As the health care debate came to its surreal end earlier this year, I had to remind myself that I was from Massachusetts. That was bound to color my perspective. But honestly, nothing Massachusetts has served up prepares us for what we’ll see if we try to implement a similar system country wide.
When the Massachusetts plan took effect in 2007, I thought: what do you expect? This is the People’s Republic of Massachusetts. This is the same place where rich people in Cambridge still think it’s okay to have rent control. One stupidity leads to another. For all that, I never thought Democrats in Congress, and Democrats who support the Democrats in Congress, would be so stupid as to enact a plan like the one they did. Completely blind to their foolishness, they even pointed to the Massachusetts plan as a model for federal health care reform!
The Massachusetts plan is a slow motion train wreck, to be kind about it. It’s supposed to save money, but of course it costs way more than the state can afford. The plan is supposed to make health care accessible, but access to regular health care is still endlessly complicated, especially for people who don’t have employer based health plans. The plan is supposed to be comprehensive, but people who are unemployed, who may be employed part-time or seasonally, or who work as independent contractors are stuck with financial burdens difficult to bear. God help you if you don’t have a regular job with benefits. The state will come after you to make you pay a fine for not having health coverage.
Even more significantly, the state wrangles with health insurers about coverage for small business employees. The insurers put in for something like 268 specific rate increases for small business plans. The mere number of applications suggests the level of detail in the state’s oversight. Well let the negotiations begin. The state denies most of the requested increases. The insurers say we can’t cover our costs at the old rates. The state says, “Tough, sell the insurance at the old price.” The insurers object that they can’t do business at a loss. The state says, in effect, “You’re just a bunch of money grubbers anyway, and we’re going to make you sell this insurance.” You can see where this dispute is headed: nowhere. Meantime the small business employees must wonder if they’ll be fined for not having health insurance!
We’ve seen this kind of thing before. The state comes in saying it’ll make things better, and it makes things worse. It says it stands for the little guy, and the little guy gets crushed. It says it’ll take care of all the complications – all the rules and oversight and management of financial transactions – and it leaves another costly trail of failure, disappointment, and questions about how things could go so wrong.
Remember how the congressional leadership crowed when health care reform passed? They pointed to Medicare as a wonderful first step, to the Massachusetts plan as the future of health care, and to their own legislation as a crowning success. They hugged and smiled and overflowed with good feeling for each other. Just ten months later, the same members of Congress are up for reelection, and they’re not so smug and smiley anymore. Some of them will lose their seats because of their stupidity. Whatever happens in the November elections, we have to get rid of this health care reform, fast. Some three million people may have to live in the People’s Republic of Massachusetts, but do we want hundreds of millions in the entire United States to suffer a similar loss of freedom?