Christie Raniszewski Herrera
Christie Raniszewski Herrera is director of the Health and Human Services Task Force at the American Legislative Exchange Council, the nation’s largest nonpartisan individual membership organization of state legislators.
In that capacity, Christie drives model legislation, conducts research, builds coalition support, and heightens media awareness in support of free-market health care policy. During the 2006 session, ten states enacted model legislation drafted by ALEC’s Health and Human Services Task Force.
Christie previously served for two years as director of public affairs at The James Madison Institute in Tallahassee. Prior to joining JMI, Christie spent three years at the Cato Institute, where she directed all policy events at Cato and on Capitol Hill.
Christie has testified before legislatures in Florida, Kansas, Kentucky, Michigan, Oklahoma, and Wisconsin. Her work has appeared in The Washington Times, Congress Daily, Health Care News, and Budget & Tax News, among other publications across the country. Christie holds a B.S. in communication studies and an M.S. in political science from Florida State University.
Friday, October 26, 2007ALEC Passes Health Care Choice Act for StatesBy Christie Raniszewski HerreraThe failure of U.S. Representative John Shadegg's (R-AZ) Health Care Choice Act in the last Congress doesn't mean that states can't form voluntary agreements allowing consumers to purchase health insurance across state lines. That's why ALEC recently approved as model legislation the Health Care Choice Act for States (ALEC members only), which allows for the purchase of health insurance across state lines. Critics say that this kind of competition between states and insurance providers will yield a “race to the bottom” in health care. But with legislation like the Health Care Choice Act for States, consumers may purchase basic policies with as few as 13 mandates (in Idaho) or they can also choose to purchase gold-plated coverage (for example, in Minnesota, which has 62 mandates). Watch this blog for news on ALEC’s Health Care Choice Act for States in the 2008 session.
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Tuesday, October 23, 2007Daniels Begins Rollout of "Healthy Indiana"By Christie Raniszewski HerreraCategories: HSAs, etc., IndianaIndiana Governor Mitch Daniels recently unveiled a fancy, new website to administer his “Healthy Indiana Plan,” (HIP) which was approved by federal officials late last month. Like many state health reform plans, HIP has some good, bad, and ugly components. Among the bad and ugly provisions: Medicaid expansion for pregnant women and children up to 200% of the federal poverty level (FPL); SCHIP expansion up to 300% FPL; a “slacker mandate” allowing “children” up to the age of 24 to remain on their parents’ health insurance policies; and a 44.5-cent, per-pack tobacco tax to fund expansion of government-subsidized care for all individuals up to 200% FPL. We’ll have to wait and see whether or not the “good”-sounding provisions turn out to be good at all. For the uninsured up to 200% FPL, HIP will establish an HSA-like ”Power Account” that will be seeded with $500 in state funds and a mandatory contribution from the “Power Account” owner. The money can be used to buy a standard benefits package from a pool of competing insurers. If the funds are exhausted, the individual can qualify for up to $1 million in insurance benefits; leftover money can be rolled over from year-to-year, or withdrawn for any purpose. Some conservatives love the idea of “Power Accounts” – I’d suspect because, finally, a Republican governor dared to introduce an HSA-like mechanism for covering the uninsured. I’m not that optimistic. Besides the obvious crowd-out issues . . . Isn’t the tobacco tax a regressive and unstable funding source? Doesn’t “standardized benefits” mean a costly, one-size-fits-all package for everyone? And finally, are government-funded and government-administered “Power Accounts” really like HSAs, or will they become entitlements in which the government contributes more and more and individuals contribute less and less? My fingers are crossed that we’ll see some positive answers to these questions as HIP begins implementation. In the meantime, however, free-market types should remain skeptical of seemingly-expansionist health reform plans wrapped in free-market rhetoric.
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Monday, October 22, 2007The Real-Life "Dr. McDreamy"By Christie Raniszewski HerreraLast month, the Wall Street Journal’s excellent Health Blog posted the story of newly-minted M.D. Jay Parkinson, whose Brooklyn practice has no office and no staff. A $500 yearly fee buys patients two face-to-face visits (he’ll come to your apartment or office), as well as unlimited “e-visits” via cell phone, e-mail, IM, text, or video chat. Need a prescription filled? Parkinson can tell you which nearby pharmacy has the lowest price. Need an MRI or a blood test? Parkinson has negotiated big discounts for his cash-paying patients with hundreds of NYC-area specialists – and he can view your test results via e-mail and then discuss them with you via text messaging. (Parkinson is not a covered entity under HIPAA because he does not submit insurance claims; however, he has an encrypted and password-protected site through which he can communicate with patients.) Parkinson makes no bones about the nature of his practice – you have to be young and a resident of lower Manhattan or Brooklyn to be his patient (“I’m not going to deal with people who have old-people diseases,” he tells the WSJ, pointing out that other doctors specialize in pediatrics and geriatrics). But getting the “young and healthy” to be, well, young and healthy is an untapped market – over half of the uninsured are between the ages of 18 and 34, and they need this kind of low-cost, tech-friendly care in the face of New York’s mandate- and premium-heavy insurance plans. Move over, Patrick Dempsey. There’s a new “Dr. McDreamy” in town.
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Tuesday, September 18, 2007HillaryCare Redux ReaxBy Christie Raniszewski HerreraIn the spirit of not reinventing the health commentary wheel, here are some free-market reactions to the announcement of HillaryCare, Part Deux. My favorite quote thus far, courtesy of Cato Institute Director of Health Policy Studies Michael Cannon:
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Friday, September 14, 2007Frequent Fatty Cards: The Answer to NHS' Problems?By Christie Raniszewski HerreraCategories: Nanny State, Single-Payer FolliesIn a move that turns the "no-hassle rewards" idea on its head, British conservatives proposed the much-maligned National Health Service (NHS) issue "Health Miles Cards" through which patients can earn reward points for healthy activities such as losing weight, or be penalized for "unhealthy" activities such as binge drinking. Earning rewards can help NHS beneficiaries (if you can call them that) get discounts on fruits and vegetables, or even move to the top of the list for public housing. Not following the NHS' guidelines could mean the loss of some routine treatments, such as hip replacement surgery. Although the Tories should be congratulated for even this half-hearted attempt at NHS reform, further nanny-fying the NHS isn't the way to do it. Public health activists worldwide often call for seatbelts, helmets, smoking bans, and trans fats restrictions because of the costs they impose on others. But the problem isn't that people smoke, eat trans fats, or drive without seatbelts. The problem is collective health care, which restricts personal freedom in the name of socializing costs. That's why all of the "health miles" in the world won't fix the inherent problems of socialized medicine. When Britons can take full responsibility (and accept the consequences) of their health decisions, healthy behaviors will follow.
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Wednesday, September 12, 2007AFF Roundtable Event: Conservatives and Health CareBy Christie Raniszewski HerreraNext Wednesday, September 19th, the America's Future Foundation(AFF) will present a roundtable discussion on health care. Conservatives tend to get tongue-tied when discussing health care policy. Other than opposition to "HillaryCare," there isn't much agreement on a conservative response to America's health care problems. For example, some say we should focus on insuring the uninsured, while others believe that many of the uninsured are that way only temporarily or by choice. A series of different free-market plans have been proposed, ranging from Association Health Plans to health care tax credits. Should we advocate incremental steps or a bold change? Maybe reform won't be driven by Washington but will come from the states. Are Massachusetts-style health insurance exchanges a model for the nation or the latest example of phony, big-government conservatism? Joining AFF to discuss these issues are Michael Cannon of the Cato Institute, Greg D'Angelo of the Heritage Foundation, and Christie Raniszewski Herrera of the American Legislative Exchange Council. David Barnes of the Heritage Foundation will moderate. The event will take place at the Fund for American Studies, 1706 New Hampshire Avenue, NW, near Dupont Circle. Drinks at 6:30; Roundtable begins at 7:00. Roundtables are free for members, $5 for non-members. Please RSVP to Kathleen O'Hearn at kathleen@americasfuture.org.
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Thursday, August 30, 2007Advice to the Healthy: Dump Your Fat FriendsBy Christie Raniszewski HerreraCategories: Nanny StateThe New York Times reported last month the results of a study which claimed that obesity can "spread" like a virus, because when one person gains weight, close friends tend to gain weight, too. I have long said that obesity has more to do with personal responsibility than happenstance; you can't gain an extra 10 pounds by being in the same room with an obese person or a bunch of cookies. In catching up on some summer reading, I found this hilarious (and on-point) response from Cafe Hayek's Russell Roberts:
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Monday, August 27, 2007Should We Be Shaming Obese Children More?By Christie Raniszewski HerreraIn this Onion News Network parody "news" clip (warning: with some mildly-coarse language), fake pundits debate whether or not America is doing enough to shame its obese children into losing weight. As one of the clip's talking heads puts it, "A simple regimen of 8-10 insults per day can help a child lose three pounds." Unfortunately, this reductio ad absurdum argument isn't just a parody. This year, four states—Connecticut, Mississippi, Texas, and Virginia—proposed to put children's body mass index (BMI) on their report cards (or to otherwise publish or calculate the number), and New Mexico introduced legislation to study "health and fitness report cards." Aside from the physiological problems with using BMI as the final arbiter of children's health—and besides the obvious fact that public schools need to teach kids to read and write, not avoid junk food—this humiliating practice may lead to low-self esteem and eating disorders. For example, a high BMI number can pigeonhole some children into the "overweight" category, despite the fact that kids experience puberty (and subsequent weight gain) at different ages. And while it may be troubling that 17.4 percent of school-aged adolescents are overweight, it's also troubling that one-half to one percent of American women suffer from anorexia—which usually appears in early-to-mid adolescence—and that bulimia affects an additional 1-2 percent of adolescent and young adult women.
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Thursday, August 23, 2007Giving Doctors a Check-UpBy Christie Raniszewski HerreraLast year, I wrote (PDF) about the growing popularity of weblogs and online rating systems for doctors, like Rate MDs.com, where patients can share their experiences. Doctors hate these websites because patients can post anonymous, negative reviews about docs' bedside manner. Consumers love these websites because when health care "buyers" get together to share their experiences, it helps them make more-informed choices about the doctor that's right for them. I, too, am a fan of these websites -- I recently used RateMDs.com to pick my own primary care physician (users said that my doc was "wonderful, kind, and smart"). But the real benefit is that these patient-driven rating systems make health care function more like a real marketplace, where consumers can aggregate and share diffuse information. From epinions.com to Roger Ebert, we get recommendations or ratings for every product or service imaginable. Health care should be no different. Yesterday, the Wall Street Journal's Health Blog reported on an interesting twist to the controversy:
The WSJ further reports that about a third of the 1,600 doctors who pay Medical Justice’s annual fee have asked for the online-review contract since the company started offering it earlier this year.
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Wednesday, August 22, 2007SWAG Does Little to Boost SCHIP EnrollmentBy Christie Raniszewski HerreraCategories: SCHIPIn the wake of CMS' announcement that states must cover 95% of already-eligible kids before expanding SCHIP, the New York Times reported today that despite a decade of marketing efforts by government and private foundations, as many as 30% of SCHIP-eligible kids have not yet enrolled in the program. The NYT article outlines the efforts of North Carolina, a state that has eliminated waiting periods, hired translators for eligible immigrants, and hawked refrigerator magnets in the name of SCHIP enrollment. Despite the push, however, the number of uninsured kids in the Tar Heel State is actually increasing. Another article outlines the SWAG that states use to promote SCHIP enrollment, including balloons, change purses, coloring books, Frisbees, safety covers for electrical outlets, and WIC vouchers. This underscores the key reason why CMS is restricting SCHIP expansion in the first place: States shouldn't expand SCHIP "supply" up the income ladder when, despite freebies and bribes, SCHIP "demand" from the truly needy hasn't yet topped out. More than anything else, this story exposes the real agenda of state SCHIP pushers: enrolling kids for enrollment's sake in order to ensure their bureaucratic survival.
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