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Walker right on Obamacare exchange

The new online format of the Daily News doesn’t allow me to post a link, so I’ll just post the whole column. Here’s my column from yesterday’s paper:

West Bend Daily News 11/20/2012, Page A06

Walker right on Obamacare exchange

Control will never really leave Washington

One of those truisms that applies in almost every area of life is that one should never accept responsibility for that which one cannot control. It applies in one’s job. It applies in one’s personal life. And it applies in governance. That is what is at the heart of Gov. Walker’s decision last week to decline to run a state health insurance exchange for Obamacare and defer to the federal government.

As part of the rules of Obamacare, online health insurance exchanges are to be set up for consumers to shop for a health insurance provider. Each state was given a choice as to how those exchanges could be implemented. The first option was for a state to set up its own exchange and manage it. The second option was for a hybrid model where the state acts on the behalf of the federal government. The third option was for the state to not do anything and defer to an exchange to be set up by the federal government.

The problem, as Gov. Walker rightly points out, is that all three options use the veneer of choice and free market principles to cover a colossal federal program that will only be controlled from dusty cubicles in Washington. Obamacare grants sweeping authority to the federal executive branch to set and change rules as they see fit. Regardless of the means by which the exchanges are implemented, the control of those exchanges will never leave Washington. For that reason, Gov. Walker did what any prudent governor should do and did not subject Wisconsin to be responsible for an exchange it would never control. It would be poor governance to put the taxpayers of Wisconsin in a situation where they would be forced to adhere to and pay for rules and programs yet unknown and unforeseen. Lest you think this is folly, the federal government has a long history of mandating things and making state taxpayers foot the bill for their largesse. It has happened with welfare, Medicaid, s pecial education, transportation and any of a host of other examples.

While Gov. Walker was correct in his decision for the reason he stated, there were other reasons for Wisconsin to let the federal government set up the exchange. First, the legal future of Obamacare is still unknown. While the Supreme Court has found a way to uphold the unconstitutional individual mandate, several aspects of the law are still being challenged in court. Those items being challenged include the employer mandate, the federally-facilitated exchange subsidy, the preventive care mandate, maintenance of effort, the origination cause challenge, the super-governmental independent payment advisory board and the legality of the delay in issuing formal rules and regulations.

With so many aspects of the law still working their way through the courts, it would be rash to charge ahead with creating the exchanges and the bureaucracy to support them without knowing how the law will look at the end of the tunnel. It would be like setting up your deer stand on someone’s land before knowing if you have permission from the property owner.

A second reason that Gov. Walker was sensible to let the federal government set up the exchange is purely practical. By law, the exchanges are supposed to be live and working by Oct. 1, 2013. That’s just 10 1/2 months away. Setting up a secure and redundant infrastructure with the web servers, databases, firewalls, management applications, monitoring applications, backups, telephony, power, cooling, staff, and everything else it will take to support hundreds of thousands – perhaps millions – of users is daunting enough to do from scratch in that little time.

But to add to the complexity and difficulty of the task, the federal government has been slow to absent in informing the states of the thousands of details they will require of the exchanges. The federal government has been derelict in issuing the necessary regulations so that the law can be implemented. There is the real likelihood that states that have begun to put together their exchanges under some assumptions will have those assumptions shattered when those regulations are finally issued. This will result in even more chaos.

While many of us opposed Obamacare from the start and continue to oppose it, the reasons for Wisconsin to defer to the federal government when it comes to the health insurance exchange has nothing to do with such opposition. It has everything to do with protecting the taxpayers of Wisconsin and good governance. Gov. Walker is to be congratulated for making this politically difficult decision in support of Wisconsin’s citizens.

(Owen B. Robinson, a West Bend resident, is a blogger who publishes at http://www.bootsandsabers com. .His column runs Tuesdays in the Daily News.)

Posted by Owen at 0943 hrs
Politics + Politics - General + Politics - Wisconsin

1. I say again…GOOD for the following reason. http://crooksandliars.com/karoli/gop-governors-unwittingly-move-us-toward-si
   The buying power of the federal government will drive better bargains with insurance companies than any individual governor helping his cronies. Look at health care for federal employees. The result will be better for those covered but not for the insurance companies.

   Posted by .(JavaScript must be enabled to view this email address) on November 21, 2012 at 1248 hrs
   
   
   

2. Dave-what happens when we quickly morph to one sole buyer of everything healthcare?  i.e. the Federal Government.

   Insurance plans, drugs, medical devices, etc.  It all goes to the Feds since as you say, they are more efficient.

   Let’s say someone has an idea for a new version of the Pacemaker, and if given a chance, this hypothetical new version is superior in most ways to the original version.  The inventor would like to sell this new version to some clinical groups and hospitals. 

   But the only buyer of these things is the Federal health care conglomerate.  And Medtronic, maker of the pacemaker has already paid off the Obama bureaucrat in charge of purchasing.  And Medtronic is already paying the medical devices tax to the Feds per Obamacare.  So the Feds aren’t going to buy the new pacemaker since Medtronic is the preferred government vendor who pays taxes and tribute to the Feds.

   Where does this new person go to place their device?  How does innovation occur?  What is the motivation for this person to invent and perfect this device in the first place?  Who puts up all the risk capital for the R&D and clinical trials of the new device? 

   How many people get free pacemakers because of Obamacare?  How many people down the road die as a result of the new improved version never making the market?

   We’ve all seen what the Feds do with monopoly power. It’s called the Post Office.

    

   Posted by .(JavaScript must be enabled to view this email address) on November 21, 2012 at 1513 hrs
   
   
   

3. Steve , if you buy your insurance in the so called free market, you know that it’s the only business model in the world where prices only go up.

   Having paid for my employees insurance for 35 years, few can lecture me on the
   Positive nature of the current insurance   model.

   New hospital, prices go up. New clinic, prices go up. Free market my ass.

   Having the government splash into this pool of non competitiveness could not thrill me more.

   Posted by .(JavaScript must be enabled to view this email address) on November 21, 2012 at 2244 hrs
   
   
   

4. The Feds, efficient? There’s actually someone who believes that the Feds do ANYTHING efficiently?! I guess there’s always someone who closes their eyes to reality.

   If you want to see what a one-buyer market looks like, look at the Defense Department. Like that efficiency?

   Posted by .(JavaScript must be enabled to view this email address) on November 21, 2012 at 2301 hrs
   
   
   

5. Good point nerdbert, the VA health care system is an excellent example of successful single payer health system that could be expanded to cover all.

   Posted by .(JavaScript must be enabled to view this email address) on November 22, 2012 at 0829 hrs
   
   
   

6. Oh, the VA…it’s okay if you’re not worried about catching HIV or hepatitis:

   http://www.cbsnews.com/2100-204_162-5091478.html

   Or receiving healthcare that is so poor, it was deemed unconstitutional:

   http://nation.time.com/2011/05/10/appellate-court-rules-poor-va-mental-health-care-for-vets-is-unconstitutional/

   Or receiving an incorrect or delayed diagnosis:

   http://www.courierpress.com/news/2011/mar/16/marion-va-cited-for-poor-care/

   Or dealing with poor customer service:

   http://consulting.ohmygov.com/?page_id=481

   Why don’t you do everyone a favor, Dave, and leave.

   Posted by Badger on November 22, 2012 at 0954 hrs
   
   
   

7. Mark, what three areas of our economy have seen non stop price increases well above inflation?  And which of those same three areas are ones that are in all sorts of turmoil?

   Residential Housing, Higher Education and Healthcare.

   And the common denominator with all three is the that Federal Gubermint decided all three were good things for everyone, so they have intervened, regulated and subsidized in each industry.

   Start to put the free market back in all three and we’d see affordability improve and get better outcomes.

   Posted by .(JavaScript must be enabled to view this email address) on November 22, 2012 at 1014 hrs
   
   
   

8. Steve, I might disagree about home ownership for all but put me squarely in favor of health care for all and higher education for those to aspire to it ( and a government who supports those thoughts)

   53 million souls voted for those ideas and
   Elections do matter.

   Would love to be in the room when Paul Ryan lectures the Re-elected Potus about the mandate’Ryan/Romney received for their version of limited government .

   Yeah, I know, it’s all about the “free stuff.“God, I hope the right is still saying that in 4 years.

   I love hearing the right say “we have the right message about limited government but we just didn’t sell it well enough “

   My sales manager when I was a kid used to say ” it’s great dog food kid but the dogs ain’t eatin it “

   Grateful for the conversation. Happy thanksgiving

    

    

    

    

   Posted by .(JavaScript must be enabled to view this email address) on November 22, 2012 at 1250 hrs
   
   
   

9. Steve - aside from your abysmal election predictions, I’ve found your comments to be somewhat reasonable. But healthcare?? neighbor please.
   The US spends more than twice per capita on healthcare compared to the rest of the first world. And yet, we have results resembling a third world country. These are facts, not opinions. You cannot possibly defend the current system.
   The Affordable Healthcare Act is certainly not the complete answer, but we must find a way to buy ounces of prevention.

   Posted by Charlie Hillman on November 23, 2012 at 0029 hrs
   
   
   

10. “7.Mark, what three areas of our economy have seen non stop price increases well above inflation?”

    The USPS…run by….you know who.

    Posted by .(JavaScript must be enabled to view this email address) on November 23, 2012 at 1305 hrs
    
    
    

11. Right, the USPS that has had imposed on it legislation that requires it to fund its promised pensions for the next 75 years now! Hence the 11 billion deficit.  If that standard were applied to any private pension or social security it would be broke too, which it is NOT despite the protests by many of you. The only reason to impose that standard on USPS is to destroy it so there is no USPS and the private sector paying the lobbyists can take over.
    

    Posted by .(JavaScript must be enabled to view this email address) on November 24, 2012 at 1004 hrs
    
    
    

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