Louisiana-Style Health Care

I was working out at the gym and noticed that Bobby Jindal was on Fox News, talking about his opinion article[1] in that bastion of liberal mainstream media, the Wall Street Journal. In his article, he repeats a lot of the misconceptions that are coming out of the right wing and summarizes seven points for which he feels there can be bipartisan support. As a side note, those seven points somehow became the 10-point plan on Fox News [2]. Do those guys even have fact-checkers?

These ideas sound good on the surface, but they leave some unanswered questions.  His points are:

  • Consumer choice guided by transparency. That’s a great concept. The idea is for medical professionals to adopt best-practices – which is in the Democrat’s plan – and to publish pricing and outcome on the Internet. There are a couple of issues. First (and I make this mistake, too), not all people have access to the Internet. More important is the missing element of governance. Would we expect the medical professionals to accurately report on their failures?
  • Aligned customer interests. People should have health savings plans, lower premiums, etc. Well, HSAs – Health Savings Accounts – already exist. We agree on lower premiums, but he fails to mention how that is to be accomplished.
  • Medical lawsuit reform. I agree with this in concept, too. The challenge here is to come up with a mechanism that ensures people maintain their lawful right to seek remuneration for the malfeasance of others while also ensuring that juries do not rule pity awards for issues that are simply bad fortune. Of course, Jindal doesn’t address how to accomplish those goals. That is a difficult problem of governance.
  • Insurance reform. There should be rules for policy portability. I guess there are regulations about insuring across state lines. I would like to know the history of that ruling before I make a final judgment, but my initial reaction is to agree. Jindal states there should be “more coverage” for pre-existing conditions, but apparently doesn’t think it should be eliminated. Eliminating pre-existing conditions is, in my opinion, the number one issue for health insurance reform.
  • Pooling insurance purchases for small business. I completely agree with this. It doesn’t solve the big problems with health insurance, of course.
  • Pay for performance and not care. The ideal that Jindal floats here is that somehow coordinating care of chronic illness and emphasizing prevention is going to take care of something. He doesn’t elaborate on how this reduces cost, or how to construct a policy that governs and monetizes “pay for performance.”
  • Refundable tax credits. This is probably the most ignorant idea of them all. The Republicans have become a one-trick-pony for policy decisions – reducing taxes. The problem is that they apparently haven’t made the connection between taxes, government revenue, budgets and deficits. Since taxes are the revenue stream for government activity, if we reduce taxes, we have to reduce expenses or deficit-spend.

Like the health care “plan” floated by Michael Steele in his fundraising e-mail a few weeks ago, there is nothing of substance in Jindal’s ideas. There is no analysis of the costs, both to the government and the savings supposedly made available to consumers. There is no approach to solve the problems of lower-income Americans. Tax credits and Health Savings Plans aren’t effective for low-income Americans. That’s why they are already uninsured.

It is much easier to criticize than to solve problems. The modern G.O.P has indicated repeatedly that it doesn’t think the government can solve problems, but for some reason, they still want to govern.

Bobby Jindal uses an example that is close to home for him. From Jindal’s article, “For all of us who have seen the Federal Emergency Management Agency’s response to hurricanes, this contention [that government involvement won’t diminish quality] is laughable on its face.”  He seems to have forgotten recent history. FEMA responses to natural disasters under the Clinton Administration and past Republican administrations were very effective. The failure under the Bush Administration was due, in part, to the belief by the Republicans that governance isn’t part of the role of government. If we elect people who don’t want to govern, government will most certainly fail.

I will state it again. The Republicans are not interesting in solving difficult problems. They simply aren’t serious about effective policy or governance.


[1] http://online.wsj.com/article/SB10001424052970203946904574300482236378974.html

[2] http://www.foxnews.com/search-results/m/26748731/10-point-plan.htm


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