A poor exchange
Published October 2, 2013
Editorial by Greensboro News-Record, October 2, 2013.
Last year, N.C. Insurance Commissioner Wayne Goodwin was developing plans for the state to operate a health care exchange. That was before the General Assembly said no.
The legislature enacted a bill in February rejecting Medicaid expansion and state participation in the “Health Benefit Exchange” under the Affordable Care Act.
The measure directed all state agencies to stop efforts to provide “any services” related to the exchanges and to return unspent federal grant money intended to launch the medical insurance program. That pushed Goodwin to the sidelines. What he sees from there bothers him, he said in an interview last week.
The exchanges opened Tuesday, operated in North Carolina by the federal government — despite its partial shutdown. Consumers can look online (healthcare.gov) at medical coverage plans and select what best suits them at a price they can afford. Depending on their income, they may qualify for subsidies.
North Carolina residents face fewer choices and significantly higher prices than the national average. Goodwin traces the reason for that to the bill enacted in February and signed by Gov. Pat McCrory in March.
The decision to refuse federally funded Medicaid expansion left “500,000 North Carolina residents, by my calculation,” without that option for health care coverage, Goodwin said. It created a large pool of potentially expensive-to-cover consumers.
Goodwin also said his department could have worked to recruit insurance carriers to offer residents the widest possible menu of options, increasing competition and potentially dropping costs. But, because of the dictates of the legislature, his staff isn’t even permitted to answer questions posed by residents who call his office. Callers have to be referred instead to federal offices.
No one should think that Obamacare will deliver on all its promises. There are indications that insurance companies will raise rates for everyone because of coverage mandates in the law. There will be glitches as people try to navigate online exchanges. Young, healthy consumers will defy requirements that they enroll in plans — and that might be seen more often in North Carolina because of the higher costs.
Yet, Goodwin — an elected state official directly accountable to the people — saw an opportunity for North Carolina to “control our own destiny” by operating exchanges with the goal of providing the best possible service for North Carolinians. Why should anyone think Washington can do better?
Unfortunately, finding practical health care solutions for North Carolina residents was not the priority in Raleigh. Just like congressional Republicans, state legislative Republicans simply want Obamacare to go away. If they think they can kill it by shutting down the government or by letting residents pay higher costs for fewer choices, they will.
They should re-evaluate.
“I do hope the governor and lawmakers will keep their eyes wide open,” Goodwin, a Democrat, said. Last year, the line he heard often was, “Let’s see where we are a year from now.”
That’s now, and where we are is not good. Leaders in Raleigh owe a new look at whether the state should belatedly accept Medicaid expansion and operate these exchanges to get a better deal for the people.
October 2, 2013 at 8:53 am
Richard Bunce says:
"There will be glitches..." Right up there with "Where's the beef?"
October 2, 2013 at 9:58 am
Norm Kelly says:
'Why should anyone think Washington can do better?' Is this a rhetorical question? Let's run down the list of those who think the feds can do better than private business, state government, local government, or individuals. We'll start with His High Holiness, Mr. Obama. (i use 'high' to refer to his position, not his college years spent admittedly high on whatever drug he could get hold of!) Then there's the Democrats in the Senate. Then there's the Democrats in the House. Then there's used-to-be major media outlets. Oh, and let's not forget the average editorial in our state, including this editorial.
If all these people didn't think Washington could do it better, then why would Washington have implemented a take-over of 1/6th of the economy, why would they take-over the health care insurance system? So either the writer was posing a rhetorical question or is trying to play dumb and convince somebody, somewhere, that socialized medicine really is a good thing & is going to work.
'finding practical health care solutions for North Carolina residents was not the priority in Raleigh'. Finding practical solutions to health care needs was obviously not a priority in Washington either. Finding practical solutions would have involved more than the feds simply taking over the system. Finding practical solutions would have involved things like tort reform, allowing cross-state lines purchases, allowing small businesses to form coalitions for group purchase discounts, allowing individuals choice in their coverage rather than requiring one-size-fits-all mandates by government at any level. But instead of trying to fix the existing system, the only thing Democrats/liberals/socialists in Washington could think to do is take federal control of the insurance market. Obviously the majority in Washington thought they knew better. What they provided is a one-size-fits-all solution with mandates on coverage, mandates on profits for insurers, new taxes on device manufacturers, and a special tax on those who choose NOT to participate in a specific market. (the commerce clause is meant to protect those who CHOOSE to participate in a market that crosses state lines. years ago washington prevented cross-state lines health insurance purchases. socialists in washington decided that the commerce clause can be used to force people to participate in a market, and fine us if we continue to choose not to participate. and scotus did NOT uphold the law. they changed the law to exactly what socialists in washington promised us would not happen - they promised there would not be a tax on individuals who didn't participate. so they called it a fine. scotus said that they could not fine us, but instead redefined/changed the law to say that taxing non-participants was legal.)
When socialists implemented their take-over plan, their version of socialized medicine, what they called 'step 1', they promised that my premiums would be lower, I'd have MORE choice, I'd be able to keep the plan I already had, I'd be able to keep my doctor, if I wanted. The truth is much different. Insurance premiums are going UP. I actually have fewer choices for coverage. My plan is probably NOT available anymore, because the feds PREVENT private insurers from providing this plan to me. If my doctor does not participate in the specific plan provided by the feds, I most definitely will NOT be allowed to keep my doctor. So what exactly is the good part of socialized medicine? Where's the part that I'm supposed to like?
And when phase 1 of socialized medicine fails, which it most definitely will, what will Washington's response be? How will editorialists respond? Well, naturally, they will all say that Washington is not involved enough in my life, that a full take over, single payer system is the only way to resolve the issues. Their plan will be to eliminate all private insurers, will set pay/income for doctors and hospitals, will determine who gets what services, and whether a lawsuit is possible along with determining how much a settlement should be.
Ask socialists what their end game is. They want to ask House Republicans what their end game is, implying they don't have one. Ask the socialists the same question. They will hem, haw, hesitate to answer. Because their only answer is a complete take-over. Just like Dems in Washington, including the King, have already said.
Should Republicans in the House stand up for the citizens and fight full implementation of socialized medicine? Of course. Am I proud of the constitutionalists who are representing 'we the people' in Washington? More proud than I am of those who choose to lie to me about what they are doing.
October 2, 2013 at 2:06 pm
TP Wohlford says:
For most of NC, our "Exchange" would simply be a redirect to BCBS's web site. Why have an "Exchange" when we have only 1 carrier for most of the state, and only 1 more for a few counties?
This IT guy says, just do single HTML page, asking the person where they live, and if they live in most of NC, then they get redirected to the BCBS page. If they are lucky enough to have a choice, then present them with a menu between the 2 companies, and be done with it.
Simple. Good HTML person could have that done in under an hour. Probably the meeting to decide to have the meeting to plan the meeting that will decide when to have the meeting will take longer that that....
