State insurance exchanges?

Interesting.  Here’s a poll question asked in December of registered voters in South Dakota (exact wording):

“The Affordable Care Act, also known as Obama Care, gives states the option of setting up a state-run insurance exchange where people who have trouble finding private health insurance can shop for health insurance.  The law also says that if a state does not set up such exchanges, then the federal government will step in and do it.  Do you think South Dakota should go ahead and set up an insurance exchange, or do you think we should let the federal government do it?”

71% said the state should do it, while 23% said they wanted the feds to do it for us.

Support for having the state set up the insurance exchange (which so far Governor Daugaard has opposed), runs 2 to 1 or 3 to 1 in favor across all age groups and income groups.  Republicans favor state exchanges 77-17, which is 20 points better than Democrats, one in four of whom would rather have the feds do it.

Tea Party supporters favor state-run exchanges over the feds doing it, 68-24.

The hidden tax most people pay

There’s a misconception that needs correction.  The notion seems to be that if we deny Medicaid coverage to the working poor, it will somehow save money.

Well, true, it might save taxes — but you and I, my fellow South Dakotans — are going to pay one way or another.  Every person who is right now paying for health insurance, or who pays hospital or doctor bills, is paying for health care that is received by fellow South Dakotans who do NOT have health insurance.

You are paying those costs via higher insurance rates and higher hospital and medical fees, because when those folks finally show up in the Emergency Room, they cannot be turned away.  A problem that might have cost $100 in a doctor’s office visit costs many times more when  it turns into an emergency room visit.

There are 48,000 South Dakotans in this category and the hidden tax (paid via higher insurance rates and provider fees) is $9 million per year FROM HOSPITALS ALONE.  Add in clinics, labs, nursing homes, mental health centers, etc. and the hidden tax gets even larger.

Some not-so-recent Rapid City health care history

In the 1960s, the sisters of Saint Martins, who operated Saint John’s Hospital in Rapid City, asked laymen to be on their advisory board.  In time that board became their corporate board of directors.

I was asked to serve on the advisory board and later on the corporate board that operated the hospital.

As the operation of hospitals became more complex, Mother Magdalene asked if I would serve as the chairman of the Board of Directors.  It was a wonderful experience being the Jewish chairman of a Catholic hospital.

Doing that job, nearly thirty-percent of my waking hours were spent at the hospital—sometimes at 11 p.m. at night—or in Board meetings other conferences relating to health care.

It became readily apparent that Saint John’s hospital practiced a much higher standard of medical care than did the folks “competing” Bennett-Clarkson Hospital.  Frankly, the competing hospital’s origin arose out of antipathy towards the Catholic Church and the idea of a major medical facility being run by nuns.

In order to promote more congeniality, as chairman, I established a “Joint Liaison Committee.”  It was made up of three or four members of our board to work with three or four members of the Bennett-Clarkson board.

It seemed to the Saint John’s board and to its brilliant administrator, Sister Sarto Rogers, that the hospitals should merge to save duplication of equipment, effort, and to ensure a higher standard of medical care.  When the question was raised at a Joint Liaison Committee, the Bennett-Clarkson members suggested that it would be impossible to come up with a way to merge.  When asked if there could be a committee of citizens who were involved with neither hospital that could negotiate a merger, the answer was that there was no way to choose such a committee.

We handed the leader of the Bennett-Clarkson group a sheet of paper and asked that he write down seven names that he would like to see on a committee, and that we would do the same thing.  When they came back in fifteen minutes, we would compare names on both lists and those that we had in common would immediately become members of the Merger Committee.  The number needed to increase the committee to seven would be selected by each board by selecting from the other’s board’s list, and we gave Bennett-Clarkson the first choice.

From that meeting emerged a Hospital Action Committee (HAC) that negotiated the merger.  They became members of the new Rapid City Regional Hospital Board of Directors and built the present hospital—though the size of the building and its complexity have increased many times during the years.

At a meeting sometime during the late sixties, Sister Sarto announced that she learned that there was a bill in the legislature which would require every licensed hospital in the state to perform abortions.  She said, “Saint John’s will not do so, and I will go to jail.”

Also on the board was my friend Harvey Fraser, who was then the president of the School of Mines.  Harvey had been an Army General and a professor at West Point.  He was a straight-forward person.  He asked, “What are you going to do, Stan?”  I replied, “I will go to jail, too.”

He said, “Why? You don’t even agree with her.”  My reply was, “I knew what the values of this organization were, and I committed myself to them, whether I totally agreed or not.  If a few leaders in Europe would have been willing to go to jail for principle, six-million people that are just like me would have not have been murdered.”

It’s amazing what you can get done if you stand by your principles and respect others when they do.