Tag Archives: Health Care Exchanges

Our Political Charade

I’ve reluctantly concluded that self-government doesn’t work. Voters respond to vacuous platitudes and bumper-sticker slogans, and candidates are perfectly willing to pander to their uninformed biases while evading the complexities of policy.

Case in point, an egregious but certainly not the only available example: Mike Pence.

Yesterday, in the “candidate conversation” hosted by the Public Policy Institute at IUPUI, Pence said he wants Indiana to have more control over how federal dollars are spent in the state. His campaign literature features a promise to create a new state agency to “reject” federal regulations, and (an unrealistic and ridiculous) promise to return federal dollars to Washington.

A couple of days ago, he declared he would not create a state- based health insurance exchange.  (The Affordable Care Act authorizes states to set up these new, competitive marketplaces to allow individuals and small businesses to choose among an array of affordable, comprehensive health insurance plans.) The ACA provides for these exchanges to be established at the state level, but if a state refuses to do so, authorizes the U.S. Department of Health and Human Services to come into the state to establish that state’s exchange.

It is obviously in Indiana’s best interests to control our own Exchange. The ACA gives states considerable flexibility to tailor these mechanisms to the needs of the people living in that state, and a locally-run Exchange is likely to be more responsive to the concerns of our elected officials and the professionals and nonprofits who serve the constituency using the Exchange. Refusing to allow the state to create an Exchange doesn’t keep the dreaded “Obamacare” from being implemented; it simply assures that it will be controlled by Washington–something Pence claims he opposes.

This pastiche of inconsistent positions makes no sense as policy. But that really isn’t the point–at least, it isn’t the point for Pence. The point is to tell voters what they want to hear–that they can get services without paying for them, that (despite substantial evidence to the contrary) further reducing taxes will create jobs, that a program to increase access to healthcare is an assault on their freedom (Pence’s website really does say that), that Indiana should control its own destiny –except where we refuse to do so and thereby hand control over to the federal government. It’s all ludicrous and incoherent, and it has kept Pence ahead in the polls.

It’s been said that we get the government we deserve.

That’s the problem.