Government health exchanges: What’s the rush?

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Bluegrass Beacon column by Jim Waters

Despite Kentuckians’ great consternation over the current administration’s determined efforts to push states down the treacherous path of an all-out paternalistic nightmare, Gov. Steve Beshear already has accepted $67 million – more than any other state except New York – to establish a government-run healthcare exchange.
The rotten fruit of this bureaucratic disaster soon will be in full bloom on a website where people without health insurance can shop for coverage.
Just like Obamacare, officially misnamed the Patient Protection and Affordable Care Act, forces individuals to obtain health insurance, the feds give states no option when it comes to establishing exchanges – though D.C. bureaucrats have offered to move in to any delinquent state and run the exchanges however they see fit.
How gracious of our federal masters.
Unlike most of his fellow governors, Beshear, who has become Obama’s lapdog in Kentucky, was not about to wait and carefully consider the best response to such a trampling of the states’ Tenth Amendment rights. Heck, he didn’t even exercise his option to compel the federal government to step in, run the program and shoulder any additional costs. 
After all, it’s not as if the states can actually offer plans with any sort of flexibility. Setting up their own exchanges would merely force the states to shoulder the blame for unhappy participants.
The new healthcare exchanges are about as flexible as mannequins modeling the newest, flash-in-the-pan fashion trend. Not only must the exchanges offer services the federal government deems essential – and which will drive health care costs even higher, especially for healthy, responsible Kentuckians – but they also are forced to adhere to a “benchmark” plan.
Insurers wanting to participate in the exchange must provide at least as much coverage as the “benchmark.” This, of course, removes all ability of plans to offer less coverage for healthier patients or to charge higher costs for those who require more care and, as a result, use more of the system.
This approach sounds good to unsuspecting citizens. But it doesn’t work.
When Kentucky Kare passed in 1994, Kentuckians were promised lower prices and increased care (sound familiar?), yet insurers left the commonwealth in droves rather than “participate” in a government-run health care system that dictated coverage and costs.
The difference with Obamacare is: There’s no shaking off its shackles – either for insurers or individuals – short of leaving the country altogether.
Speaking of learning lessons from the past, even Beshear’s fellow Democratic and state Auditor Adam Edelen is rightly concerned about the governor’s pace of implementing such a huge bureaucracy – especially in light of the administration’s recent policy failures.
“My big concern right now about the health exchange is whether or not we have the time to implement it in the most effective manner,” an uneasy Edelen told “Pure Politics” host Ryan Alessi. “We all know what happened when we rushed to implement the managed care system in Kentucky. There were a myriad of mistakes.”
Disastrous implementation of the managed care system last fall, which is meant to replace a fee-for-services approach to health care, was so poorly done by Beshear’s big-government team that patients were denied treatment while providers didn’t get paid, threatening the very existence of some physicians’ practices.
Edelen has pledged his office to serve as a “vigilant watchdog making sure that we take the exact amount of time so that when we introduce the health exchange, that we get it right.”
History has yet to reveal government intrusion into America’s health care system getting it right. But at least Edelen recognizes the dangers inherent in implementing such a huge bureaucracy.
It’s a start.
Jim Waters is acting president of the Bluegrass Institute. Reach him at jwaters@freedomkentucky.com.