Good Government

Patrick B. McGuigan | September 1, 2009

A New Oklahoma Standard

Patrick B. McGuigan

With her usual classy style and gift for brevity, Peggy Noonan -- who has actually been quite generous toward President Obama -- captured in an August 14 essay the shocking collapse of prospects for enactment of "ObamaCare" and the former Illinois senator's summer from hell:

"The Obama White House has done the near impossible: It has united the Republican Party. Social conservatives, economic conservatives, libertarians-they're all against the health-care schemes as presented so far. They're shoulder-to-shoulder at the barricade again." Suddenly, she wrote, Obama is "reminiscent of Jimmy Carter, who was brilliant at becoming president but not being president."

After courting the health care industry in his early weeks in office, and in campaign promises that he opposed a single-payer system, Obama allowed allies like House Speaker Nancy Pelosi to characterize insurance companies as "the villains." She's describing key players in a system where 83 percent of Americans do have health insurance, and the vast majority of those are satisfied with their plans. To say that there will be some "legacy costs" from Pelosi's demagoguery is an understatement. Even if the president rallies to pass his package, Noonan wrote in a later column, he has lost the opportunity to forge a broadly supported reform bill, and has reinforced the hyper-divisive brand of politics he so often denounced in last year's campaign.

Here in Oklahoma, pollster Pat McFerron found the summer brought a 25-point shift against Obama himself, and nearly 3 to 1 opposition to his health care proposals.

As for Oklahoma's elected Democrats, it's clear those closest to the state's political mainstream are looking for alternatives to what has become known as ObamaCare. Governor Brad Henry wants to expand "Insure Oklahoma," a comparatively moderate-but still statist-oriented-bipartisan plan aimed at small businesses and workers of modest means.

It is financed by the state (60 percent), employers (25 percent), and employees (15 percent). The plan has grown by leaps and bounds and will apparently run out of available tobacco settlement-linked money by year's end.

Insurance Commissioner Kim Holland, a Democrat like Henry, says of the approach advocated by national Democrats, "a public plan would not be helpful in Oklahoma. But, we don't know which direction the federal government will ultimately take. It could be an opportunity for states to develop public plans, and if that's the case, I could be in support of that, and it would be up to Oklahoma to decide whether that's what we need."

The common sense of the Oklahoma mainstream has been a wonder to behold. As screaming matches unfolded at town hall meetings across the nation, exchanges here were lively and robust, but rarely rude. Obama and his allies, press reports indicate, have outspent, by a margin of at least 3 to 1, critics of his plans.

To be sure, the opposition of strong conservatives has been no surprise. The shocker has been that with all the pro-Obama spending advantages and nearly nonstop advocacy by most of the national news media, the wheels came off as Blue Dog Democrats (fellows like U.S. Rep. Dan Boren) and moderate Republicans broke decisively against Obama's proposals.

In terms of national policy, the new circumstance may create an opening for the ideas of a man like U.S. Sen. Tom Coburn to take hold. Coburn has advanced ideas to provide meaningful tax deductions for individuals (and subsidies for poorer workers) to access insurance coverage, in cost-sensitive ways that would lead consumers "to shop for health care" as they do other goods and services.

Coburn is an interesting guy, who has forthrightly opposed Obama's plans while encouraging fellow conservatives to debate issues and not to assail the president. His personal relationship with the president might provide a path to a market-oriented compromise, but don't hold your breath on that.

As for what all this means for Oklahoma, it's normally a bad habit to quote yourself, but here's an observation offered in these pages nearly two years ago: "Conservative governance is possible, but it requires the practice of conservatism. Establishing or sustaining conservative governance requires voters and legislators who will elect and then support conservative executives. Limited government is possible, but only if professed conservatives limit government power, and support those who actually govern in ways that restrain the power of government agencies."

Anyone seeking an alternative to socialized medicine must be tempered and realistic. The late Edward L. Gaylord once scolded me, circa 1993, as I waxed indignant about the "socialized medicine" in Hillary Clinton's health care proposals. As he said, "Pat, we already have socialized medicine in America. The question is whether or not we can build into the system some market incentives to correct the excesses of government control."

Our state government inevitably will be involved in finding ways to reduce the number of uninsured Oklahomans. But just for discussion: Instead of growing government, how about greater efforts to provide vouchers or credits allowing individuals to choose for themselves high-deductible policies, or basic-care policies like those in Tennessee?

As an alternative to Insure Oklahoma, even as improvements are studied for that program, why not create voucherized access to private health insurance policies for the working poor, as advocated in the late 1990s by then-Labor Commissioner Brenda Reneau?

Let's pay for that by ending the use of literally millions of dollars in resources to hector smokers and demonize tobacco companies in advertising financed by tobacco settlement money. Instead, use that money to allow individuals to use tobacco settlement money to buy high-deductible private sector insurance for themselves-without involving either employers or the government.

There's more: In the late 1960s, only a handful of health insurance mandates existed. By 2007, in the U.S. there were 1,961 laws mandating that insurers cover specific providers, procedures, or benefits. These laws are often billed as pro-consumer, but they are mostly pro-producer, adding to the cost of health insurance and health care by requiring insurers to cover services. Higher insurance premiums due to state-mandated benefits are responsible for about 25 percent of the number of uninsured, according to private-sector studies.

Mandates increase insurance premiums and increase the number of uninsured people. Mandated benefits disproportionately affect those who are self-employed, unemployed, or work for companies too small to afford insurance benefits for employees. Let's allow workers to use vouchers to access for themselves mandate-free, high-deductible private-sector insurance.

In the course of human events, sometimes stress or crisis forces emergence of new and unexpected leadership, women or men who unfurl a banner of common sense and clarity. In an August 11 essay in The Wall Street Journal, John Mackey, owner of Whole Foods Market, Inc., said that current projected deficits, even before consideration of ObamaCare, "are simply not sustainable. They are either going to result in unprecedented new taxes and inflation, or they will bankrupt us."

As an alternative future, he made the case for health care reform that would bring "less government control and more individual empowerment." He suggested high-deductible plans, health savings accounts, equalization of tax treatment of business-provided and privately purchased insurance, repeal of anti-competitive laws to make insurance coverage fully portable across state lines, repeal of insurance mandates, tort reform, cost transparency (so that even those with good plans know what coverage is actually costing), and Medicare reform.

And, here's a concept: "Make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance."

Nationally, Mackey's reward for his brave pro-health and pro-liberty commentary is that his Whole Foods business is being targeted by ACORN-style operatives for a boycott. In Oklahoma, let's reward the fellow by modeling the next round of state health insurance reforms around the proposals he made in his essay. Freedom works. Let's prove it.

In the end, as the incomparable Margaret Thatcher observed, "The problem with socialism is that eventually you run out of other people's money."

Oklahoma does not have enough money to waste any more resources. Let's establish a new Oklahoma standard: liberty, justice, and access to affordable market-based health care for all.

Patrick McGuigan (M.A. in history, Oklahoma State University) is an editor at The City Sentinel, a weekly newspaper in Oklahoma City. He is the author of two books and the editor of seven.

Patrick B. McGuigan

Independent Journalist

A member of the Oklahoma Journalism Hall of Fame, Patrick B. McGuigan is founder of CapitolBeatOK, an online news service, and editor of The City Sentinel, an independent newspaper. He is the author of three books and editor of seven, and has written extensively on education and other public policy issues.

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