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Your Health Idaho: Importance of a state-based marketplace

I will start by quoting words of wisdom from one of America’s great leaders, Ronald Reagan, “Millions of individuals making their own decisions in a marketplace will always allocate resources better than any centralized government.” Your Health Idaho is just the type of marketplace.

I’m a Barry Goldwater/Ronald Reagan Republican who believes in limited government and the free marketplace. I am about to retire from a long and satisfying career as a physician and surgeon. I wish my generation had been able to pass on to the next generation a practice model that incorporated a greater respect for the doctor-patient relationship. Government intrusion has further eroded the doctor-patient relationship.

The practice of medicine is a service business and government-mandated health care systems based on a manufacturing model never work. Look at single-payer systems in England and Canada, where 30-35 percent of health care is transacted in the private sector and where in each country there is a thriving health care insurance market. Not only that, but look at the waiting lines in those two countries to see a primary care doctor or even longer to see a specialist.

However, when Gov. Butch Otter asked, I agreed to serve as a board member for the new Idaho Health Insurance Exchange. And I’ve spent the past few months talking with Idahoans about why Idaho must continue working to build and operate Your Health Idaho, which is our state-run health insurance exchange marketplace.

Believe me. I’ve taken some heat as I’ve talked with folks. I’ve been called a “turncoat conservative” and a lot of other names not suitable for print.

Still, I remain a supporter of an Idaho-based health insurance exchange because it is the one way we as Idahoans can be assured that we can control our own destinies, no matter what happens in Washington D.C. concerning health care policy.

Idaho has little choice. We can operate our own health insurance exchange. Or we can subject our citizens to an exchange run by the federal government. As we are all well aware, the federal government’s solution is not just clumsy, it isn’t functional.

Because Idaho got a late start in establishing our own state exchange, we must work with the federal platform for now – as shaky as it is. Meanwhile, we are building an Idaho Health Exchange platform that will be controlled 100 percent by Idahoans and with a 100-percent guarantee that Idahoans’ private health and financial information will stay secure.

There’s no question that public-private exchange Idaho has today is far preferable to a federal default exchange, which our state would have if the legislature decided to repeal the 2013 health exchange law.

Idaho’s health insurance exchange protects Idahoans’ interests in a number of ways including:

• A lower user fee —1.5 percent versus 3.5 percent on the federal exchange.

• Idaho vendors do the work and can be held accountable if the technology failed to perform.

• A state-run exchange protects Idaho’s insurance brokers and agents and minimizes the use of “navigators.”

• The plans are approved by our own state Department of Insurance.

Personally, I support Gov. Otter’s call for the federal government to grant Idaho at least a one-year delay in imposing the individual mandate for compliance with health insurance coverage requirements in the Affordable Care Act. The federal government has failed to keep its promise to deliver a health insurance website that works.

Ultimately, I’d prefer to see Idaho have a privately operated health insurance exchange. In the short term, however, and given all of the uncertainty ahead with the federal government, Idaho is in a far better position to continue with its own independent, state-run health insurance exchange.

In the spirit of Reagan’s message, I am confident that a health insurance marketplace, built by Idahoans for Idahoans, will serve Idaho well.

By Dr. John Livingston, member of the Your Health Idaho board of directors.


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