Candace

Talmadge

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March 13, 2009

Don’t Look to Massachusetts to Model Heath Care Reform

The Massachusetts model of health care reform is a costly, unsustainable failure, according to a recently published study from three Harvard Medical School professors. The authors are Dr. Rachel Nardin, assistant professor of neurology at Harvard Medical School; and Dr. David Himmelstein and Dr. Steffie Woolhander, associate professors of medicine at Harvard.

Keep this in mind during the debate over national health care reform. One prominent Democrat taking a lead role in drafting health care reform legislation – Sen. Max Baucus of Montana, who chairs the Senate Finance Committee – is talking about national reform “somewhat similar to the Massachusetts plan.”

If that’s the case, the rest of us are shafted, big time. Not only will Congress have poured mega-billions of our tax dollars into failed banks with no oversight, it will “reform” health care by giving away the entire candy store to the health insurance industry.

The foundation of Massachusetts’s 2006 health care reform is a mandate that individuals and businesses with 11 or more full-time equivalent employees buy health insurance. If they don’t provide proof of purchase at tax time, they face state penalties that rise every year.

Curiously, the Bay State did not impose any reciprocal mandates on health insurance companies. Carriers are free to accept or reject anyone they like, raise premiums as far and as fast as they see fit, and rescind coverage if/when policy-holders become ill. (Premiums for the four state-subsidized insurance plans rose 9.4 percent for 2009, far outpacing inflation.)

The result of this lopsided deal, the Harvard physicians note, is so-called reform that, unlike its proponents’ promises, does nothing to rein in soaring costs and actually adds to them with an extra layer of bureaucracy called the Massachusetts Connector. Under reform, the state’s health care tab has soared from $629.8 million in fiscal 2007 to $1.1 billion in fiscal 2008, and is projected to be $1.3 billion this fiscal year.

And, after all that, Massachusetts-style reform still does not provide universal health insurance coverage. Between 20 percent and 33 percent of the state’s uninsured in 2006 remain that way, according to various calculations cited by the study’s three authors.

Baucus has mentioned a combination of private-public health care reform. Is this what he means? Massachusetts-style reform privatizes the profits for the health care insurers while shifting onto the public – state taxpayers – the risks and ever-rising expenses. On a national scale, we simply cannot afford this kind of private-public partnership.

The study’s authors also make a key point too often overlooked in the discussion. Increasing access to health insurance does not guarantee access to actual health care. In many cases, low-income Massachusetts residents whose physician office visits and prescriptions used to be completely free now face unaffordable deductibles and must do without health care as a result. This kind of reform is not an improvement by any stretch of the imagination.

Just as bad, Massachusetts reform shovels Medicaid dollars toward expensive care such as CT scans and surgeries, diverting the funding from basic health care that can reduce the need for more costly measures. This year, to meet soaring costs of the program, the state siphoned $150 million in tax funding from hospitals and community clinics that provide primary care and, prior to reform, functioned as the state’s health care safety net.

The authors note that Massachusetts isn’t the first state to attempt health care reform. Since 1988, Oregon, Maine, Minnesota, Tennessee, Vermont and Washington have all tried to provide universal health insurance coverage – without success.

The problem, of course, is conflating health insurance with actual health care. The two are not the same. Unless and until our legislators get this message and act accordingly, we can all look forward to outrageously expensive health care reform that still comes up far short of its goal.

© 2009 North Star Writers Group. May not be republished without permission.

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