Tim Pawlenty, Republican governor of Minnesota, writes in the Washington Post that the February 25 health care reform summit is “an opportunity for Washington to start fresh and for conservatives to lead the way after the apparent defeat of the Democrats’ plan.” And to show how conservatives will “lead the way,” the governor provides five “common sense” plans for reforming health care. Let’s take a look.

1. “‘Incentivize patients to be smart consumers.” Gov. Pawlenty says that public employees in Minnesota pay less if they go to a low-cost, high-quality health facility. This encourages them to “shop” for the best health care deals, he says. That’s fine, except that I can’t see how Pawlenty’s little “incentivizing” tweak would work with a managed care plan, which I suspect accounts for most insurance these days. If you’re in a network you don’t shop for the best deal; you go where the insurance company tells you to go.

According to a Minnesota state government website, public employees in Minnesota are insured through “a group insurance purchasing program that was created by the MN State legislature.” Does that make it “government-run health care”?

Rachel Nygaard of Minnesota Progressive Project writes of the state program,

Creating wiser consumers, while helpful, doesn’t solve the problem for Minnesotans who are uninsured or underinsured. The number of uninsured Minnesotans rose 100,000 to 480,000 with 85,000 uninsured children. How does becoming a smarter consumer, help those without the option to consume?

I’m glad that we, as taxpayers, provide such a wonderful health insurance package for all our state employees. Could you please do the same for all Minnesotans?

2. “Pay for performance: Under America’s current system, health-care providers are rewarded for the number of procedures they perform, not for performance.” He says Minnesota measures performance of health care providers and make the results public. That’s fine, and the Senate bill (S. 1679) calls for setting up quality measures of health outcomes and making the results public.

3, “Liability reform.” In other words, the Republican plan for protecting corporations and health care providers from liability for their screwups. This has been enacted already in several states — most of ‘em, actually — and it has yet to put a dent overall health care costs or decrease the number of uninsured in those states.

Bottom line, the CBO estimates that an aggressive program of liability protections and damage caps would reduce the nation’s overall health expenses by a whopping 0.5 percent. And, of course, it would do so at the expense of people suffering from asbestos cancer and faulty brakes as well as gross medical errors. In any event, the Senate bill encourages states to develop ways to make the malpractice system fairer to doctors and patients and provides for funding for developing new state programs.

4. Interstate health-care insurance. As the Economist astutely explained recently, the interstate health-care idea “is actively pernicious. It is a way to destroy the efforts of states to fix insurance-industry problems themselves.”

The Republican plan would allow insurance companies to set up shop in states with little regulation — Texas, for example — and sell cheap junk policies to young and healthy people nationwide. Insurance is cheap in Texas compared to, say, New Jersey, in part because New Jersey has more regulations. But in New Jersey insurance companies cannot refuse to insure people with pre-existing conditions. In Texas, they can.

Note that 15.8 percent of New Jersey residents have no health insurance. In contrast, 25 percent of Texans have no health insurance. (U.S. Census Bureau, 2010 Statistical Abstract)

As a result, insurance is more expensive in New Jersey than in Texas. And if the young and healthy take their business to another state, the older and sicker New Jerseyites left behind will be paying even higher prices. According to Consumer Reports Health Blog,

The effect on overall health coverage would be a wash, concluded the nonpartisan Congressional Budget Office in its analysis of the bill that includes this proposal. The proportion of uninsured legal residents would be the same in 2019 as it is today—17 percent. What’s more, the uninsured would be sicker—and thus more in need of insurance—than they are today. (For comparison’s sake, the health reform bill passed by the Senate would result in an uninsurance rate of just 6 percent by 2019, according to the CBO.

That said — the Senate Democratic bill does provide for selling insurance across state lines. However, it does this by allowing states to form voluntary compacts, so New Jersey could refuse to allow its residents to buy policies in Texas. The policies also have to contain a minimum level of benefits. Conservatives don’t like this plan; it cuts into insurance company profits.

5. “Modernize health insurance.” Gov. Pawlenty is a bit vague about what he means by “modernizing.” “We should make health insurance transferable so employees can keep their coverage if they switch jobs,” Pawlenty says. Sounds great. In fact, such portability is also a goal of President Obama “Principles for Health Reform.” Everybody’s in favor of it. But I’ve yet to hear a feasible plan for making this work in a system made up of a patchwork quilt of private, for-profit corporations. Now if we’d go to single payer …

Anyway, the point is that all of Pawlenty’s “common sense” reforms are either covered by the Democratic legislation and/or are not really reforms. Republican reforms are not really about helping more people get insured or bringing down the cost of health care; they’re about helping the insurance industry be more profitable.

See also:

Health Care Reform: Conservative “Solutions” Won’t Work

This entry was posted on Monday, February 15th, 2010 at 12:14 pm and is filed under Liberal. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.