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Massachussets-style health-care reform: results are in

A group, Physicians for a National Health Program, has an interesting press release, distilled from an "open letter" signed by 250 doctors in Massachussets. (I learned about it from CJR, which says that it's not getting any media coverage.)

The ostensible goal of the program is to "provide residents with medical insurance", that is, by requiring them to pay for health insurance. If they don't, they will be fined. If they're a certain distance below the poverty line, there's a tax refund for the insurance. Employers who don't provide health insurance to their employees are also fined.

So, how's all that working out?

  • only 37% of the previously-uninsured currently have coverage
  • only 16% of those who qualify had enrolled in the subsidy program
  • barely 7% of those whose incomes are above the line have coverage (suggesting that the line is too low to be practical)
  • fines for employers who don't provide insurance are 80% below projections, "the funding gap will widen in future years as health care costs escalate and insurers raise premiums."

Most significantly, 79% of those previously-uninsured who are now covered under the new program would have had free coverage under Medicaid or similar plans before, but now have co-payments, "in effect, public funds for care of the poor that previously flowed directly to hospitals and clinics now flow through insurers with their higher administrative costs."

While patients, the state and safety net providers struggle, private insurers have prospered under the new law, and the costs of bureaucracy have risen. […] All of the major insurers in our state continue to charge overhead costs five times higher than Medicare and eleven-fold higher than Canada's single payer system.

Emphasis mine. So who, exactly is this plan benefitting?

Template, meet Results

Why is all this important? Because Massachussets' law could soon become a template for the rest of the country. Presidential candidate Mitt Romney brags that he created this program, and candidate Hillary Clinton's health-care proposal shares many fundamental similarities. Governor Schwarzenegger has a proposal on the table in California that seems practically identical to the Massachussets plan.

Someone, somewhere, when you get access to these politicians, please ask the question: if the plan isn't working, why copy it?

Permalink • Posted in: 2008 election, politics, rant