Weekly Opinion Editorial

GROUPTHINK!

By Steve Fair

The Oklahoma Health Care Authority is a seven-member board composed of three appointees by the Governor and two each by the Speaker of the House and the Senate President Pro Tempore. Their stated mission is, “To purchase state and federally funded health care in the most efficient and comprehensive manner possible and to study and recommend strategies for optimizing the accessibility and quality of health care.” The OHCA wants Oklahomans to enjoy optimal health status by having access to quality health care regardless of their ability to pay.

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To that end the OHCA proposed the establishment of a ‘health insurance exchange’ in Oklahoma. One of the tenets of the federal health care program, commonly known as ObamaCare, is that individual states would set up an exchange or have the feds do it for them. A health insurance exchange provides a single portal for comparing and enrolling in health insurance coverage. There are both public and private exchanges.

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What is the stated justification for the establishment of health care exchanges? According to the OHCA, “Current market choices present challenges for individuals and employers that include confusion about choices, eligibility, costs and benefits. The idea is that individuals and small businesses would join a massive pool of consumers, increasing the exchange’s ability to negotiate a lower group insurance rate for them.”

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Governor Mary Fallin and Speaker of the House Kris Steele, (R-Shawnee) supported Oklahoma setting up their own health care exchange by accepting 54 million in federal money, but their plan was not supported by Senate President Pro Tempore Brian Bingman, (R-Sapulpa).

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Fallin said, “The only way to avoid federal control is for Oklahoma to have a plan.” Steele said Oklahoma needed to get ahead of the curve on ObamaCare in order to protect the free market principles, competition and individual responsibility. Bingman said, “We will work with the House and the governor, and work out an exchange that is right for Oklahoma. I prefer the use of private or state resources, to put together our own exchange without the federal strings.”

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After the State House passed HB #2130, a bill setting up an exchange, 51-34 with 19 Republicans opposing the proposal, Bingman said it wouldn’t come to a vote in the Senate. “I don’t think we’re going to be hearing that bill. Republicans in the Senate are not for ObamaCare. We want to support the lawsuit to fight ObamaCare. … As this was discussed, we decided to slow that process down, “ Bingman said.

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After intense pressure from conservative legislators, which included the majority of ‘freshman’ Republicans and citizens across the state, Fallin announced on Thursday she will reject the 54 million dollars, noting that the move "accomplishes my goal from the very beginning: stopping the implementation of the president's federal health care exchange in Oklahoma." This is a reversal of her public position on HB 2130 and her statements about health care exchanges.

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There has been a lot of misinformation concerning this issue on the Internet and blogs about the health care exchange. Here are my comments:

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First, establishing a public health care exchange would help some Oklahomans to have access to insurance coverage that don’t have it and with the high cost of health care, that is a good thing. Establishing a health care exchange would allow us to be prepared in case the lawsuits to declare ObamaCare unconstitutional are not successful. It would probably help Oklahoma’s effort to recruit jobs and industry to the state. It would not increase taxes. The motivation behind HB 2130 was not as devious as some claim. Admittedly, the accepting of the 54 million from the feds while engaged in a lawsuit against the very program giving you the money reeks of hypocrisy, but this issue was not as black and white as some have made it out to be. The inability of some to see the acceptance of the 54 million as hypocritical reveals a pragmatic approach to governing that bears watching in the future. Pragmatism is one of the four tenets of situational ethics.

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Second, the reversal by Fallin on the acceptance of the 54 million should be a lesson to all elected officials. Instead of citizens contacting their legislator, it should be the other way around. Elected officials should reach out to a cross section of their constituency and ask their opinion on key issues. All too often, elected officials engage in ‘groupthink.’ Groupthink is a type of thought within a group whose members attempt to minimize conflict and reach consensus without critically testing, analyzing and evaluating ideas. It is a potential negative consequence of group cohesion. Holding the ‘caucus’ together may be critical to passing the ‘agenda,’ but allowing an honest exchange of ideas will give us better government.

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Health care is sixteen(16) percent of the U.S. economy and growing. The debate on access to health care and the cost of health care is not going away, but expanding government’s role in health care is not the answer. We need to emphasis prevention of disease and get patients more involved in the financial decisions in their health care. We should not just pragmatically resign ourselves to socialized medicine and do something because the feds told us to.