“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.