On August 31, 2010 our Minnesota Governor, Tim Pawlenty signed Health Care Executive Order 10-12; Directing State Departments and Agencies Regarding Discretionary participation in the Federal Health Care Law. This was our governor’s attempt to essentially tell the Patient Protection and Affordable Care Act to take a hike.
Now, our governor is probably running for President and he’s made his views very clear concerning any government involvement in health care- and anything else for that matter. This Executive Order was a political statement more than anything else. You can’t object to legally directing those in our government to use some discretion in requesting and using federal funds- if we don’t need it, don’t take it. That’s not the way government works. The only way to filter spending is to hold someone accountable- Pawlenty is assuming that role and I can’t object to that.
It’s the way he did it that bothers me. Instead of a directive focusing on federal and state fiscal responsibility- he used it as a political statement. Here’s a “fact-check” of the reasons supporting his Executive Order:
1. PPACA was signed on March 23, 2010:
True
2. PPACA is a dramatic attempt to assert federal command and control over this country’s health care system and reduces individual freedom for health care decisions.
PPACA establishes the framework at the federal level, and allows the states to implement as they see fit. Pawlenty is free to participate or not. However, the reason the government set some framework is because the private sector could not or would not do it on its own. Somebody needs to take control of health care spending before it breaks the bank.
3. PPACA is unprecedented federal intrusion into the individual liberty including the mandate to purchase health insurance.
This one would be easy to fix- have the health insurance companies eliminate pre-existing conditions for those who can’t receive coverage today and not require everyone to participate. They won’t do it- and we can’t have it both ways.
4. PPACA is funded by taxes and fees coupled with unrealistic assumptions purported for future cost savings.
This is true, to an extent. The only reason the cost assumptions are "unrealistic" to some is because nobody is willing to give. Hospitals, health plans, consumers, and employers will need to realize the old way is not sustainable. The days of $0 co pays are over, fee schedules will be determined by value, and the technology will be dispersed efficiently instead of on every street corner. If everyone embraces the broader need and sucks it up a little the assumptions may not be all that far off.
5. PPACA increases federal spending at a time when the government debt threatens private sector economic growth.
Yes it does- but if we don’t do something, the unfunded liability of our health care debt could bring our entire economic picture down in the not so distant future. Just advocating for more HSAs, competition across state lines, and malpractice reform is not going to cut it. The problems we have created are much deeper.
6. PPACA includes many demonstration projects intended to speed the transition to federally-controlled health care.
This is just silly. The intent of all of this is to organize care better than it is organized today. Once again, if the private market wanted to do it- it should have by now.
Pawlenty’s Executive order would have been much more palatable if he had just stated that since health care represents over 1/6 of our national economy- and since fiscal responsibility is of paramount importance- all requests for funds will need to be directed and approved by his office.
But, he’s running for President, so I guess he felt he needed to create a buzz. That’s the way we do it nowadays.
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