Obama defends regulation at the health-care summit
One of the chief substantive disputes of the White House’s health-care summit concerned, not surprisingly, regulation -- whether the federal government should set minimum standards for the policies that would be available on health exchanges. Republicans, in their more rhetorical moments, argued that this constituted yet another case of the federal government coming between patients and their doctors -- as if the insurance companies this provision is designed to regulate didn’t already do that, as if the effect of this provision wouldn’t be to make the insurance company’s limitation on doctor-patient relationships less onerous.
In their more substantive moments, Republicans such as Virginia’s Eric Cantor complained that this is something that should be left to the states rather than to Washington. In effect, though, this is to subject life-and-death decisions to the accident of geography. The crazy-quilt nature of American health coverage has been well illustrated in the past two weeks by the stories emerging about increases in people’s insurance premiums, including increases of up to 39 percent from the largest individual-policy vendor in California and more than 50 percent from a company in Michigan. One hitherto obscure fact that emerged from these tales is that in 25 states, the state insurance commissioner has the power to roll back excessive rate hikes, and in the other 25 states, he or she has no such power. Clearly, if health-care spending is to be brought under some control, and if the ability to obtain health care is ever to become an American right, a federal standard is needed.
All the more so since members of both parties support changes in the law that would allow health insurers to sell their policies in more than one state. Absent minimum national standards, companies based in states with little or no standards could market skimpy policies to the young, forcing older and sicker Americans to purchase much more costly policies with high deductibles and the like. We’ve seen a version of this in the credit card market, when companies incorporate in states with no serious regulations, such as South Dakota, and then market their cards, with ruinous fees and interest rates, across the nation. Why Republicans think the credit card industry provides a viable model for a nationwide health insurance industry is a good question.
President Obama didn’t use the credit card analogy, but he did recall having a car-insurance policy when he was a community organizer in Chicago that clearly wasn’t designed to pay for damages incurred in accidents where there was no bodily harm. He mentioned that drugs would be cheaper if we didn’t have a federal agency testing them to see if they worked and if they were safe. Same with the price of food and food safety standards. In short, he defended the idea of regulation, which the Republican Party, currently in its most libertarian phase ever, seems to dismiss, except when they’re reminded that, in fact, they support safety standards, too. (If government has no role in assuring such standards, why were Republicans asking questions of Toyota’s executives in yesterday’s hearings?)
Does the fact that the government sets standards for drug, food and auto safety mean that the government has taken over pharma, agribusiness and the auto industry? Of course not. And does government setting standards for insurance policies mean it has taken over health care in America? Contrary to Republican talking points, it surely does not.
| February 25, 2010; 4:55 PM ET
Categories: Meyerson | Tags: Harold Meyerson
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