Senator David Sanders was interviewed by John Brummett for Talk Business & Politics. The subject was the Private Option. It should have been an easy interview for Sanders, who is known as one of the architects of the Private Option, especially since Brummett frequently sings the praises of the Private Option.
Instead, Sanders repeatedly tried to divert the conversation away from the Private Option and what he said about the Private Option wasn’t very good for supporters. Republicans who had voted for the Private Option were basically thrown under the bus by Senator Sanders admissions. As I watched the video of the interview, I couldn’t help drawing a parallel to the videos of John Gruber and the damage he did to Obamacare.
Sanders – Private Option is not conservative
Republican support for the Private Option in 2013 and 2014 was built on the sales pitch that the Private Option was the conservative thing to do. In 2013, the Private Option was sold as the “conservative alternative” to Medicaid Expansion (despite critics correctly pointing out that it is merely a more expensive version of Obamacare Medicaid Expansion). In 2014, a year after passage of the Private Option, legislative amendments were added to allegedly make the Private Option more conservative. Despite all their effort to try to make the Private Option look like a Republican plan to bring conservative ideas, astoundingly, Sanders admits the Private Option is still not conservative. This is what opponents have been saying for two years.
In the interview, Sanders did try to claim that the Private Option could become part of a sweeping transformation of health care in Arkansas that somehow would be conservative. More bad news for Republican supporters of the Private Option – his ideas about sweeping transformation of healthcare sound like they could have come out of a liberal playbook of big government solutions.
Here are four excerpts from the interview.
- SANDERS: If you lock in on the policy [Private Option] as it is, then yeah you could be discouraged, but if you look at where you’re trying to drive the train and that is to reform health care in the state of Arkansas in spite of what’s happening outside of these borders to do what’s best for Arkansas and if you have had the conversation that I’ve had with members who voted against it some of them have been vehemently opposed to the policy but understand better where we’re trying to go I think you have no reason but to be optimistic.
- BRUMMETT: Is it conservative to spend this federal money?
SANDERS: Is a conservative to spend it only in a vacuum? “No” it is not. But, to do it with reforms in mind and to prove what we are proving now, I think it is.
- BRUMMETT: Let me back up to one thing you said. If you considered the Private Option a static thing unchanging in a vacuum you would be discouraged?
SANDERS: Absolutely. And I wouldn’t support it.
BRUMMETT: You mean you today don’t support the Private Option?
SANDERS: No, I support it as is, but again we tend to think in small increments. We tend to be very transactional in the legislature. We don’t think long-term. If the overall goal is not to change healthcare, proliferate coverage. Not just in this Medicaid target audience but in the small business market and also to improve healthcare in self-insured market, that’s 63% of the healthcare market in Arkansas. If you’re not looking to shift the entire system to one of openness and transparency, more individualism, more consumerism, then, yeah, I wouldn’t want it … first, it wouldn’t be worth supporting because then what you have is just another government program with a constituency that’s on the program and constituencies around the program supporting it.
- SANDERS: You started by asking is it conservative to spend this money. And the answer is “no”, unless you are looking to transform the system, which transforming the system means more transparency, more coverage, and to do so in a way that lowers cost and increases quality, and get people engaged with healthcare.
Look at the third quote again. Senator Sanders would not support the Private Option but he supports it as part of some grand scheme? And, this vague comment is from one of the architects of the Private Option.
Not conservative UNLESS it is part of transforming the whole healthcare system
Sanders ideas about transforming the health care system sound like they could have come out of a liberal playbook of big government solutions. As you listen to his vague ideas about transforming health care you may find yourself wondering-Haven’t we already had one of those grand transformations and isn’t it called Obamacare, of which the Private Option is one part.
It appears that some of the puzzle pieces for this grand transformation include more regulation and more government control. His transformation is not just about the Medicaid target audience but he also wants to get involved in the small business market and the self-insured market. As an example, Sanders said he plans to file legislation requiring more reporting (“disclosure”) by physicians, hospitals and other healthcare providers in order for the government to determine physician quality, hospital quality, etc. He would have the government analyze patient outcomes and make a government determination of the quality of services provided by that physician. Sander’s idea for legislation led Brummett to quip, “Of what? Here’s how many patients you had and here’s how many survived?”
More bad news for Private Option supporters
Senator Sanders also admitted that one of the flaws of the Private Option is that there is an incentive for insurance companies to maximize the flow of people and money though the insurance companies, which maximizes their profits. There doesn’t seem to be a solution to this problem. He says it is part of the rules Washington gave us. Here is what he said:
SANDERS: What, unfortunately, the rules that Washington gave us with respect to insurance and insurance management, the insurers are almost, no, they are incentivized to keep people and to see money flow through their books because they have these things called risk corridors. What we have to do is not only work with the legislature and the Governor to see the broader picture, but we have to work with insurers, we have to work with doctors, we have to work with hospitals, specialists, pharmacy benefit companies, and all the pharmacy benefit managers see the bigger picture.
Who will be the voice of the Private Option?
Senator Cecile Bledsoe has become the voice of those who oppose the Private Option. She is also the Chair of the powerful Senate Committee on Public Health, Welfare, and Labor. But, who will be the voice of Private Option supporters?
It was thought that Senator Sanders would assume that role since he is known as one of the architects of the Private Option. The general perception that Sanders would lead supporters is clear in John Brummett’s comments in the interview.
BRUMMETT: Senator Sanders do you sometimes feel like the last survivor of the Private Option? You got your co-architect Representative Burris – gone. Andy Allison the helpful Human Services official – gone. Governor Beebe will be gone. Your buddy Dismang, Senator Dismang is otherwise occupied running the entire Senate. You’re right there at the vortex of the big issue.
After the disastrous interview, will supporters stick with Sanders as their voice? If not, who will be the sacrificial Republican to take his place? (I refer to the “sacrificial Republican” because the Private Option has proven to be disliked by the voters and supporters will need a Republican to try to sell the Private Option to Republicans.)
No matter who tries to lead the pro-Private Option side, the message to Republican legislators is clear. The Private Option is not a conservative initiative. It is just Obamacare.
To view the full interview of over 30 minutes [CLICK HERE]