"I think it would be wiser for our policy leaders in this state to wait until November, that's the final decision break point on this healthcare debate."
In other words, take your time.
And a side note on the question of WHOM is to be running the exchange? Name three or four of the current governor's best friends, and you will be pretty close. If they are not currently, then they are soon-to-be, as it will involve vast amounts of money.
Let me remind the house leaders of testimoney they heard earlier this year (Below the fold)
Abigail Nobel's Testimony before the MI House Health Policy Committee, January 19, 2012
I am a Bachelor's- prepared nurse of 23 years, Board-Certified in Ambulatory Care Nursing.
I've been passionate about nursing since I was 3 years old, but I'll be the first to grant that my profession faces major problems. My goal is to stop Obamacare until it can be repealed. Even when that's done, we'll still be left with major problems in healthcare. It just so happens most of them are caused by poor government policy. Let me give some examples from my experiences in various areas of care.
As a Nurse's Aide working my way through college, I had to haul 90 year old nursing home residents out of bed at 6 AM, because regulations dictated how many hours were allowed between supper and breakfast. No excuses for these elderly survivors of life! This was the first time I felt the gut-wrenching impasse of being forced to choose between obeying the law and giving good patient care. Unfortunately, it would not be the last.
As a nursing student, I learned that OB providers had the highest malpractice insurance, not because they were bad doctors, but because when it came to babies with problems, juries would award any amount.
In surgery, well-established protocols were scrapped in favor of nationwide "best practice" standards, putting Michigan patients at risk because a surgeon in Florida amputated the wrong body part.
In postoperative care, I learned that patients' vital signs were routinely over-monitored --a nurse might take extra vitals, but woe to one who skipped any, no matter how stable the patient or how sore their arm from the BP cuff!
On medical units, regulations mandated I stay at the side of a comfortable patient instead of going to ones who needed me--simply because the standard number of minutes had not passed since administering a medication the patient and I both knew was safe for her.
I left homecare soon after the day it took eight hours of stultifying paperwork to document one hour of patient care.
Not all of healthcare's micromanagement comes from insurance and government. Some comes from hospitals themselves as they give a whole new meaning to "preventive medicine". Healthcare law is so complex, and the threat of lawsuits so frightful, that many hire full-time lawyers to guide their policy. This is in addition to industry lobbyists who jockey for legislative advantage to improve their market share.
Throughout my nursing career, I've noticed that patients who paid the least for their care were often the most resistant to education about lifestyle change, the key to up to 90% of hospital admissions.
In short, top-down organization and government regulation of healthcare have been tried and failed abysmally either to control costs or to improve patient health. Furthermore, these ever-tightening controls have served to actually increase costs due to heavier documentation and staffing requirements of the over-regulation. But it's not like there aren't better options for legislative action! In my lifetime healthcare has never enjoyed a free market environment. It is well past time to turn to genuine free market solutions.
Please, be clear about Michigan's policy going forward:
Insurance is not care; and healthcare is a service, not a right.
Repeal existing regulations such as Certificate of Need and BCBS/Priority Health monopoly protections which stand in the way of innovation and entrepreneurship in the real healthcare marketplace, which is found in our yellow pages across Michigan.
Reduce reliance on 3rd party payers by promoting direct pay, HSA's, and a culture of patient independence rather than reliance upon insurance or government programs.
Reverse the trend to single payer.
Michigan previously passed legislation to reduce the cost of malpractice litigation. Please revisit this area and consider further reforms in all areas I've mentioned. More information is available at heartland.org and other resources like Cato Institute.
Finally, please draw the line for special interest groups. We Americans have a long, proud tradition of helping our neighbors in person and through charitable organizations both secular and religious. Let us assume our proper role of love and accountability. It is not one for which government of any level is suited!