POLICY: Is Romney the next ‘liberal’ governor of Massachusetts?

Here’s my editorial in today’s FierceHealthcare:

The passage of a universal health initiative in Massachusetts is big news. Of
course it was also big news when a certain Michael Dukakis rode that headline to
the Democratic nomination in 1988. This week a Republican governor with strong
social conservative credentials, albeit one from liberal blue state, is hoping
that the same headline will propel him to his party’s nomination twenty years
later. Naysayers on the left and the right point out that there are plenty of
holes in Romney’s plan. It depends on Federal dollars to fund Medicaid
expansion. It demands that individuals buy affordable insurance while it may
just be cheaper for them to pay the $1,000 fine. The same problem is doubly true
for employers not offering insurance who only have to pay the equivalent of one
month’s regular insurance premium–an assessment not a tax, you understand. And
of course it does nothing to rein in the underlying increases in care costs,
which are as high in Massachusetts as anywhere.

But the politics and the symbolism of this news are well worth watching. Most
observers of the health care system are agreed that we are in a crisis and
things are getting worse. Costs are going up, insurance is becoming less
affordable, employers are dropping coverage, and the population is getting
older, albeit only one year at a time. At some point we have to have the big
conversation that hasn’t happened since 1993-4. If a leading Republican feels
that he needs to support universal health insurance–a traditionally Democratic
issue–then we may just be seeing the ground symbolically prepared for the
coming debate. On the other hand, we might just remember what happened to
Dukakis and his universal health insurance legislation.

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8 replies »

  1. “Is Romney the next ‘liberal’ governor of Massachusetts?”
    Hardly, it was just announced that Romney had vetoed the part of the bill that imposed a fine for businesses that don’t contribute the $300/mth/employee. I guess he’s going to keep the fine on individuals. So much for the, “We’re all in the same boat and need to share the load” approach to policy.
    This thing is shaping up like Bush’s drug benefit plan – tax dollars funneled to private business at a rate that keeps profits and revenues in place, as well as campaign contributions.

  2. For sure restrictive malpractise lawsuit legislation helps docs and insurance companies. What does it do for patients hurt by doctors? Just because there are less lawsuits due to provider friendly laws doesn’t mean there is less malpractise, just less access to compensation. So if Texas saw a 60% drop how did that impact insurance premiums for healthcare and docs billings and docs defensive medicine? Any change or just better profits?
    Seems to me docs and for profit hospitals are getting rich from “over utilization”, insurance companies seem to be doing ok to. Why are you complaining? As for employers providing healthcare, well that’s just competition for workers by business acting in an open and free market. Why are you complaining? Should the guv’mt have stepped in and restricted “free enterprise”? Yea, we don’t have rationing here.

  3. When you start talking nonsense about how medical malpractice reform isn’t necessary then I know you know very little about this subject. My malpractice premiums have more than doubled in the past few years, all with no claims against me. Every state I can think of that’s enacted reforms has seen premiums down or stable, and a big drop in malpractice lawsuits. For example, Texas saw almost a 60% decline in cases. That tells you how many bogus lawsuits are being filed in this country, costing everybody money. There are places in this country where you’d have to travel hundreds of miles to find certain specialists, and it’s all because of nonmeritorious lawsuits by patients with the Lotto mentality.
    And no, free enterprise didn’t get us here. What essentially got us here was employee paid for insurance, which was tax deductible to the company paying for it, and that didn’t require the patient to spend much out of pocket, which has led to overutilization of services, skyrocketing malpractice premiums, demanding Americans who always want the latest medications, tests, and treatments whether they need them or not, and a culture that will not stop trying to prolong the lives of elderly people who should not be receiving any type of aggressive treatment. It has nothing to do with free enterprise per se. Of course, socialism would fix all of that because rationing of everything would occur so that you’d be lucky if you could even get rudimentary care. Seems like cutting off your nose to spite your face doesn’t it?

  4. Didn’t free enterprise in healthcare get us to this point? Free enterprise works great in most everything else except heathcare. In all other sectors people of all different incomes get to choose how they want to participate in the economy. Can’t afford to buy – rent, can’t afford a new car – buy used, etc. Healthcare does not give anyone these kind of choices, everyone has to pay “the rate”. But the rate is driving many people to bankruptcy and leaving many providers with nothing but bad debt write-offs. The real advantage of a government run single pay system is cost reductions and savings and a bigger pool. Yes a lot of those cost controls are painful but where does the U.S. stand now, tinkering around the edges and not fixing anything while our dishonest politicians do nothing but pander to the big money groups that fund their election campaigns. My recent insurance increase was about 40% due to an age incease bracket and the usual double digit rate hike. My compounded rate increases have averaged over the last 6 years about 13%. I did some extrapolation to 10 years out based on these inceases and in 2016 I would be paying about $800 per month (not including co-pays & deductibles) for what really amounts to catastrophic coverage. If I continued to pay these premiums I would pay about $75,000 to my insurer, a so called “not-for-profit. Tell me how this economy can afford these kind of increases? Tell me why this one industry deserves to get so much of the economic pie? I am healthy and take reasonable care of myself and so I decided I was not going to play the game any more, I cancelled my insurance and will deposit my own premium into a money market account to be used for my own healthcare as my insurer had done pretty well by me over the last 6 years. I ended up paying for all my medical needs anyway and then some. I’ll let the other sick people get their healthcare costs paid by someone else, not me. I can go to Thailand or Canada or India or Europe for about 25% of the cost here. Hows that for free market forces! And for all those so-called free enterprisers who think the government should stay out of free market intervention, look where they’ve gotten us. As a “liberal” I would have taxed costly human behavior and put that money in a pool to be used for what we have now, a growing, sick, aging population with diabetes and heart disease. Fat food, high sugar, no exercise, alcohol, smoking, would have all been taxed if I had my way, and the money dedicated to the healthcare consequences we have now. That’s responsibility because the so-called “personal responsibiltiy” conservatives actually believe in cost transference to someone elses books, usually society’s, while they get rich promoting bad behavior. Does that sound like irresponsible socialism? There is no free lunch but the blind free marketeers are no better than the Russian comis who thought they could go on pretending to pay people while people pretended to work. Disbanding ideology will start to fix this problem but as usual our political leaders like to wait until they are in a position to elbow their way to the front of the lynch mob.
    And as for the red herring of malpractise suits being the cause, check this out: http://www.citizen.org/congress/civjus/medmal/articles.cfm?ID=9125

  5. No Peter, the “old time religion” is socialism.And, socialism has been proven so many times to not work. There’s no reason tho think it’ll work here, when it doesn’t work anywhere else. There’s no way Americans will tolerate being told they can’t have an MRI, they can’t have surgery for this or that, they can’t have the newest best medication, they can’t see a specialist for nine months, etc. etc.
    Will the pols in D.C. be stupid and lazy enough to bring us to a nationalized health care system, or will they have the balls to work on free market fixes to our current problems, like medical malpractice reform, allowing people to shop around for health insurance all over the country instead of just within the state they live in, etc.

  6. Just another thought, how will this country’s reliance on low paid undocumented workers/turned citizens(or not)affect the Mass. plan? As we prepare to welcome all these illegals into the citizenship home, with most not able to afford any “premium”, where will the premiums go for those who meet the income level to pay the $300? I just love the benefits of low income workers, trouble is these workers are not offshore and so we will bear that cost.

  7. Industry will drive the push for a universal system as they try to compete with other countries providing universal care, costs will then drive a government run system. The problem now is the religion of free enterprise capitalism/competition ideology that prevents people from seeing any alternatives. Hang on to that old time religion. But the increasing number of healthcare cost bankruptcys will turn the most faithful into a reformer pretty quick.

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