Worst Person In The World*

Max Borders.

Borders is a policy analyst and media coordinator at Art Pope's Civitas Institute, and contributes to their blog Red Clay Citizen.  He published a hate piece recently on our own Adam Searing, titled Mandate Mania: Does Adam Searing Hate People?  Max implies that, yes, Adam does hate people.  In addition, Max knows this about Adam: he lies to himself, he wants you to pay for things you don't need, he wants poor people to be uninsured (an odd accusation against the Director of the North Carolina Health Access Coalition), he hates freedom, and finally, Max knows that "Adam thinks he's smarter than you." 

Adam is too much of a gentleman to rebut Borders' vitriolic post.

But I'm not.

This is not just score settling, either.  Borders post serves as an object lesson of the dishonesty of the organs of right-wing propaganda.  Never forget…the only thing they care about is their free-market ideology.  Everything else is irrelevant.

Now for specifics.  Borders responded to a straight-forward post from Adam which asked gubernatorial candidate Bob Orr which mandates he was willing to eliminate in his "market based" health plan.  Fair question, since as Adam noted, the majority of NC's mandates cover medical essentials such as colorectal, breast, and cervical cancer screening, 2 day hospital stay for mom after delivery, and inpatient care following mastectomies.

Borders' venomous response included this bullsh*t quote:

N.C.'s mandates account for 45-50% of premium costs in North Carolina.

This is a lie.  When I asked Max where his data was generated, he referred me to this report by this organization.  Borders' "data" is from a health insurance lobbying group, who describe their mission as "an active advocate for market-oriented solutions to the problems in America's health care system."  Hardly an objective source, don't you know, since their clients stand to benefit directly from their "research findings."  Max is the ever useful tool to be exploited for special interest profit.

Alas, the little Emperor has no clothes, and Max has no data specific to North Carolina.  Max made it up.  Presumably, he extrapolated "research" from insurance lobbyists to spin his fairy tale.  By the way, if you want a list of other treatments considered "optional" (ie. mandated) by Max's resource, they also list: chemotherapy, emergency services, prescription drugs, well-child care (including immunizations), hospice care, diabetic supplies, cleft palate repair, and mastectomy, among others.  I don't know about you, but most of my patients would consider these mandates essential to care, not Cadillac care.

And that's the point.  The majority of so-called mandates are part of standard insurance coverage.  Usual and customary, whether required or not.  What Max calls "coercive" the rest of us, physicians and patients alike, call "standard of care."  Two respected resources regarding health care costs (unlike Max Borders sham resources) do not even mention insurance mandates as cost drivers.  Adam links to them here in his latest post.  Neither report references mandates, which would be hard to believe if they actually accounted for 45-50% of premium costs as they do in Max's imagination.

So Max doesn't do truth and doesn't do research… no surprise there, but what is a reasonable estimate of the cost of mandates?  It is likely somewhere between 5% and 7.6% of premium costs according to The New York Times, the Congressional Budget Office, and the Minnesota Department of Health.  Think of it like this: these mandates function as a consumer protection program.

And if you don't think consumers need protecting then you haven't been paying attention.  Consider the sub-prime mortgage mess or the history of predatory lending.  Do we really want to unleash the greed is good crowd and allow them to more easily plunder the health insurance market?  Buying health insurance is a hell of a lot more complicated than purchasing a mortgage, and the opportunities for unscrupulous sellers would be significant.

Remember this lesson about Max Borders and the right-wing think tanks.  They delude themselves into believing they are  some sort of freedom fighters in Art Pope's Army.  They like to bestow titles upon themselves: Chairman, President, Vice-Chairman, Vice-President, Senior Fellow, Resident Scholar, Research Director, Policy Analyst, Media Coordinator.  None of this matters.  They are nothing more than partisan hacks, as blinkered by their hate-filled ideology as any tribal leader in Northwest Pakistan. 

*Thank you, Keith Olbermann.