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Why Republican Governors Should Oppose State Exchanges


ObamaCare needs to go, and FreedomWorks has a Five Point Plan for Full Repeal. One of best ways states can stop ObamaCare's unprecedented intrusion into the lives and pockets of their citizens is to block the creation of health care exchanges.

An exchange is a government-run “marketplace” for obtaining health insurance. The new system can't operate in those states that don't set up an exchange. (This is true even if the federal government comes in and sets up an exchange because the state failed or declined to do so.) We must fight to stop the exchange in every state where one doesn't yet exist, and dismantle the exchange in any state that has one or is trying to create one. 

In order to encourage governors to block exchanges in their states, FreedomWorks drafted a memo explaining the drawbacks of exchanges, and why its best for states to not allow ObamaCare to take over. You can download and read a copy of that memo here

Katherin Kirkpatrick

INSURANCE IS NOT THE ISSUE: Fighting over who pays for insurance detracts from the real issue, that we're not getting meaningful medical service in return for our premiums. PREVENTION IS NOT THE ISSUE: Obamacare's audacious claim that it'll pay for itself with what we'll save in prevention is patently false. People can already prevent the preventable on their own without doctor help. Medicine is for things that CAN'T be prevented: genetic disorders, congenital heart defects, accidental injuries. These things are becoming MORE prevalent, NOT LESS, because we live long enough to get them (instead of dying young and quickly) thanks to clean water, reliable crops, vaccinations, and other widely available modern conveniences. Now that we survive disabilities instead of dying from them, we remain patients for longer. That costs money. And that money is wasted when medical schools churn out practitioners incapable of (even indignant toward) treating chronic and incurable illness because they've been indoctrinated, and spoiled, into thinking they can coast by on questionnaires and preventive lectures rather than help people with challenging chronic medical conditions find answers. MEDICAL SCHOOL: I agree with the commenter who spoke of his father's training as a PA. Reform must begin with medical school. Reduce our dependence on costly "elite" education that doesn't produce better-educated practitioners, just more-indebted businesspeople, who must then build their practice around marketing strategies instead of patient service. Communities are crying out for PAs and NPs; and capable, intelligent applicants are lining up for training; but universities can't fill the demand and community colleges aren't allowed to offer comparable graduate-level training, even though they already are in many cases (because local employers require it even of associate degree holders), and more cheaply. Why require them by law to call it undergrad (200-level) curriculum when they actually cover much of the same graduate-level material that universities do? And, given the chance, they could do more. Universities have become bloated, entitled parasites; whereas community colleges are directly answerable to local taxpayers and employers. If they can provide local employees with quality four-year and graduate medical training, let them!!! ELIMINATE PREPAYS: When practitioners are paid up-front before service is rendered, it makes simple economic sense for them to deliver less service in return. Why spend hours researching and managing a challenging health problem when you've already been paid for 20 minutes, and can spend that playing with your computer while the patient fills out useless questionnaires that will never be read, then deliver a perfunctory lecture on saturated fat avoidance, then skip onto the next PREPAID patient without breaking a sweat? (Not that all do this, and bless those who don't; but insurance pays them no more than those who shirk, and that is driving the conscientious out of business.) Can you imagine paying your auto mechanic in advance to deliver a lecture about safe driving then sending you on your way without lifting the hood? Give patients and their insurers better power to refuse payment unless meaningful service is delivered, and to pay fairly when meaningful service IS delivered. PHARMA REFORM: Bring back generic drugs. Push the "reset" button on the sweetheart Obamacare deal that now shields pharmaceutical companies from generic competition. The common and safe generic migraine drug Midrin is already gone, and more will follow. Stop rewarding a system that pulls effective compounds off the market just as they're getting cheap and re-invents them as "new" (and more expensive) by tucking some extra chlorine atom into an unused corner of the same molecule. End regulations that stop compounding pharmacies from making established-safe drugs more cheaply. AND OF COURSE INSURANCE REFORM: It goes without saying we must disconnect insurance from employment, allow people to purchase across state lines, allow preexisting pools, the whole deal. But unless we reform the actual PRACTICE of medicine first, we're just arguing about who pays for the invisible cloth.