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Monday, April 26, 2010

Hated and Poorly Debated: Nelson, Curd, Noem Blow Smoke on Health Care

Health care reform is hated by all... all three GOP candidates for South Dakota's House seat, that is. They evidently hate it so much, they can't even debate it right. Compare what they say to RCJ's Lynn Taylor Rick with what they were actually thinking.
  1. R. Blake Curd: “At this point, we don’t know the extent of the bill and its reaches. It is a significant increase in the governmental intrusion into health care."
  2. Chris Nelson: "Because you exist you must purchase insurance? That particular mechanism is not constitutional."
    • Translation: I don't want to talk about why insuring everyone is a good idea. I don't want to confuse people with policy details. Keep it simple, shout Constitution!, and hope no one asks about all the other things required of people by dint of their existence, like wearing clothes and signing up for Selective Service.
  3. R. Blake Curd, on the insurance mandate: "You can’t criminalize any behavior you don’t want to happen because you think it’s a bad idea."
  4. Kristi Noem, on banning exclusions for pre-existing conditions: "I haven’t really evaluated it. I don’t like the mandates."
    • Translation: Oh no. That's one of those facts about the law that people like when they cut through my Michele Bachmann impersonation. I can't admit Democrats did a good thing. What do I do? What do I do? Help, R!
  5. R. Blake Curd, same topic: "I’m not sure that a blanket federal law is best solution for it."
    • Translation: I don't know, either, Kristi! Um... um... do like Chris and change the topic to the 10th Amendment again!
  6. Kristi Noem, on why Republicans didn't do something about health care when they held the reins: "Maybe we haven’t had the people in Washington, D.C., with the will to do it. But I don’t think it’s good to pass bad legislation to be able to stand up and say we passed something."
    • Translation: Stop reminding people of the facts! Everyone knows it's easier to say no to Democrats than to create policies of our own. And that's the same do-nothing obstructionism I'll take to Washington!
  7. Chris Nelson, same topic: "I’m not making excuses for what Republicans did or didn’t do in the past...."
    • Translation: Yes, I am making excuses....
This is why I like primaries: the more Republicans talking, the more blog material they provide.


  1. Five stars, Cory. I know you're not big on religion, but God bless you anyway.

    I hereby proclaim you an honorary Episcopalian.

  2. I'd rather give you one star for this one Cory, a single red one to proclaim the honorary status made clear with your ideology. Cheap shots at sound bite snippets are usually beneath your intellect.

  3. If people who didn't sign up for insurance were automatically enrolled in a public option and taxed at a fixed percentage of their adjusted gross income, the mandate issue would not exist.

    I'd likely have signed up for the public option so I could move to Wyoming or Nevad, or Hawaii, or Massachusetts or Monaco or the Cook Islands, and not have to worry about the cotton pickin' health insurance conundrum! Just pay the tax and have done with it, and live out my years scribbling about mathematics and electronics in between trips to the beach.

    Now you know why I don't turn teabagger. I've got these leftist bugs up my software. I wonder where they came from? Not my parents or friends! Maybe just common sense?

  4. Thanks, Curtis... but I think living with a future Lutheran pastor is as close to church as I care to get. ;-)

    Oh, Roger. It's the candidates' sound bites that are below our intellect.

    Stan, interesting point: a public option, arguably a larger intrusion of the federal government into the health insurance market than the individual mandate, might actually produce more liberty for citizens. That sense, alas, is not common enough!

  5. Stan, if insurance companies were allowed to sell insurance across state lines, you could move anywhere without losing your insurance, and this would all happen without the gov't in control. This whole issue is not about controlling costs of health care or even insuring everyone; it is about gov't control and nothing more.

  6. Linda, if insurance companies were allowd to sell insurance across state lines, the federal government would have more authority to regulate it as interstate commerce. Without that regulation, you'd see a race to the bottom, à la credit cards, where every insurer would move to the state with the lowest requirements and sell everyone the crappiest insurance possible. You'd get no cost control, only more profits for insurers and less care for policyholders.

  7. Why couldn't they allow insurance to be sold across state lines but force compliance to each state's mandates if they choose to sell in that market? It would be more complicated to sell and service but certainly possible.

    But regardless, if your company didn't sell and service in every state (likely they would not) you wouldn't have complete portability as Nonnie suggests.

  8. Cory: "sell everyone the crappiest insurance possible"

    The race to the bottom is a fiction. Yes they would seek out the state offering the least regulation but they would ALL congregate there or in similar states and then compete with each other for customers. Not all customers would demand the wall-mart priced coverage. There would be competition for various levels of coverage, not just the government established black and white box. Even if the consumer did just seek out the cheapest one and the degree of coverage declined...so what?! Shouldn't we be free to decide this for ourselves? (and shouldn't people be free to sell the product they choose to?)
    Credit Card usury doesn't compare well to insurance (and it could be solved with less regulation anyway, not more)

  9. Cory is right, again. It goes way beyond price and mandating coverage. In Colorado for example, their Division of Insurance actually became involved in 3rd level appeals which helped protect policy holders and held companies to a higher operating standard and pushed them toward fairness.

    The idea that markets just take care of themselves is laughable and a high school mentality. Companies care about profit, and with health insurance there are huge barriers to entry which greatly restrict competition.

    Naive people or those unable to see beyond black and white thinking they should impact policy are just as dangerous as the crooks.

  10. JohnSD: Market forces aren't a cure all, profit is their primary focus and there is nothing wrong with that, but when it is necessary for society to demand the market provide something or abide under conditions that conflict with profit it undermines profit. Fans of regulation of market forces need to at least recognize that cost, which often helps creating more restrictive barriers to entry into that market. You say the health insurance market is not competitive and hard to enter but it is government action that has makes it so expensive and uncompetitive.
    Your example of the department of insurance stepping in lacks detail. If they were making the insurance company follow their contract with customers that's fine. However if they were taking action to meddle in how policies are written then that sucks. It isn't the responsibility of the government to get me a good deal or protect me from myself.

  11. In short: "no cost control, only more profits" means lower prices and more competition leading to better care.

  12. Look at the business. If government had no regulation in health care would Dakotacare overnight (or ever) become a nationwide company? To expand it takes massive capital, contracts with providers, a sales force, ability to process claims & service policies, and then remain viable.

    Roger, a comment is necessary on this statement: In short: "no cost control, only more profits" means lower prices and more competition leading to better care. Do you have some specific health insurance examples to provide?

    I worked in a large non-profit health insurance company (BCBS of Colorado) that went for-profit, and I’ll tell you the opposite was true. Benefits were restricted, policy prices went up, service went down (dreadfully so). After Anthem took us over it was all about numbers. I created spreadsheets every day, none of which were about bettering the health of our members, but maximizing call volume, squeezing employees, all to increase profit. That was the bottom line, which is not the same thing, and does not necessarily lead to bettering the health of the member. We had “hatchet ladies” (RNs in managed care) that visited hospitals to ensure you still needed to be there, so please make me laugh and say keep bureaucrats out of my health care and from between me and my doctor. Certainly don’t take my word for it. Ask your doctor if he (and you) make all the decisions about your health care, or how much of it is guided by insurance company policies. Practitioners know the policies in and out so they know what care is covered.

    How about considering facts and circumstances on an issue, forget your ideology for a moment, and see what your brain has to say?

  13. JohnSD , Asking Roger to forget about his Ideology is like asking Jughead to forget about hamburgers. Good luck. :' )

  14. "a large non-profit health insurance company (BCBS of Colorado) that went for-profit"

    Don't compare apples and oranges for starters. Look at the historical context. As a non-profit charitable organization, the environment BCBS existed in gave it resources commercial insurers didn't get. So why did they get end up being bought? The simplest explanation is that they became unsustainable. The Virginia BCBS plan failed and the Nevado group was merged with Colorado because it had massive debts, when the national organization lost it's tax-exempt status in 1987 it lost a gigantic advantage it had over commercial insurance companies as well as the ability to keep going indefinitely without making the cost cutting measures you hated. The profit motive in a competitive environment provides the best care possible within the confines of the resources available. If BCBS had been able to retain it's tax exempt status, it may have been able to continue providing the better care you experienced with it prior to the conversion. In it's early existence BCBS wasn't considered an insurance company and so was free of the insurance regulatory agencies, but by the 1987 decision it had evolved to be just another insurer with unfair advantages. Instead of blaming the free market for the decline as you experienced it, blame the people who allowed it to evolve beyond it's original intended focus to help where normal insurance couldn't.


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