Alaska Dispatch

Former Alaska Gov. Sarah Palin posted a piece on her Facebook page Saturday evening, criticizing the health care bill approved last week by the Senate Finance Committee. Unlike some of her other posts, this is more of a wonkish, plodding piece, absent talk of "death panels" or any of that kind of spunky, spontaneous spirit that we've come to associate with her.

Apparently, she's going for respectability.

Palin's objections aren't at all new. Reform, as it is proposed in the Baucus bill, would raise taxes, reduce access, and add to the country's debt, she and other Republicans have repeatedly said.

"Americans want health care reform because we want affordable health care," she wrote. "We don't need subsidies or a public option. We don't need a nationalized health care industry. We need to reduce health care costs."

Her solution, too, is lifted from Republican talking points: allowing insurance companies to cross state lines to sell insurance, and a federal tort reform law that would reform medical malpractice litigation.

What's so strange about this is that both solutions, even if they did work to cut costs (and there's much debate about that), would do so at the expense of state's rights, something that Palin has claimed to be a staunch supporter of.

Most Republicans, including our own Sen. Lisa Murkowski, are also being ideologically inconsistent here. What makes Palin's inconsistency so startling is that most Republicans have also not been in the positition to so directly effect change. Palin had the power as governor of Alaska-- had she not quit halfway through her term--to enact these reforms herself and urge other states to follow her lead. Now she says she prefers that the feds get involved and create mandates, and in the process, a huge federal regulatory agency that would enforce those mandates.

As it is right now, something called that McCarran-Ferguson Act, passed in 1945, defined insurance as a state activity, meaning it's not interstate commerce and isn't subject to federal regulation. So the states themselves get to decide if they will accept an insurance policy from another state, but they aren't forced to. For instance, Premera Blue Cross, which has more than 60 percent of Alaska's health insurance market, is domiciled in Washington State, but sells policies in Alaska. In doing that, it must conform to Alaska's insurance laws.

When Palin was governor, she could have changed Alaska state law so that we would have had the option of buying insurance from even more companies across state lines. Perhaps that would have allowed the upwards of 33 percent of our uninsured population to buy insurance in a state that's now so prohibitively expensive.

It could have worked. Minnesota's governor Tim Pawlenty (R), has recently proposed to do just that. He's looking to create an interstate health insurance program modeled off of the Interstate Insurance Compact, a group of 36 states that permits the interstate regulation and purchase of some insurance products, including life insurance and annuities.

Tort reform, too, is another issue that has traditionally been left to the states. But Palin and other Republicans are calling for a federal law that would trump state law, and what effect that would have is hotly debated. Already, most states have enacted some form of tort reform. In 1997, the Alaska State Legislature passed a law that limited the amount of "non-economic damages" that can be recovered in a wrongful death action to $400,000, or $8,000 times the person's life expectancy, whichever is greater.

It was tough to get it through, but proponents promised that such reform would open up Alaska's insurance market to its citizens, lower malpractice insurance rates for doctors and entice them to come to the state.

Neither happened. According to the American Medical Association, Alaska was one of five states where, between 1998 and 2007, an increase in population did not lead to a proportional increase in the number of doctors. Between 2000 and 2009, health insurance premiums for Alaskans rose a whopping 90.8 percent, while earnings rose by 17.3 percent.

But perhaps Alaska's law was too watered down? If so, she could have stayed in office and fixed it. That might have lent her the real respectability that she seems to be going for, through footnotes.

When Katie Couric interviewed her last year, Palin talked about how abortion and other issues "are best held on a state level and addressed there."

Why is abortion a state's rights issue and insurance regulations and malpractice laws aren't? Maybe, if she ever again rears her head and comes back into the air space of the United States, someone can ask her as well as those who are penning her policy papers to explain.

Name

Email

Title

Comment

Subscribe via email (registered users only)

Post