Monday, September 21, 2009

Buying Health Insurance? Only If He Likes It


by Rowan Scarborough

The House Democrats' huge health care bill bestows immense powers on one Washington bureaucrat who it authorizes to regulate every step of insurance buying and to collect any data on the American people the czar deems necessary to do the job.

The position is called the Health Choices Commissioner. The post will be filled by the president and confirmed by the Senate to oversee a brand new government agency whose health industry powers seem boundless under the bill. This person, and this person alone, will decide whether a health coverage plan is acceptable to Washington or not.

"He will rigidly and vigorously defined the choices that are available to you," said Robert E. Moffit, a health policy analyst at the Heritage Foundation.

It is a massive shift in state's rights, moving decisions made by legislatures, governors and local insurance commissioners from the people to one desk in Washington.

"The big story in the House bill is that what you're looking at is a massive transfer of regulatory authority from the states to the federal government over health insurance," Moffit said. "This basically will undermine state independence, innovation in the provision of health insurance, the writing of health insurance and regulation. States vary from state to state on the kind of rules governing health insurance. What this does, it federalizes the entire process."

The choices commissioner will create a single, national insurance exchange -- a place to shop for private insurance or the federal government option favored by liberals -- and decide which companies can participate.

Because of the way the bill is written, almost certainly all private insurers will want to join the exchange and compete with the feds. Regardless of whether a company joins, the commissioner will rule on the acceptability of its plan, too. And by 2013, all individuals seeking insurance must apply through the exchange.

The commissioner will create the standards for all plans, meaning an insurer must meet his dictates on benefits or get out of the business. He can decide where companies can put their profits and tell them how to write brochures and other marketing tools.

The bill's section on Medicaid, a health care program for the poor, reads, "The commissioner shall establish effective methods for communicating in plain language and a culturally and linguistically appropriate manner."

In other words, languages other than English.

The commissioner also has free rein to audit any health plan and charge the company for costs. Moreover, Democrats have given the commissioner control over provider networks, meaning in theory he can decree the number of doctors or nurses or beds in a particular region.

"By concentrating so much authority into this one agency governed by a health choice commissioner and allowing the commissioner to have such vast discretion over what qualifies as health insurance, you're vesting an unelected bureaucracy with a tremendous amount of power," said Greg Conko, a senior fellow at the Competitive Enterprise Institute. "Certainly unprecedented. And then he has the authority to punish plans for breaching what he decides is the right way to provide insurance."

Perhaps the most disturbing power is an blank check to collect data -- a power that in the past has rankled liberals and the mainstream press. But in this case, with a Democrat bill backed by liberals, the prospect of unchecked "data mining" has stirred no leftist protest.

Under section 142, which details the commissioner's authority, the bill states:

"The Commissioner shall collect data for purposes of carrying out the Commissioner’s duties, including for purposes of promoting quality and value, protecting consumers, and addressing disparities in health and health care and may share such data with the Secretary of Health and Human Services."

That's it. No qualifiers. No limits. Analysts told HUMAN EVENTS under such broad language the commissioner's bureaucrats can obtained people's tax records, credit reports, employment history. They could argue the data is needed to understand the region's demographics, patient requirements and income trends.

Another section specifically gives the commissioner authority to read tax returns.

"It gives him basically a blank check to go after all kinds of stuff," Moffit told HUMAN EVENTS. "Whatever he decides he needs. It's at his discretion. One of the things that is outstanding about the health choices commissioner is that as a public official he has enormous discretion in the exercise of his duties. Certainly I've never seen anything like this in my experience."

Then there is the section letting the commissioner oversee private insurance company finances.

"It's basically saying how much you can spend on benefits and how much you can retain for administrative costs or profits," Moffit said. "The health choices commissioner is an enforcer."

To Moffit and other conservatives, the ultimate purpose of the national health exchange is to put private insurers out of business. Afterall, when one government bureaucrat, the commissioner, is writing the rules for everyone, who is he going to favor: private industry or the government?

Afterall, one section allows the commissioner to automatically enroll individuals in a health care plan. "Such process may involve a random assignment," the bill says. To conservatives, "random" means the commissioner will shoe-horn them into the federal government plan.

Mr. Scarborough is a national security writer who has written books on Donald Rumsfeld and the CIA, including the New York Times bestseller Rumsfeld's War.

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