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Sometimes, in some weird markets, too much consumer choice can be a bad thing.

Unfortunately for Republicans, health insurance happens to be one of those weird markets.

Republicans believe the problem with the health-care system is that Americans are forced to buy too much insurance, in plans that are too prescribed. Their solution is to give consumers more choices for what kinds of plans (including no plan at all) they can buy.

The Consumer Freedom Option, recently proposed by Sen. Ted Cruz (R-Tex.), is emblematic of this: It wouldallow insurers to sell plans that dont comply with Obamacare regulations (such as protections for preexisting conditions), so long as they also sell at least one plan that does.

Were guaranteeing them exactly what they have now but giving them more options, Sen. Mike Lee (R-Utah)saidSunday. Options that would inevitably unleash free-market forces, that would in turn bring down the price of health care.

(Jenny Starrs/The Washington Post)

And who doesnt like options?

Choice is as American as apple pie, a core perk of living in a capitalist society. We arefree to choosewhatever car or yogurt we want, from an enormous menu of colors, features, flavors and prices, and economists (generally) believe were happier for it.

But the health insurance market has some distinctive properties that mean too many choices can lead the whole market to unravel.This would leave nearly everyone consumers, insurers and health-care providers much worse off.

Why? The answer is somewhat counterintuitive. So counterintuitive, in fact, that the economists who figured it outwon Nobel Prizesfor the insight. Lets take it step by step.

At its core, offering greater choice in health plans means eliminating both standardization and basic quality minimums.

Eliminating standardization for example, Obamacares rules forwhat benefits are covered, coverage tiers and out-of-pocket maximums would make it much harder for consumers to comparison-shop.

Shopping for health insurance isalreadysuper-complicated and timeconsuming, and lots of people makeobjectively bad choices. You have to comb through fine print and in-network doctor lists. You have to sort out which deductibles and premiums match your familys likely needs and risk tolerance. Imagine how much more complicated this would become if insurers could offer many more plan configurations with more hidden exceptions and fewer quality controls.

Maybe one plan covers breast cancer but not throat cancer. Another covers statins, but only if youve never been diagnosed with heart disease, or maybe just one months supply. With so many variables, and so much opportunity for obfuscation, apples-to-apples comparisons become impossible.

Consumers might also end up buying mini-med insurance that turns out to cover virtually nothing. This happened a lot pre-Obamacare.

Theres a larger problem than consumer confusion, though. Its that the entire individual market would fall apart under Cruzs plan because of adverse selection the idea that people with higher health costs will self-select into more generous coverage.

The cost to a supermarket of selling you a yogurt is basically the same as the cost of selling me a yogurt. Thats not true for health insurance, where I might turn out to be a much more expensive customer than you are.

In a world where patients know more about their health status (e.g., a bum knee) or future health spending (e.g., pregnancy, long-delayed surgery) than insurers do, insurers try to attract only the cheapest, healthiest enrollees by offering the cheapest, stingiest plans. Cruz would eliminate quality minimums, remember.

When consumers have a choice of many plans, and insurers can tweak those plans to attract the healthiest patients, you get a death spiral.

In Cruzs health insurance market, sick people would end up in the relatively generous, Obamacare-compliant plans, which couldnt turn away patients and healthy people would get siphoned off into the mini-med plans, which could. Or these healthy people would drop their insurance altogether, since there would no longer be a mandate.

With only sick people in the Obamacare-compliant plans, the plans would become very expensive, causing slightly less sick people to drop out, causing the pool to get even sicker (and costlier), causing even more people to drop out. And so on.

Cruz says the government would kick in money to subsidize coverage in these plans, but weve already seen how limited Republicans appetite is for adequately funding high-risk pools (which Obamacare-compliant plans would essentially become).

In the end, wed have what we had on the individual market pre-ACA: healthy people buying razor-thin coverage, and few good answers for everyone else. All because Republicans gave consumers, and insurers, that beloved freedom to choose.

See the article here:
The reason Republican health-care plans are doomed to fail - Washington Post

PALCO, Kan. At his first town hall meeting since coming out against the Senate Republicans health-care bill, Sen. Jerry Moran (R-Kan.) wanted to make himself clear.

He didnt want legislation jammed through on a party-line vote, but he would not necessarily vote against it. Hed met people who tell me they are better off because the Affordable Care Act was passed, but he knew plenty of people were hurting, too.

Its worthy of a national debate that includes legislative hearings, Moran said after the 90-minute event that brought 150 people to a town of 277. It needs to be less politics and more policy.

Moran, the only Republican senator holding unscreened town halls on health care this week, revealed just how much his party is struggling to pass a bill and even how to talk about it. The people who crowded in and around Palcos community center aimed to prove that there was no demand for a repeal of the ACA, even in the reddest parts of a deep red state.

That had taken some planning. Moran announced the Palco event with a full weeks notice, and Kansass pro-ACA groups mobilized to fill it. Planned Parenthood transported at least 20people from the Kansas City suburbs, 4 hours to the east; the citys chapters of Indivisible did the same. The American Association for Retired People and Alliance for a Healthy Kansas made more calls, driving loyal voters to Palco. The result was a polite but heated round of questions that Moran occasionally chose not to answer.

When a 59-year old veteran named Jeff Zamrzla asked if it was time for Medicare for all, Moran waited for applause to die down, then moved on to the topic of Medicaid funding. With a smile and a shrug, he told women in bright pink Planned Parenthood shirts that he wouldnt have an answer they liked.

That was a win for Planned Parenthood patients, said Elise Higgins, 29, the regional director of organizing for Planned Parenthood Great Plains. He didnt just talk about defunding.

Moran did the opposite, largely allowing skeptics of the Republican bill to frame the whole conversation. For all 90 minutes, a woman named Yaneth Poarch, 46, stood behind the senator holding a sign with caricatures of Republican leaders, and the warning When you lose your health care, remember who took it away.

Neither security guards nor staff did anything to move her.

The setting made the dissent, and Morans careful positioning, verge on surreal. Palco was in Kansass rural Republican heartland, miles from Morans home town of Plainville. The visitors from eastern Kansas, and the local Democrats from nearby Hays, found themselves next to Morans old roommate, some high school friends, and a physician. All of it took place in Rooks County, which gave the president a 73-point landslide over Hillary Clinton last year; Moran beat a token Democratic opponent by 79 points.

Until this year, the voters who cast those ballots had confidently favored repealing the ACA. Like Trump, Moran ran on full repeal, claiming to be the first Republican member of Congress to do so.

Obamacare was rammed through Congress on a purely partisan basis in the face of significant public opposition, Moran said in 2015 after the new Republican majority in the Senate passed a test vote on repeal. Moran had chaired the partys 2014 Senate campaign effort, making that majority possible.

On Thursday, Moran took another tone. He did not describe the task facing Republicans as repeal; it was repair, replace, whatever language people are using.

Pressed by activists and voters, Moran said that he did not want to cut back Medicaid. I have concern about people with disabilities, the frail and elderly, Moran said. I also know that if we want health care in rural places and across Kansas, Medicare and Medicaid need to compensate for the services they provide.

After the town hall meeting, Moran told reporters the version of the GOPs bill that he opposed put too much of Medicaid at risk.

Medicaid, except for the extension part of Medicaid, is not really a part of fixing the Affordable Care Act, he said. So weve coupled two things, both of which are very difficult. Kansas is a place thats treated Medicaid payments very conservative. If there are people receiving those payments who dont deserve them, deal with that issue.

In Washington, and at the height of the tea partys activism in Kansas, it had been easy to find conservatives who could sell Medicaid cuts. None of that came out in Palco. Instead, Moran was stopped several times by disability rights advocates who worried that the GOPs bill would destroy their lifestyles.

I am very worried about waivered services, said Mike Oxford, a 58-year old activist with the disability group ADAPT.

Well, my concern with Medicaid is in significant part related to people with waivered services and youre right, said Moran.

Oxford, who carried a sign reading I am Medicaid, said he was comforted by the answer. Here in Kansas, that would be the only place they could find money, he said. The senators right weve been skinned down to zero.

But despite the thanks from people who wanted him to kill the Senate bill, Moran never ruled out a yes vote. Despite the Kansas Hospital Associations opposition to the bill, Moran said he had not found any hospitals that benefited from the ACA. Asked after the town hall whether he could vote for a repeal-and-delay plan favored, in some interviews, by President Trump Moran didnt rule it out.

Thered be skepticism by many Americans because of how long its taken, he said. Can we come up with something in another year? Maybe, if that happened, there would be a desire on the part of all members of the United States Senate to find a replacement.

The desire wasnt there quite yet, he said. There are senators with genuine concerns about this legislation. More senators then are having town hall meetings, said Moran, who has two more town halls in western Kansas in coming days.

Read more at PowerPost

More:
A town hall in Kansas shows Republican struggles with health-care bill - Washington Post

My hope of Dissolving Illinois to save middle-class taxpayers from being stuck in this toxic wasteland of a state hit a snag on Thursday.

It wasn't the hazmat crews crawling over the Capitol Building in Springfield after finding some mysterious white powder tossed around the governor's office.

It was what Democratic Boss Mike Madigan's legislature did with quisling Republican help in overriding Gov. Bruce Rauner's veto of their $5 billion, 32 percent tax increase without any real structural economic reforms.

For leverage, Democrats and pro-tax activists used warnings from Moody's Investors Service, stressing that without a tax hike Illinois bonds would likely revert to junk status.

Moody's later said that even with the tax increase, that state bonds might still be considered junk, because there were no real spending reforms.

And then 71 members of the state House, dominated by Democrats, wafted their toxic fumes all over the taxpayers of Illinois.

"It's been kind of brutal for me," whined State Rep. Steve Andersson, the Geneva Republican and Boss Madigan enabler who voted for the Madigan tax increase and the Madigan override.

"I've received hate mail, death threats, my personal cellphone has been given out," Andersson said, "but you know what I've thought about? The people, suffering ..."

I thought I could see his lower lip quivering a bit.

And David Harris, Republican Madigan enabler from Arlington Heights, speechified that he had precious little joy. He, too, voted for the Madigan tax increase and the override.

"There's no joy here," Harris moaned. "There's no joy. We are looking into an abyss, a financial abyss, and action is required."

Well, what about all those Illinois homeowners being squeezed out of their homes? Do they have joy?

And what about the small business owners who won't take it anymore, and will take the jobs with them across the state line?

And what about taxpayers who don't hold news conferences, who don't have public relations consultants to call network TV reporters to chronicle their pain? Where's their joy?

They just leave.

As Andersson and Harris whimpered about their bruised feelings and their courage, I was reminded of what my grandfather, Papou Pete, told me about politicians:

"When they speak, the donkeys break wind."

Papou was right. So please stop speaking, Andersson. Please, stop, Harris. It's not only obnoxious. It smells.

So now, after all the talk and all the stunts, who won and who lost?

Boss Madigan won. He's the Khan of Madiganistan for a reason. He works harder, he's more ruthless, he's smarter, and he's cautious, until he strikes.

He wins because he knows what he wants: the money and the power. That's all he's ever wanted.

And Rauner lost, big time.

Madigan pushed the tax increase through days ago, with mostly Democratic support, but also with the help of 15 Republican votes. He then overrode Rauner's veto on Thursday.

With all the political noise over the past few days, I don't want you to forget something else. And without that something else, none of this would have happened.

Those 15 Republicans who voted for the tax hike gave Madigan enough votes to pass the tax and to give ample political cover to eight House Democrats, some in suburban districts, to vote against it.

In effect, the 15 Republicans protected the Madigan Democrats, so Madigan didn't have to expose his pet minions. And now they can send out direct mail advertising approved by Boss Madigan to tell voters in their districts that they're Democrats independent of Madigan, that they care for middle-class suburban taxpayers, that they haven't lost touch.

Of course that's nonsense. If Boss Madigan told them to lick the white powder off the Capitol Building floor, they'd do it.

There were 10 Democrats who voted against the tax increase: Mike Halpin; Marty Moylan; Michelle Mussman; Jerry Costello II; Natalie Manley; Sue Scherer; Katie Stuart; Sam Yingling; John Connor; Rita Mayfield.

Eight of these, all but Connor and Mayfield, were expected to have been targeted by Republicans.

You need a scorecard in this game.

Madigan would never have allowed them to risk voter anger. Because without them, he'd risk losing his majority and then he wouldn't be Speaker of the Illinois House.

There will be much talk of Republicans and Democrats jumping from tax vote to veto override, and who flipped and who didn't. But please consider this:

That's all about confusing the voter.

Remember that without the 15 Republicans voting for the tax hike, the rest of it would have been moot. Some Republicans were in districts where universities eat tax dollars, and perhaps the universities will protect them. Yet each deserve a vigorous primary challenge.

And I'm mentioning the 15 Republican Madigan enablers here by name, so you can keep score on them as well:

There was the lead whiner, Andersson; and Terri Bryant; John Cavaletto; C.D. Davidsmeyer; Mike Fortner; Norine Hammond; and Harris, because after he spoke, all the donkeys were exhausted.

And Chad Hays, who is not seeking re-election; Sara Wojcicki Jimenez; Charlie Meier; Bill Mitchell; Reggie Phillips; Bob Pritchard; David Reis; Michael Unes.

Yes, Papou Pete is long gone, but he understood their kind.

They always have good reasons for reaching into your pocket and taking your money. They're always sad about it. And some almost cry.

See the article here:
Boss Madigan's Republican enablers give his minions cover - Chicago Tribune

Most mornings I spend my commute listening to the New York Times podcast The Daily. Managing editor Michael Barbarohosts an informative, well-produced look at the major news themes of the day, and it tends to feature some of the papers best reporters and analysts. This morning, Barbaroand domestic-affairs correspondent Sheryl Gay Stolberg examined an interesting alleged contradiction: Few states benefited more from Obamacares Medicaid expansion than Kentucky, yet its Republican senators are leading the charge for Obamacare repeal, including for Medicaid reform. How can that be?

The exchange had echoes of a long-voiced Democratic complaint. How can working-class Republican voters keep voting against their interests? After all, dont they know what Medicaid does for them? Moving beyond Medicaid, dont they know that higher taxes mean better social services? Dont they know that voting for GOP politicians means enriching the fat cats, at everyone elses expense?

Hidden within todays podcast was a clue a critical clue showing why GOP voters make the decisions they make. Stolberg said that coal-industry job losses had been abysmal, crushing at the same time that roughly 400,000 Kentuckians had taken advantage of the Medicaid expansion. And shes right. The Lexington Herald-Leader reported last year that coal jobs in the state had fallen to their lowest level in 118 years to a mere 6,900. Magnifying the crisis, a coal-mining job pays so well that its virtually impossible to replace that income without significant retraining and (often) relocation. You cant move from the mine to Walmart and maintain the same standard of living. People do, however, move from the mine to Medicaid and at least have health insurance.

And so were left with an odd definition of interests. For years the Left has unapologetically waged regulatory and rhetorical war on coal, implementing policies that were most assuredly not in the economic interests of Kentuckys mining families. But now those same families are going to let bygones be bygones and rally around a second-rate welfare program advanced by the same movement? Some will. But some will quite reasonably look at a bigger picture and distrust the party that helped bring them to penury.

Lets move beyond Kentucky and its coal. Family dissolution is perhaps Americas foremost driver of poverty and dependency. The rules are simple. Follow the success sequence graduate high school, get a job, get married, and then have kids and your poverty rate is extremely low. Deviate, and the problems magnify. Now, between the two parties, which one has centered its appeal around married parents with kids and which party has doubled down on single moms? Even worse, the Democrats far-left base has intentionally attacked the nuclear family as archaic and patriarchal. It has celebrated sexual autonomy as a cardinal virtue. Then, when faced with the fractured families that result, it says, Here, let the government help.

Thus we have the 2012 Obama campaigns celebrated Julia, the single woman who never needed a man. Like nuns marrying Christ, single moms were bound to big government, and to the many bountiful benefits it provides. Yet the fracturing of the family is not in the best economic interests of women. Sure, some of those women will let bygones be bygones and rally around the party that most celebrates the sexual revolution while expanding public assistance. Others, however, will reasonably look at a bigger picture, one that asks whether government dependency helps perpetuate the larger and worse crisis besetting Americas families.

Moreover, since when is a vote a mere economic decision? Should every family sit down at their supper table, open their calculator apps, and do simple math based on each partys government giveaways? Are you really telling a family that values religious liberty, abhors abortion, seeks a more decisive approach to jihadists, and believes good citizens should be armed citizens that theyre voting against their interests if their senators policy will increase their insurance premiums?

Its not that simple, and wealthy progressives the very people who are most likely to advance the argument that working-class Republicans vote against their interests understand this all too well. Why? Because they dont apply this kind of crude economic calculus to their own votes. Wealthy liberals routinely vote for higher taxes to fund public schools, state and federal welfare programs, and other government benefits that theyll never use. Why? Because they are trying not just to maximize personal benefit but to create a particular kind of society that they believe is most conducive to human flourishing. Theyre not simply thinking about themselves and thats to their credit.

Its time for progressives to understand that conservatives have the same mindset, just filtered through a fundamentally different ideology. David Brooks argued in a July 4 column on this same topic that most Americans vote on the basis of their vision of what makes a great nation. Hes absolutely correct, and our interests depend on the complex interplay between our faith, our families, and our communities. For example, is a person who enjoys more religious freedom but has less economic stability better off than a person whose liberty is diminished but has reliable health insurance? All too many progressives think theres an easy answer to that question. Theyre wrong.

Our interests are inextricably linked to our values, and millions of Republicans long ago decided that progressive political values no matter how well-intentioned ultimately harm the nation they love.

READ MORE: Conservatism in the Era of Trump The GOPs Ideological Earthquake and the Aftermath The Trump Tipping Point for Conservatives?

David French is a senior writer for National Review, a senior fellow at the National Review Institute, and an attorney.

More:
Stop Saying Republican Voters Are 'Voting against Their Interests' - National Review

I would like to ask Nancy Roberto, where was the outrage when images of President Obama being lynched, having his throat cut or burned alive were daily flooding the internet? When gun-toting, flag-draped patriots compared him to Hitler? Was she concerned then with what his little daughters felt seeing them? Where were the well-behaved Republicans then?

Her cry for Republican outrage illustrates perfectly the hypocritical double-standard that Republicans live by. Sure, scream, cry out, exhibit plenty of outrage as long as it benefits them. Her outrage against a progressive, liberal agenda reflects totally the business as usual attitude of the GOP tax cuts for the rich, no health care for the poor, discrimination against minorities of all kinds, a backwards, destructive agenda which threatens a socio-political and economic dark age for the nation, and its current poster boy is certainly not a leader in any sense of the word.

If Connecticuts Republicans are constantly amazed at why the state remains blue, its suggested quite well in her letter. The level of unfairness and seeming downright antagonism towards anything liberal would only open the door towards turning Connecticut into a more difficult place to live then it is now. It is not wanted here.

Wheres the outrage, Nancy Roberto? Well, whats good for the goose is good for the gander. You want it you got it.

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Barry Hatrick

Milford

Original post:
Letter to the Editor: Republican outrage 'hypocritical' - New Haven Register