Twila’s sure about MNsure part II

She still doan wan it!

The first installment is here.

Q: So Twila, you do think we should prevent people from dying in the street for lack of health care, and you don’t think the current system of sticking (principally) county taxpayers and private providers and insurers (because the cost of uncompensated care is spread among those who do pay) for the care of the poor is fair.

A: I don’t think I said that.

Q: Well, Twila, you did. Go back and read the first installment of our conversation.

A: [pause, papers shuffle] Okay.

Q: So, what do you propose we do?

A: You’re the idea guy around here.

Q: Well, what would you think of encouraging people to buy health insurance on a sliding scale of what they can afford, subsidizing them when necessary out of a pool paid for by all taxpayers, not just property owners, in order to increase the number of people who have insurance, and reduce the amount of uncompensated care?

A: That sounds like a really good idea!

Q: And maybe make insurance companies disclose their premiums on the internet and really compete for customers.

A: I like that.

Q: So I gather you like the idea of the individual insurance mandate and the health insurances exchange that will start up in October?

A: MNsure? Are you crazy?

Q: People have said so, for assorted reasons, but I’ve given you a pretty fair description of what is going to happen when the exchange starts up and the individual mandate kicks in in January of next year.

A: That’s all well and good, but I won’t be able to pick my doctor because, well, not freedom!

Q: Can you pick your doctor now?

A: Of course I can.

Q: From the list of doctors in your plan, right?

A: Well, right.

Q: And you have to get advance permission and maybe a referral to see a specialist, right?

A: Yes.

Q: Why do you think the exchanges will further limit your choice of doctor?

A: Because, well, Obamacare!

Q: That’s the best you’ve got?

A: [pause] Yes.

Q: The fact is, Twila, that the exchange is just a marketplace, a clearinghouse of information. Among the things it most clearly doesn’t do is tell insurers to limit your choice of doctors. As we’ve seen, the insurers are capable of doing that on their own and have for a long time.

Q: But my health care premiums have been going up because of Obamacare!

A: Your health care premiums have been going up for decades before Obamacare was a gleam in Obama’s eye.

Q: My employer will stop offering health insurance coverage now.

A: We’ll take that and other matters up next time, Twila; sit tight.

[Still looking for the identity of the pouting woman on the billboard.]

Update: Someone wrote in and said, “Twila would never agree to subsidize anybody’s health care, even under the relaxed structure of this fake interview.” Of course, that’s true, but several people have said to me ever since the Affordable Care Act was adopted, “I want poor people to get health care, but . . .   .”

The purpose of this little, I like “imagined” better than “fake,” dialogue is to take these people at their word, and ask them, “Okay, how do we do it?” Because the tooth fairy will be of no help at all.

Further update: The woman depicted on the billboard is an “upset woman” on a stock photo website. Nuts. I thought it was Katie Kieffer.