic is circular, the end result is the same.

    As I mentioned in another column post, Colorado and Washington states told the fed's, screw you, we are going to smoke pot, regardless of what you say .... and Idaho has the same option with healthcare. We indeed can do it better.

    So do we stand for freedom or let the insanity of the ruler (fed's) force us to willingly take our own life and drink the koolaid?

    Over 50% of the funding for PPACA is taken from Medicare (CBO cost analysis) .... and AARP supported PPACA because they are expected to earn hundreds of millions of new revenue dollars in insurance commissions. See how easily even AARP screwed it senior citizen members. As we say in politics, "Follow the money."

    We can fix health care in Idaho and do it in a way that provides care for the poor and sick amongst us, reducing costs and building the best system in America for our citizens and businesses. But to do that, we will have to not roll over to all the special interest groups lobbying for money. Butch and some of our legislators appear to have rolled over for the special interests.

    I wrote an alternate state based health care plan back in 2009 and some tried to push it up the ladder, today at 12:30 at the cda library another person (famous doctor) is holding a public forum to show his plan for Idaho. I'm going to go listen to what this doctor says will work and perhaps you should too.

    I know one thing, Idaho should not drink the koolaid.

  • The Simple Truth posted at 9:54 pm on Fri, Mar 1, 2013.

    The Simple Truth Posts: 563

    And that's just the GOP!

  • JoeIdaho posted at 9:07 pm on Fri, Mar 1, 2013.

    JoeIdaho Posts: 2841

    Government; in charge of the people, controlling the people, manipulating the people.
    blowbamacare will go down in history as the worst concieved and largest boondoggle in the history of mankind.

  • searcher posted at 2:43 pm on Fri, Mar 1, 2013.

    searcher Posts: 365

    So there's one good recommendation, when are you going to take the expanded Medicaid money Gov. Otter? Time to bring back some of those income taxes back to the state of Idaho. I'd rather spend it on those who need it in this state instead of letting it go to support those in need in another state~!

  • Why Not posted at 12:25 pm on Fri, Mar 1, 2013.

    Why Not Posts: 4524

    "It has quite simply to do with our right and responsibility to keep as many options as possible open to the people of Idaho. As much as we might object to the necessity, creating a state-based exchange is the only way to preserve options, oversight and accountability for our citizens.

    If we fail to seize this opportunity, if we default to total federal control of this process, the result will be an unresponsive, one-size-fits-all federal exchange wreaking havoc on some of America's most reasonable costs of coverage."

    You know what I call this? Scare Tactics; Governor Otter is pandering to the lobbyists in Boise again. This is no different than Obama running around and blaming everything wrong in Washington on Republicans. The same political morass we have in DC is happening in our own state and in the state of Washington where “Governor Doesn't Know the Time of Day” is crying Chicken Little about possible leaks at Hanford. HE-Double L - they've wasted Billions of tax dollars over 40 years at Hanford and things haven't changed one single bit. "Wantington" Govenor KNTD, he's just pandering for federal money so he can bring more federal funded jobs which pay lots to do little.

    I digress, the state exchange is the way to go, but what's the rush? We have no clue what the ACA will look like one year or two years down the road, nor does the government. They are flying by the seat of their pants. If we rush into a state exchange and it isn't designed to give the users the best services for the least cost, then what Governor Otter? There is absolutely no reason to run around acting as if the sky is falling pal. My pappy once told me a story about a young bull, an old bull and a herd of cows. Pull up your big boy pants and act like a leader, not a money motivated politician.

  • voxpop posted at 11:47 am on Fri, Mar 1, 2013.

    voxpop Posts: 738

    So the bureaucracy/legislature of Boise will run health insurance for the people of Idaho. Why don't I feel any better? Oh, right. Look how they've managed public education. Put Goedde in charge - get the pain over quick.

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