Mitch Berger, a Washington-based lawyer, has a rare, incurable and very expensive-to-treat cancer. He is not fond of insurance companies.

As Democrats scramble to assemble a health care reform package that a majority of the party can support, Republicans have agreed on what they claim is a quick and easy way to reduce health insurance costs. In delivering the Republican reply to the President’s recent joint-session speech, Charles Boustany of Louisiana offered the GOP plan, saying "Let's also talk about letting families and businesses buy insurance across state lines. I and many other Republicans believe that that will provide real choice and competition to lower the cost of health insurance."

It's an approach conservatives have been talking up for a while. Probably its most vocal proponent is Representative John Shadegg of Arizona, who introduced the idea formally this July with "The Health Care Choice Act of 2009." But a closer examination shows that it's the "Drill baby Drill" of health care reform--a cynical slogan masquerading as a serious public policy solution.

The basis for this approach is the work of the Council for Affordable Health Insurance (CAHI). CAHI describes itself as "a research and advocacy association of insurance carriers"--in other words, the insurance industry. Its position? That state insurance benefit mandates "increase the cost of basic health coverage from a little less than 20% to perhaps 50%". Based on this assumption, Republicans argue: To lower insurance costs dramatically, all you have to do is get rid of or drastically reduce benefit mandates.

See, the real problem is that the state governments have been passing laws that require insurance companies to offer coverage. That's a problem because is order to have your profits rise 28% over seven years, they need to take your money and give you nothing in return. So, it's a problem.

The Republicans say over and over again that the worst possible thing that could happen is these insurance companies facing competition from the government. They seem to think they are doing a great job and that costs would go down if only they could allow the insurance companies to stop covering sick people. Therefore, their plan is, as Alan Grayson pithily stated, "don't get sick and if you do get sick, die quickly."

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