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States have ability to allow insurance sales across state lines

To The Daily Sun,

As the folks in Washington drive to eliminate the current Affordable Care Act there are many “facts” floating around that need substance to be called “facts,” but lack explanation of their effects if they were to be implemented.

Removing nonsensical analogies like covering pre-existing conditions is akin to having the person in back of you pay for your groceries, there are seemingly (on the surface anyway) logical sounding solutions that many claim would solve the problem. Rather than rant by throwing a dozen “opinions” against the wall, resulting in nothing more than fecal wall covering, I want to address just one, a decade old talking point claiming that the ability to sell insurance “across state lines” would solve the problem. While it sounds like it would foster competition and drive down costs, it does not take too much work to untangle this concept and see why it does not contribute to solving the problem.

States already have the right to allow “sales across state lines,” and have for years, the ACA has a provision in section 1333 regarding “health care choice compacts”. States can allow the sale of policies from any other state or choose to allow insurers from neighboring states. States also have the ability to determine which regulatory functions they control. The well beaten pseudo-argument of “states' rights” is well supported when it comes to health insurance policies.

So, if it is touted as the panacea to solve the insurance problem, why is there still a problem?

Turns out that regulations aren’t the main reason insurance tends to be uncompetitive. Selling insurance is a lot more complicated than just hanging out a shingle. It involves setting up complicated contracts with doctors and hospitals so customers will have access to their insured care. Then they have to attract enough customers to create a profitable risk pool. Establishing those networks of health care providers can be hard to impossible and expensive, even for current in-state providers, let alone for new market entrants. Furthermore local doctors’ offices and health care providers see new overhead costs with the addition of more insurance companies. Hence the basic rational for supplier contracts, in-network providers, primary care physicians etc.

In 2012, the Georgetown University Health Policy Institute completed a study of a number of states that passed individual laws specifically allowing out-of-state insurance sales. Despite offers to all the major providers, not a single out-of-state insurer choose to participate. Most states, including N.H., want to regulate local products themselves, and they should. N.H. has the second oldest population in the country, Utah has the youngest, and the needs of each state are very different. An insurance policy that meets the requirements of Utah simply would not meet the needs of N.H.

The Affordable Care Act actually has a few provisions to encourage more regional and national sales of insurance, but insurance companies have stayed clear. Notably, neither the insurance lobbying groups, nor the Blue Cross Blue Shield Association have endorsed any such plans when they have come before Congress.

So the concept is not a solution looking for a problem, it’s a slogan without merit, a further impediment to providing a real American national health care solution. Let’s support candidates who actually offer vetted solutions and stay away from those armed with only talking points.

Quinn Golden


  • Written by Edward Engler
  • Category: Letters
  • Hits: 559

Laconia will drive away tourists with its version of parking kiosks

To The Daily Sun,

Recently we joined with friends for a cruise on the Mt. Washington on N.H.’s great lake. We arrived early and secured a boardwalk parking space. I went to the nearest parking kiosk, which was not so near, only to be told by other folks that it was out of order. Fortunately there was another just a short distance away. There was a growing line of folks attempting to use it, however, and some gave up. When my turn came I realized I needed to know the space number where I had parked. I had failed to notice the sign that says you need to know your parking space number (my bad on that one). Back down the boardwalk a few hundred feet then back in line.

When my turn came, I tried three different credit cards multiple times but the machine would not accept any. I even read and re-read directions but to no avail. Now, more than anxious and with a growing audience I took a break and went to my vehicle to retrieve my bag of laundromat quarters. Back in line I was hearing the same frustrations I had experienced being voiced by other honest folk seeking to avoid scrutiny by some parking enforcement person who was sure to arrive after our cruise left the wharf. I deposited many quarters to assure my parking place. Ahh, time to take in the beauty of the lake on a perfect day for this voyage.

Before boarding I inquired at the ticket office regarding anyone who could assist others with the frustrating machine(s) and was told that the City of Laconia was in charge of that. I called the PD and asked for the department or persons for parking. The officer with whom I spoke did not know who the supervisor was for that division or even which department was actually in charge of the parking at Weirs Beach. I offered some suggestions to the officer, such as providing an attendant to assist during these important times. If someone was there prior to boarding I said, not only could the city realize the revenue from this system but they would have more happy tourists that would return to make N.H. even greener. The officer said he would pass the message (hope he learns who it is that might listen) but not before he mentioned that he had heard that "that new system up there had experienced some problems."

Much as we may not like to pay for parking, that is what helps to maintain certain aspects of the city right of ways. But Laconia, come on now, take a page from others who have instituted this kiosk thing; Dover, Concord, etc. They don’t number their spaces, they set a time limit (think three hour cruise), actually accept credit cards without problems or cash and place the kiosks conveniently (think elderly, special assistance) all to MAKE IT EASY FOR THE CUSTOMER to spend their money, be happy and maybe return to do it again. Otherwise they are just going to move on.

I would be surprised if the cruise company has not poked the city on this to get them to correct the situation as they will lose money otherwise as will the city.

S. W. Bailey

  • Written by Edward Engler
  • Category: Letters
  • Hits: 620