By Sen. Shawn Mitchell
I see just a few problems with Senate Bill 200 to create a Colorado health insurance exchange: the policy, the drafting, and the politics. Otherwise, it’s a great idea.
Proponents argue exchanges will create an insurance marketplace where insurers and consumers can interact in an open and competitive market with convenient comparisons and easy shopping. Most activists for limited government and health care freedom see a different picture: Lucy holding the football and beckoning gullible Charlie Brown for one more kick. There are good reasons for such wholesome pessimism.
Liberty activists start with the observation America lacks a free market in health care or anything close. Government has long been a major player in controlling, funding, regulating and delivering health care and insurance. Conservatives believe most the problems cited by critics of the “free market” are actually distortions introduced by government, either as original well-intentioned policies, or by ripple effects and new layers of regulation aimed at solving unintended consequences of earlier layers. Add inevitable rent-seeking (legislating for privilege and profit) by powerful interests in a complex industry, and our current ills are the foreseeable result.
Opponents fear that exchanges are just the next layer: a government solution to government problems. But it’s worse than déjà vu. Exchanges are likely to exacerbate the problem of political distortion. They concentrate heath care issues into a perfect little shooting gallery that will prove irresistible to politicians, bureaucrats and rent-seekers. The same crew that has brought us to our current woe now wants to create its own reality video game of health insurance. Government will build the stage so citizens can pursue happiness and health care.
Forgive my doubt. It’s kind of like the feeling of gun owners who oppose the government keeping them all on a list, or maybe Soviet era Jews being wary of going to government sponsored “sanctuaries” to protect them from “hostile factions.” I made that one up, but you get the point.
Here’s a better idea. Why doesn’t government pare back the distortions it inflicts in the real world, instead of trying to create a new and better playing field in a legislated world? Free choice in goods and services spontaneously creates some amazing “exchanges,” efficiencies, innovations and advances.
Which brings us to the drafting of SB 200. Advocates argue there are good and bad exchange designs. Some are too government-heavy and smack of single payer, while others are “free market” and supported by the “business community.” But SB 200 is very slight on substance and detail. It sets up a commission to design the exchange. Lobbyists at the capitol proudly announce the commission’s makeup is “business friendly.” Well, that’s not Rock of Gibraltar inspiring. Pharma and Big Insurance were right at the table passing Obama’s health care bill too, cutting deals and slicing pie. Now they’re reportedly quietly opposing repeal or roll-back, because the bill brings them big new controlled markets. Sometimes business has different priorities from defenders of freedom.
Further, there’s no escaping that exchanges are a cog in the machinery of Obamacare. States are mandated to make their own or be defaulted into the federal exchange. Proponents argue this proves we should pass SB 200 and establish a Colorado exchange rather than be governed by bureaucrats from Washington. But opponents see that acting now is submitting to the policies and the premises of Obamacare. If it’s established—and accepted—that Washington has the power and authority to control national health care and mandate the purchase of insurance, there will be no stopping the grab. To repeat, the same Congress, bureaucracies and rent-seeking interests that lurk in the real world will soon continue open season on the revenues, deal-making and headline opportunities that flow through exchanges.
That makes this a critical moment to push back. And Americans are, with substantial success. Referring to the politics of exchanges, I meant the effect on political outcomes. It’s not about posturing, but about helping to shape policy in Congress and perceptions in the courts.
One of the driving forces behind the turnover of Congress last election was public disgust at the naked power grab and bare fisted politics that punched Obamacare across the finish line. The fight is on to repeal or defund the federal bill, or to lay the groundwork for future elections over that issue. Twenty-six states have joined a lawsuit to seeking to overturn the federal abuse. Courts across the land are grappling with the weighty issues. Contrary to smug predictions, several have struck the law down in serious, thoughtful opinions. Now is not the time for citizens and states to salute and fall in line. While Congress struggles, as the Supreme Court weighs, political currents shape reality and make a difference.
As an individual and as a Coloradan, I want to be part of a vibrant spirit of reform and resistance in perhaps the most important public policy battle of our lifetime. SB 200 is a step toward surrender.
Sen. Shawn Mitchell is a lawyer and a Republican lawmaker from Broomfield.