What’s in a name?
When the market is The Market
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 — languishes in the shadow of Obamacare, which refuses to be repealed and replaced.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.