Ronald Reagan: The real socialist on health care

I’ll allow some of my favorite conservative readers to grab their blood pressure medication and Sean Hannity snuggle dolls before I get into the raw, bloody meat of this post, but first, another dispatch from the heart of Scott Walker’s adopted homeland.

As I acknowledged last week, the rollout of Obamacare has been something of a disaster, and the Obama administration bears a great deal of responsibility for turning HealthCare.gov into Black Friday in the deer musk aisle at the Chilton Walmart. I’m starting to suspect Kathleen Sebelius gave her nephew 50 bucks and a case of Mountain Dew Code Red and told him to get a Geocities site up and running by October-ish.

Now I know how conservatives must have felt when George W. Bush brought the world to the brink of depression and our country started hemorrhaging 800,000 jobs a month. You kind of run out of excuses, you know? Utterly destroyed economy that cratered world commerce and put millions of people out of work vs. website on the fritz. Let’s just call it even, okay?

But let’s keep it in perspective. We’re talking about a website, not Obamacare as a whole. Whether the ACA works or not — and ends up giving previously uninsurable people the chance to live like modern humans — depends on the efforts of all our countrymen. Unfortunately, some of our citizens have not only not been helping, they’ve been vigorously pushing in the opposite direction.

Now, the rest of us are reaping the whirlwind.

Witness Wisconsin, and our decidedly unhelpful governor. Turns out, when you decline hundreds of millions in Medicaid funds and decide not to use all the cost-control tools at your disposal, there are consequences.

In a recent report titled “A Tale of Two States: Why Wisconsin Premiums Are Higher Than Minnesota,” Citizen Action of Wisconsin noted that health insurance exchange premiums for single coverage will be on average 79% to 99% higher than premiums in Minnesota before tax credits are applied — which adds up to more than $1,800 a year on average.

In some areas, premiums will be much higher. For example, La Crosse residents’ premiums will be 136% higher than the average Gopher’s, and in Milwaukee, they’ll be 112% higher.

According to the report, there are two reasons for this disparity: 1) Scott Walker’s rejection of Medicaid funds and 2) the state’s decision not to implement vigorous reviews of health insurance rates.

Regarding No. 1, Citizen Action concludes:

The dramatically different approaches to Medicaid funding between the two states can explain part of the exchange rate disparity. This is because pushing more lower income people into the exchanges raises rates by increasing the number of people in poor health in the insurance pool.

Meanwhile, Minnesota has implemented a vigorous rate review plan that has lowered its rates considerably:

Minnesota, like some other leading states, has used a robust rate review process to lower health insurance premiums. According to the Minnesota Department of Commerce, rate review played a major role in moderating rates on Minnesota’s health insurance exchange, reducing originally filed rates from 4-37%. It is possible that this understates the impact of such rigorous rate review, as insurers have submitted lower rates in the first place knowing they would face strict regulatory scrutiny.

Minnesota is also planning beginning in 2015 to use its state-based exchange to become an active market participant, seeking to use the leverage of the buying pool to lower health insurance premiums. Many believe active purchasing has already reduced rates in California and other states. Although this did not impact Minnesota’s 2014 rates, it is an additional rate moderation tool state policymakers will use in years to come. By rejecting a state-based exchange, Wisconsin has adopted a passive clearinghouse model which will not exert the same downward pressure on rates.

So because Scott Walker wanted to burnish his conservative bona fides by rejecting federal money and statewide regulation, ordinary Wisconsinites participating in the individual insurance market will end up paying hundreds of dollars more. Kind of puts that recently passed property tax relief into perspective, doesn’t it?

Of course, as I’ve argued before, what Walker is really doing is uniting with his fellow Republicans to sabotage Obamacare before it can get off the ground. He’s doing this for no other reason than to make the program look bad so we can get another Republican president in office who can complete George W. Bush’s unfinished symphony.

Which brings me to the headline of this post, which has kept any Republican who’s stuck with me this far shaking like Rush Limbaugh during a lengthy Toblerone and opioid embargo.

In 2007, then-President Bush said this:

“The immediate goal is to make sure there are more people on private insurance plans. I mean, people have access to health care in America. After all, you just go to an emergency room.”

It’s an interesting quote for two reasons: First, getting more people on private insurance plans is exactly what Obamacare does, so one wonders why conservatives are so viscerally opposed to the program. Is it because the ACA was proposed by a Democrat? Must be, because before they were against it, many leading conservatives — such as Newt Gingrich, Mitt Romney, and the bleeding hearts at the Heritage Foundation — were for the individual mandate.

Secondly, as far as I can tell, simply having people go to the emergency room for free (and costly) medical care when they’re too sick to stand anymore appears to be a key component of the Republicans’ 21st century free-market utopia.

I say this because their universally exalted avatar, Ronald Reagan, cleared the way for all this rampant health care freeloading.

(Continued)

 

In 1986, Congress passed — and Reagan signed — the Emergency Medical Treatment and Active Labor Act, which prohibited hospitals from turning seriously ill or injured patients away from emergency rooms because of an inability to pay.

It was a good law, because who wants sick people to be dumped onto the street when they’re dying? But it was also a huge burden on private enterprise. Speaking to the trade magazine Hospitals and Health Networks, David C. Seaberg of the American College of Emergency Physicians said this: “It’s a double-edged sword. The good side is that patients with emergency conditions are being taken care of; they must have an evaluation exam and they have to be stabilized. The negative side is that EMTALA is the largest unfunded mandate [on providers] that the government has ever instituted.”

By trying to ensure that everyone has health insurance, Obamacare seeks to remedy all that. In fact, the law goes to the heart of a fundamental tenet of old-school conservatism: personal responsibility — or the notion that you should behave like a good citizen instead of shutting down the government for no good reason, turning the economy into a smoldering heap of twisted metal, or refusing to buy insurance.

Of course, when hospitals have to subsidize the care of the uninsured, everyone pays more to cover those costs. Socialism, right?

Obamacare deserves a chance to work, the (considerable) issues with HealthCare.gov notwithstanding. Early returns from states that actually embraced the law — such as Kentucky, Washington, and Oregon — show that it can work.

The implementation of the ACA has been anything but smooth thus far, and that’s the Obama administration’s fault. But it would help if everyone started pulling in the same direction. Unfortunately, Republicans like Scott Walker much prefer the status quo: a pernicious form of socialism that leaves many of our citizens sicker than they ever deserved to be.

Eat some chili with me

Apparently, I’m what passes for a vegan celebrity in these parts. Alliance for Animals and the Environment has chosen me as a judge for its 10th Annual Vegan Chili Cookoff, which takes place Nov. 2 at the East Side Club.

I’ll be joined by actual celebrities Joy Cardin (Wisconsin Public Radio), Rob Starbuck (News 3 This Morning), Jon Hinds (Monkey Bar Gym), and my wife, Cheryl Breuer, a frequent Isthmus contributor.

We’ll be tasting chili from Bunky’s Café, Monty’s Blue Plate Diner, Eldorado Grill, Weary Traveler Freehouse, Sunprint Café, Liliana’s, The Green Owl, and Tex Tubb’s Taco Palace.

I attended last year’s event, and it was fantastic. The participating restaurants go all out, so give it a try if you have a hankering for some chili or simply want to hector me in person.

Assuming Thong Cape Scooter Man doesn’t go vegan before Saturday, I’ll be there rubbing elbows with the glitterati and dribbling chili down my Big Lebowski T-shirt. 

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