17 things about I nitiated Measure 17: The Definitive
Voter Guide to a Complex Ballot Initiative Were blessed to live in a state where common sense typically prevails, and people recognize that when something sounds too good to be true, it probably is. Knowing this, proponents of Initiated Measure 17 (IM17) have deployed some very clever tactics in an attempt to cloud voter judgment and conceal the true consequences and motives behind their costly government mandate. The fact is, IM17 is a terribly complex issue that cannot be explained in 30-second TV advertisements. The proponents are using this to their advantage, expecting to lure South Dakotans in with slick, emotional messaging. What follows are 17 things about IM17, including analysis of what the measure actually does, who is behind it, and why its a bad deal for South Dakota families and businesses. 1. Reality Check. IM17 proponents have spent a lot of money trying to convince South Dakotans that a Yes vote will create a system of absolute patient choice. Proponents have strategically marketed IM17 as a wave of the magic wand that would allow anyone to see any doctor, regardless of insurance, at no additional cost. To call this notion baloney is putting it way too kindly. 2. Out-of-network fees arent going anywhere. IM17 is unquestionably a health plan mandate, not a patient rights law. If this poorly conceived policy passes, citizens will gain no greater affirmative rights than they have today. The law would instead allow any minimally qualified doctors to become part of a health plans provider network. The choice to apply for network membership rests strictly with the doctor, and there are many reasons they would not or could not pursue membership. Out-of-network fees would remain firmly in place. 3. Theres more to this than provider rates. A favorite talking point of IM17 proponents is that costs wont increase because the law would require providers to satisfy insurance plans terms and conditions, including price. This is a dangerously misleading and shortsighted argument. Health care economics require consideration of volume, quality, and efficiency. 4. IM17 destroys volume incentives. Patient volume is an important negotiating tool for health plans. Health plans can offer providers enhanced access to defined groups of patients in exchange for discounted rates favorable to consumers. IM17 fundamentally undermines this type of negotiation because it grants certain providers the government authority to essentially make themselves party to these agreements. With more providers dividing up a patient pool, volume discounts disappear. 5. IM17 doesnt account for quality and efficiency. Health plans dont simply work with the cheapest providers. Providers are also vetted for dependability. The current regulatory system allows health plans the discretion to filter and weed out those providers prone to poor patient outcomes and unnecessary expenses major drivers of cost. When health plans are forced to accommodate all minimally qualified providers, the excessive reimbursements and administrative costs that result are passed on to consumers in the form of higher premiums. 6. IM17 hurts community hospitals. IM17s for-profit proponents rarely treat those most in need, seldom accepting Medicare, Medicaid and the underinsured. According to 2011 Cost Reports from the Center for Medicare and Medicaid (CMS), South Dakotas seven physician- owned specialty hospitals without emergency departments provided $196,000 in charity care. During that same year, tiny Lead- Deadwood Regional Hospital provided $837,000 in charity care! In total, South Dakotas non-profit, community-based hospitals provided $36 million in charity care in 2011. 7. Consider IM17 in any other business context. Proponents of IM17 are seeking a self-serving government mandate that will allow them to decide the parties to a contract pretty shocking to core American economic values. Should the government require Apple or PAID FOR BY NO ON 17. General Motors to offer jobs to any minimally qualified person simply willing to accept a certain wage? 8. IM17 proponents are special interests masquerading as populists. This measure is being pushed by a small group of for- profit specialty physicians and the facilities in which they have ownership stakes. This group has disguised its economic motives as a measure that would increase patient choice and lower costs. Unfortunately, their market interference would actually raise health care costs for all of us by thousands of dollars. This is proven by the Federal Trade Commission and a number of independent academic studies. 9. South Dakota leaders already rejected this bad idea. Gov. Dennis Daugaard and state lawmakers saw through this ploy and rejected an IM17-like bill in the 2013 legislative session. Undeterred, these for-profit providers invested big sums of money to place IM17 on this falls ballot and flood the airwaves with misleading messaging. 10. IM17 proponents specialize in shareholder care. IM17s primary proponents are in the business of maximizing profits through select, lucrative medical procedures. And they are hardly mom and pop providers. For example, Black Hills Surgical Hospital, Sioux Falls Specialty Hospital, and Dakota Plains Surgical in Aberdeen are majority-owned by a publicly traded Canadian corporation. Foreign shareholders arent the only ones seeking big returns. Consider the physicians who own large stakes. 11. Monopoly is a great board game, but a weak argument. IM17 proponents enjoy suggesting that the big systems oppose this measure because the systems offer their own insurance products. The proponents dont point out that the Sanford and Avera health plans account for only 1/5 of the insurance marketplace in South Dakota. Moreover, many of the system plan offerings are highly inclusive. In fact, Dr. Blake Curd and Dr. Steven Eckrich, the for- profit stars of the IM17 TV commercials, are already part of the Sanford and Avera health plan networks. 12. Throwing stones in a glass house. Its pretty remarkable that IM17 proponents would argue conflicts of interest. Consider the whole for-profit, physician-owned specialty hospital model. The whole concept of physician-owned hospitals has long been under fire to a point its now illegal to open or expand a physician-owned hospital in the United States. 13. Not all doctors support IM17 follow the money! IM17 proponents like to claim that nearly every South Dakota doctor is in favor of IM17, pointing to an endorsement by the South Dakota Medical Association. A membership association endorsement is hardly consensus. More telling is the monetary support for IM17. See your doc on the list? Probably not, unless they have something to gain financially. 14. Common sense confirms the research. Studies aside, are South Dakotans really to believe costs wont rise if we arm some of the nations most expensive for-profit hospitals with an all-access insurance mandate? 15. Thirty-nine states dont have this mandate. Proponents have made a lot of noise about eleven states having any willing provider laws governing medical insurance. What they dont say is that these laws (along with South Dakotas pharmacy law) were implemented decades ago. The cost of everything has increased significantly over that period of time, so its deceitful to suggest these laws have kept costs in check. Importantly, no state has enacted this type of mandate since passage of the Affordable Care Act, which contains an array of potentially costly provisions the proponents want voters to simply gloss over. The proponents are willing to gamble because theyre doing so with your money. 16. IM17 destroys options for the most cost-sensitive consumers. The current insurance marketplace contains a range of choices from more expensive, broad-network plans to more affordable, defined- network plans. Those are choices best left for individuals and business owners. Folks buying insurance off the exchanges created by the Affordable Care Act overwhelmingly prefer narrower network plans. IM17 undermines insurers ability to craft such plans, which will limit value-driven options for low-income families. 17. Remember to vote this Tuesday, November 4 th . South Dakota voting information may be accessed at the Secretary of States website. A No vote on Initiated Measure 17 is a vote against higher costs and more unnecessary government interference in health care. A No vote aligns with South Dakota values, protecting our states families and businesses. Thanks for your interest and support this election season!
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