What’s in a name?

When the mar­ket is The Mar­ket

Northwest Arkansas Democrat-Gazette - - EDITORIAL PAGE -

QUICK, call on the shade of Char­lie Chap­lin, the Lit­tle Tramp him­self. He had to deal with the lat­est sup­pos­edly con­sumer­friendly gad­gets in his own Mod­ern Times, which was the ti­tle of the film he made to sum up the ma­chine’s new dom­i­na­tion of mere men.

But in his pre-email day, the lat­est in mod­ern in­con­ve­niences were mad­den­ing things like the assem­bly line, which re­duced peo­ple to au­toma­tons who had to keep pace with the fre­netic speed of the ma­chine or find them­selves thrown off. But at least Char­lie Chap­lin’s char­ac­ters were spared our own up-to­date vo­cab­u­lary that calls guides to the sys­tem nav­i­ga­tors and in­sur­ance cov­er­age a mar­ket­place, as in the cur­rent Arkansas Health In­sur­ance Mar­ket­place.

Still with us? That’s good be­cause then maybe you, Gen­tle Reader, can ex­plain just where the rest of us are in this bu­reau­cratic maze in which buy­ing health in­sur­ance cov­er­age is rechris­tened “mar­ket­place” and the folks who are sup­posed to guide cus­tomers through it are known not as sales­clerks but nav­i­ga­tors, which is sup­posed to make life eas­ier and sim­pler but in­stead makes it harder and more con­fus­ing.

Mean­while, the real mar­ket­place — re­mem­ber it? — lan­guishes in the shadow of Oba­macare, which re­fuses to be re­pealed and re­placed. That in­creas­ingly out­moded sys­tem goes from fail­ure to fail­ure and still re­tains its fan base, es­pe­cially in con­gres­sional cir­cles, which con­tinue to spin like mad and take all of us for a ride. Oba­macare not only spec­i­fied what Amer­i­cans must buy, like health in­sur­ance they didn’t need such as ma­ter­nity cov­er­age re­gard­less of age or sex, but what We the Peo­ple must not buy, like health in­sur­ance of our own choos­ing.

All of which might ex­plain why a group of con­sul­tants — for wher­ever the ad­min­is­tra­tive state goes con­sul­tants are sure to fol­low—the Pub­lic Con­sult­ing Group has rec­om­mended that the state should start ne­go­ti­at­ing a whole new slew of con­tracts to help Arkansans en­roll in the mar­ket­place that isn’t the real one but just a fancy la­bel.

The real ques­tion is how, out of all this word salad, do the con­sul­tants make a liv­ing? An­swer: By col­lect­ing fees from the health-care in­sur­ers. They paid a cou­ple of out­fits, En­roll the Ridge of Jones­boro and Fu­ture Builders of Wrightsville, a to­tal of $552,000 to en­roll folks in in­sur­ance pro­grams. These mid­dle­men got the money back via fees the so-called mar­ket­place took from the in­sur­ers. Be­fore then, the mar­ket­place got its money through a fed­eral grant — but the grant couldn’t be used to pay for these clerks called nav­i­ga­tors, demon­strat­ing once again that what the fed­eral govern­ment giveth, it taketh away in due course. It’s a process as sure as death and taxes.

But one group of con­sul­tants does seem to have wised up to this sys­tem/racket. Ac­cord­ing to the mar­ket­place’s spokesper­son, Alicia McCoy, the con­sul­tants hadn’t been billing for ad­min­is­ter­ing this Rube Gold­berg sys­tem and, un­der­stand­ably enough, didn’t want to con­tinue work­ing as a non­profit. “It’s not prof­itable for them,” she summed up mat­ters in a nut­shell.

Jim Miles, who founded En­roll the Ridge, says that its con­tract with the state, which ended with the fis­cal year, supplied nav­i­ga­tors who re­sponded to in­quiries from some 13,000 po­ten­tial buy­ers of health in­sur­ance and helped maybe 10 per­cent of them to en­roll in a health-in­sur­ance pro­gram. Of those 1,300, some two-thirds qual­i­fied for cov­er­age un­der the state’s ex­panded Med­i­caid pro­gram that has a la­bel of its own — Arkansas Works —while the rest found health in­sur­ance on their own. Which sounds like the only real so­lu­tion to this mare’s nest of prob­lems.

ALL OF this de­fies not just com­mon sense but raises ques­tions that the old Fair Pack­ag­ing and La­bel­ing Act was sup­posed to an­swer. That law di­rected the Fed­eral Trade Com­mis­sion and Food and Drug Ad­min­is­tra­tion to is­sue reg­u­la­tions that would re­quire all com­modi­ties made for pub­lic con­sump­tion to carry la­bels show­ing their con­tents, iden­tity, and place of ori­gin — whether Wash­ing­ton, D.C., or Lit­tle Rock, Ark. — and its prin­ci­ples need re­viv­ing in this state.

But not all the govern­ment’s nav­i­ga­tors and all the govern­ment’s men can put this pro­gram back to­gether again once folks catch on that, some­how, some way, we should be mak­ing our own de­ci­sions about health care and how to pay for it — without the govern­ment’s gen­er­ously supplied mis­in­for­ma­tion. For any pro­gram that re­quires nav­i­ga­tors has got to be sail­ing through stormy weather in­deed. It was Ron­ald Rea­gan who said that the nine most ter­ri­fy­ing words in the English lan­guage were “I’m from the govern­ment and I’m here to help.” They still ap­ply.

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