As I was reviewing recently introduced legislation, I was reminded of conversations that I previously had with two deceased State Senators with whom I had the pleasure of serving. Sen. Jens Tennefos often wore a lapel pin with a frog character. I asked him why he was wearing the “frog pin”. He stated that if you put a frog in a pan of water on a stove, the frog is very comfortable. If you slowly turn on the burner, the frog gets used to the warmer water until it doesn’t realize it and the frog is cooked. He likened that to the incremental changes that happen when people become more and more dependent upon the government.
On a different occasion, I was enjoying a conversation with Sen. Ken Solberg. He was lamenting about the new federal program called Health Steps, North Dakota’s version of the Federal’s State Children’s Health Insurance Program (SCHIP). Sen. Solberg was troubled how the Federal government keeps expanding their involvement in health care. He described how the Government had established Medicare to administer health care for the elderly, Medicaid for the poor, and now is getting involved in health care for the kids. He predicted that the Federal government would continue this “incrementalism” until the government controls all health care.
Now with the advent of the Affordable Care Act, the government added “Expanded Medicaid” which added an additional population into government health care. In addition, the federal government has mandated what every health insurance plan must provide in regards to benefits. People’s choices were severely restricted. With these newly mandated benefit additions and other insurance changes, premiums increased significantly.
To assist people, subsidies were established, thus making even more people dependent upon the government for their health care. Now the Supreme Court is looking at the issue to determine if people in states (like ND) that are on the Federal Exchange are actually eligible for these subsidies. The ACA had stated that subsidies are available to residents on “State-Based Exchanges”.
Let’s look at the provider side.
One of the biggest health care payers is the federal and state governments. We often hear from medical providers that Medicare and Medicaid do not pay enough to cover their costs, thus resulting in a cost shift to the private payer or private insurance.
Even though they complain, they have grown dependent upon the government payments. Even though the American Medical Association (AMA) complains that Medicare does not pay enough for government health care, they took a very public stance in support of the Affordable Care Act which in effect resulted in the further expansion of government health care through its Expanded Medicaid, changes to Medicare Part D, and government subsidies in the private market.
The government involvement into health care has continued to become insidious in our state as well. Medical education has become so expensive that communities have had to resort to several incentive programs to lure medical providers to practice in their communities.
State funded or backed loan repayment programs for doctors, dentists, and other health professionals have become the norm.
I am not saying that these loan repayment programs are bad, but rather how dependent the health care industry has become on the government. Reviewed separately, all of the programs that I
identified probably have merit. With the expansion of government health care and as you look at how the government involvement into our health care system has evolved over the years, I am reminded of Sen. Solberg and Sen. Tennefos with his frog story.
Do you feel the heat yet?