“Government-mandated?” Yes. In Massachusetts there is a mandate that all residents carry insurance. But government-run? Not really. Massachusetts does set the rules for state-subsidized coverage, which is provided by private insurance companies—Blue Cross Blue Shield, primarily—and also for the state’s shopping service. That’s no different from a state setting rules and regulations for other businesses. But the term government-run implies that the government has taken over selling health insurance and curing sick people—hardly the case. Like socialized medicine, these terms cry out for more explanation and discussion. If a news outlet can’t do that, perhaps it’s best not to pass them along, since misleading and sometimes downright deceitful campaign rhetoric fools the public.
Perry got some new talking points for his chat with assorted Iowans when a market-oriented think bank in Boston, the Beacon Hill Institute, released a report saying that the Massachusetts health law had driven up insurance costs by $4.3 billion and the state’s health care expenditures by $414 million. “Think about what ObamaCare is going to do to this country,” Perry said. The media jumped on this new information, but again did not provide any way to judge whether the think tank had a point, or whether it was providing only half the story. More money is spent on health care in the state because more people are insured and are using services. Total health expenditures equal the number of services times the price of those services, and the price of those services is the highest in the country. So insurance premiums haven’t decreased, especially for small businesses. Hospital costs, which account for the bulk of the state’s spending on medical care, have not gone down either. Since 1997, hospital costs in Massachusetts have been rising relative to the national average, and have continued to do so before and after the law passed in 2006, says Alan Sager, professor of health policy at Boston University’s School of Public Health. It would be good for the media to explain all this next time Perry throws out numbers.
It looks like the Massachusetts health plan is going to be a spark plug in the primaries and beyond. The public needs the straight scoop on health care in the Bay State.
While I agree that Romneycare is not socialized medicine (see http://byrondennis.typepad.com/masshealthstats/2011/02/romneycare-is-not-socialized-medicine.html), you make many facutal errors below:
You say:
"While the state operates the exchange, it sells nothing..."
Yes it does. If you buy through the exchange you write a check to the state. The state acts as broker.
and
"...and underwrites no insurance."
Depends on how you mean that. The state certainly underwrites Commonwealth Care in the finanical sense and the Connector Authority does all the actuarial work to decide what the Commonwealth Care premiums will be.
Perry says:
"The problem with state-sponsored health care is that you cannot contain it just within the borders of your state." True
"When that plan took effect, it also increased Medicare/Medicaid costs..." True in the sense that it raised all costs in general and Medicare supplemental and Part C premiums in particular.
“... government mandated, government-run health care is part of what he put in place as the governor of Massachusetts.” True in that everyone on all sides of this issue simplistically leaves out the word insurance when talking about reform. Massachusetts has done nothing since Dukakacare to try to regulate healthcare; it has always been regulation of healthcare insurance.
You say:
"That’s no different from a state setting rules and regulations for other businesses."
Not really. The state of Massachusetts literally says what has to be in a healthcare insurance policy and does not let insurers sell catastrophic insurance. Much different than the way your portray it.
You say
"So insurance premiums haven’t decreased, especially for small businesses."
They have increased in proportion to the state mandates for minimum creditable coverage, not because of the reasons you proposed.
You say
"Since 1997, hospital costs in Massachusetts have been rising relative to the national average...
Right. And not coincidentally, that was the year of Celluccicare. All the attempts by Dukakis, Weld, Cellucci, Romney and Patrick have been absymal failures because all tried to manipulate a market.
#1 Posted by Dennis Byron, CJR on Mon 19 Sep 2011 at 05:15 PM
What Dennis said!
Damn! It's nice to see somebody else ringing the Reality Bell in Lieberman Liberal La La Land...
#2 Posted by padikiller, CJR on Mon 19 Sep 2011 at 07:52 PM
"Manipulate a market," huh? There's your trouble. Health care is not a market. It is a right associated with the human condition. Insurance is a market, and the attempts to suppress its ill effect on people fail because all such attempts are half-vast. We never needed health care reform. We need insurance reform, and as long as we allow market-driven forces (meaning profit-mongers) to control it, we will fail.
#3 Posted by Pete, CJR on Tue 20 Sep 2011 at 08:18 AM
But meanwhile Perry supports Tx law that requires proof of liability insurance. Is this the war on poor people I lost my job,now they don't deserve to drive. Most people aren't aware that if you get caught in TX with no liability insurance your vehicle can be towed, you will be assessed a $450 ticket, must provide proof that you have obtained insurance which cost $100 to file and a $260 annual surcharge for 3 years or you lose your license. Nearly $1,500 in fines and surcharges for someone that was obviously too poor to afford insurance. Is this fair well its the law under Rick Perry and yet he thinks mandatory heath care is unconstitutional and socialized. How much did the insurance companies donate? You may argue why not use public transportation well in short it sucks whatever normal travel time would be multiply it by 4 and it isn't available everywhere.
#4 Posted by Aera, CJR on Wed 21 Sep 2011 at 07:08 PM