The GOP senate wannabes had a debate recently. Actually, I take that back. TWO of the THREE GOP senate wannabes had a debate recently since John Brunner chickened out of the debate, apparently scared to answer the questions Missourians have. This, of course, after agreeing to debates, even calling for debates, and then backing out. Bwwaaaaaak bwak bwak bwak bwaaaaaaaak. But I digress...
Sarah Steelman and Todd Akin both managed to show up, but their answers were downright frightening, particularly regarding Obamacare. Both were asked what should happen to a 28 year old man who has the ability to purchase health insurance but decides not to - these sorts of folks are often referred to as the "Young Invincibles" - and is then diagnosed with cancer.
Both Steelman and Akin both demonstrated a complete lack of understanding of what Obamacare actually does, like ensuring that insurance companies must justify rate hikes, prohibiting annual or lifetime limits on needed care, ending denials based on preexisting conditions, and many, many others policies. Of course, as was to be expected, both Steelman and Akin rolled out the fear mongering, repeatedly debunked, tea party talking points which boil down to guvment health care is baaaaaaaaaad which, really, is best left to expert fear-mongerer in chief, Ed Martin.
But back to the debate, Steelman talks about affordability and accessibility as if Obamacare doesn't address either - which it does - and talks about door knocking business people. Indulge me here for a minute: when I go door knocking for candidates or issues, I don't door knock business people, I door knock in neighborhoods where families and my neighbors live. What in the world is Steelman doing door knocking and only talking to business people? Does she ever have conversations with a working Missourian who's boss, maybe a small business owner, has now been able to provide his employees with healthcare coverage because of the small business tax credits made available by Obamcare? Has Steelman had a conversation with the mother down the road who now has access to healthcare that she was previously denied because she had a breast cancer scare but now that insurance companies are prohibited from denying healthcare for preexisting conditions she can now rest easy knowing that she can get the care she needs and watch her children grow up? Or does she only talk with business people? Just curious.
Anyway, let's debunk the "let's-sell-insurance-across-state-lines" idea right here and now. Better yet, I'll let Ezra Klein of the Washington Post do it:
Insurance is currently regulated by states. California, for instance, says all insurers have to cover treatments for lead poisoning, while other states let insurers decide whether to cover lead poisoning, and leaves lead poisoning coverage -- or its absence -- as a surprise for customers who find that they have lead poisoning. Here's a list (pdf) of which states mandate which treatments.
The result of this is that an Alabama plan can't be sold in, say, Oregon, because the Alabama plan doesn't conform to Oregon's regulations. A lot of liberals want that to change: It makes more sense, they say, for insurance to be regulated by the federal government. That way the product is standard across all the states.
Conservatives want the opposite: They want insurers to be able to cluster in one state, follow that state's regulations and sell the product to everyone in the country. In practice, that means we will have a single national insurance standard. But that standard will be decided by South Dakota. Or, if South Dakota doesn't give the insurers the freedom they want, it'll be decided by Wyoming. Or whoever.
This is exactly what happened in the credit card industry, which is regulated in accordance with conservative wishes. In 1980, Bill Janklow, the governor of South Dakota, made a deal with Citibank: If Citibank would move its credit card business to South Dakota, the governor would literally let Citibank write South Dakota's credit card regulations. You can read Janklow's recollections of the pact here.
Citibank wrote an absurdly pro-credit card law, the legislature passed it, and soon all the credit card companies were heading to South Dakota. And that's exactly what would happen with health-care insurance. The industry would put its money into buying the legislature of a small, conservative, economically depressed state. The deal would be simple: Let us write the regulations and we'll bring thousands of jobs and lots of tax dollars to you. Someone will take it. The result will be an uncommonly tiny legislature in an uncommonly small state that answers to an uncommonly conservative electorate that will decide what insurance will look like for the rest of the nation.
Now on to Akin's heartless remarks. Akin trots out the ol' personal responsibility lines as expected. He then goes on to say that Obamacare allows for a government take-over (another overused lie courtesy of Martin) when in reality it's about evening the playing field for consumers of healthcare against the corporate behemoths of the insurance industry. Nowhere in the Affordable Care Act does it allow for the government to provide the healthcare to citizens, nowhere in the law does it say that the government will take over the healthcare industry and reform it into a socialized model. But Akin takes it even further. If you're a young person - or I'd be willing to bet anyone without healthcare, regardless of age - Akin has a message for you: sell your car and fork over that money to the healthcare industry. Don't have a car? Well I guess you're out of luck.
If this hypothetical 28 year old man does indeed have cancer, the likelihood of the cost of his car being able to cover the treatment is slim to none. Cancer often requires hundreds of thousands of dollars in treatment, so it's likely that this gentleman would be forced to go without. The congressman essentially issues a death sentence if he cannot afford heathcare and/or insurance. Either that or go into extreme, life-time debt to one of the most ruthless industries in America. Akin's tone-deaf answers about access to healthcare in an economy where millions are unemployed and quite likely going without access to insurance or healthcare is astonishing.
Indulge me once more as I ask the congressman why, if government health care is so horrible, why is it that he hasn't decided to pursue his own options, removing himself from the rolls of those enrolled in government provided healthcare, as well as removed the burden of himself and his family from the taxpayers' dime? We're happy to provide our elected officials with the best health insurance and access to healthcare that money can buy, but if it's not good enough for the congressman, I humbly invite himself to alleviate us of the responsibility of providing it for him.
Q: If you wanted to repeal Obamacare, what should happen to a 28 year old male [who] has a decent job, who chooses not to buy insurance and then is diagnosed with cancer?
SS: Well, he's made the choice not, not to cover themselves. Uh, you know, I would hope that someone would take care of 'em. Now, the question is, what is the problem that is facing us in healthcare today? Why didn't he buy that insurance? So you have to go back to the root of the problem. Which is, and, y'know, it's affordability and accessiblity to healthcare insurance. In my view, that's what we need to be addressing as the problem. Y'know, back in 1998 when I ran for state senate, it was a problem then. I went door to door and I heard about this from every business person I talked to: rising costs of health insurance. How do we make insurance more affordable and more accessible to everyone? And I think one of the ways you could do that, and it's a big complex issue, so I'll just throw out the one solution here is to at least have insurance companies be able to sell insurance over state lines, across state lines so you have more competitors and you therefore put more pressure on the price to have lower prices. You know, it's just like car insurance today. You can turn on the tv and you have the GEICO and the Progressive insurance, and you can buy car insurance over the internet. We need more competition. We need to have some ability to uh, uh, put pressure on those prices. So people like this gentleman could get, could purchase and afford health insurance.
Q: Congressman Akin, what should happen to a 28 year old who can afford health insurance, chooses not to buy is and then is diagnosed with cancer?
Akin: You know, I just want to take the thing head on. That's a tough question. And, um, I think that what we have to realize is all of us make decisions in our lives and there are consequences of those decisions. And if we try to separate the consequences from the decisions we make, eventually we end up with a system that's broken and will not work. And I believe that the 28 year old who chose not to insurance is going to have to pay a big chunk of his medical bills. And um, unless you have that kind of discipline in our system, what's going to happen is everybody says, "Well I'm not going to get insurance because everybody's going to cover me." But the bad scenarios that we've seen all through Europe with socialized medicine produces lousy health care. Now, the citizens of Missouri are pretty smart. They voted 71% that they don't want the government running health care in Missouri and I agree with them wholeheartedly and I have absolutely total convinced that the healthcare that the federal government's going to provide will not be anything any of us in this room would want. And, um, I think that the thing you have to do is people have to start being held accountable for their decisions, if somebody's not buying insurance, then they're going to have to be selling their car, or whatever it is to try to help cover that.