Health Care Reform: What We Can Learn From Massachusetts, Revisited « NEOAVATARA

Health Care Reform: What We Can Learn From Massachusetts, Revisited « NEOAVATARA

This is an old post, with a few revisions, but I thought it was worthwhile to go back and look at it again.

In 2006, then Governor Mitt Romney, with the assistance of Senator Ted Kennedy and a largely Democrat legislature, passed the first of its kind universal health care plan in Massachusetts. The law mandated coverage, while taxing those that opted out of coverage heavily. The state offered subsidies to low income individuals, taxed businesses, and set up a state system called ‘the Connector’ to match patients with insurers.

Well, if the goal was to approach universal coverage, it was partially successful. Approximately 97% of Massachusetts residents are now covered…but better than the 84% rate nationwide.

However, the story is not all good.

There is a growing segment of the poor that claim that they have been harmed by the plan. Why? Because the premiums, albeit subsidized, are still significant for a person in the poverty level. Many claim they are actually poorer now than before the plan. Because they have less expendable income, many cannot afford the deductibles and co-pays for the medications that they have been on for years.

And to compound matters, they complaining that they are not necessarily getting better care. Why is that? In the old system, there was numerous networks of free clinics that provide on demand care. That system’s was eliminated, with those funds going to the general health care fund. Now, these people must wait for access to the general physician pool. The problem is, there aren’t enough primary care physicians (PCP) to meet the demand. Over half of the PCPs in Massachusetts are closed to new patients, an increase from just 31% in 2006. The average wait time for a new patient to get an appointment? 50 days.

Liberals that support a single payer point to these problems as a reason why this kind of system cannot work. I agree. I also believe, however, that many of these problems would exist in a single payer system. For example, the number of PCPs is finite…no system is going to quickly change that, other than massive overhaul of our immigration and medical licensing practices.

Also, the one failure that all of these government mandated programs have is a simple one: they have no method to control costs. Ultimately, whether private or public in nature, and universal system must confront this 800 lb gorilla. And, like I have stated many times before, the only answer is rationing, ala the British, French, Canadians and virtually every other nation that liberals enjoy pointing to as the standard of care in the world. Now, there is nothing inherently wrong with rationing, but we need to be honest about it when discussing it with the public.