Health Insurance Exchanges: One More Smokescreen?

Roger Cohen of the Times has recently weighed in on the health insurance debate with a piece that dissects our American psyche as self-reliant individualists. He says "A public commitment to universal coverage is not character-sapping but character-affirming. Medicare did not make us less American. " Looking at the increasingly dizzying array of "options" that try to steer us away from a public option is evidence enough of the effort to torpedo real reform. The latest boondoggle being floated (or flouted) is the notion of health insurance exchanges.  

Cappy McGarr who was President of the Texas Insurance Purchasing Alliance has this to say about the Texas experience with healthcare exchanges: "Our exchange failed not because it wasn’t needed, and not because the concept wasn’t sound, but because it never attained a large enough market share to exert significant clout in the Texas insurance market. Private insurance companies, which could offer small-business policies both inside and outside the exchange, cherry-picked relentlessly, signing up all the small businesses with generally healthy employees and offloading the bad risks — companies with older or sicker employees — onto the exchange. For the insurance companies, this made business sense. But as a result, our exchange was overwhelmed with people who had high health care costs, and too few healthy people to share the risk. The premiums we offered rose significantly. Insurance on the exchange was no longer a bargain, and employers began backing away. Insurance companies, too, began leaving the alliance." 

What will the next show of smoke and mirrors be?