Another Silver Bullet . . .

Republicans believe creating a national market for health insurance is one surefire way to lower costs.  What this means is that people in highly regulated states with lots of coverage mandates (Massachusetts, e.g.) could buy policies issued in states with few mandates (North Dakota? Wyoming? ) per the New  York Times blog link above.  So states that insist that we buy coverage for in vitro fertilization or obstetrical care would presumably see their local insurers lose marketshare as consumer flee to less regulated carriers and products…  What’s wrong with this picture?

Lots. Providers have been gearing up to defend their pricing for years. Massachusetts Blue Cross has pricing power with its local hospitals and doctors precisely because of its high marketshare.  What’s going to happen when the (fictional) Medical Mutual of North Dakota sits down with the Massachusetts General Hospital or their cardiologists to negotiate rates for their “less regulated” product?  MMND is going to end up paying the rack rate (e.g. billed charges), wiping out any savings from a slimmer benefit package and have a long, chilly airplane ride back to Fargo.

It’s amazing to me how many of my Republican friends cling to simplistic 1980’s high concept “silver bullet” ideas for addressing massive systemic failings.