David Himmelstein, along with co-authors Rachel Nardin and Steffie Woolhandler, have gotten an awful lot of press this past week. On February 18th, they released their paper, “Massachusetts’ Plan: A Failed Model for Health Care Reform,” and we’ve seen it reported across media. Jon Kingsdale, Jon Gruber, and others have rebutted the clear mis-statements and inaccuracies in the piece. Putting the facts aside, I’m now irritated enough by Himmelstein to blog.
The most significant argument we’ve gotten from the left on Chapter 58 is that it’s incremental; it doesn’t get to true universal coverage. Now, I’m like the rest of the folks over here at 30 Winter Street – we’d all like to see 100%. But we’re elated with 97%. 97% coverage is over 440,000 new individuals covered by health reform. It sounds like Himmelstein would rather those folks not have any new coverage.
This was posted on The Health Care Blog a week ago:
Last winter, Himmelstein spoke about health reform to students at Johns Hopkins School of Public Health. I asked him if single-payer advocates would work against any national reform effort that wasn’t single-payer, as the single-payer camp did in California. Himmelstein said that if the reform plan looked like the Massachusetts reform he probably would prefer the status quo. He believes the reform has made most vulnerable patients in Massachusetts worse off.
If you’re not a numbers person, if 440,000 in a state of 6 million doesn’t resonate with you, how about some personal stories? For the past six months, we’ve been posting on this blog real accounts from our Helpline callers (and every single outreach and provider institution in this state has their own long list to add). Though their names have been changed, their stories are real. There’s Chris and Lynn, who didn’t have enough money to get to work before health reform. Mario, whose prostate cancer was caught and covered by Commonwealth Care. Sandra, whose CommCare coverage gave her and her husband the security to plan and have a baby. How about Jorge? Or Erica? Nanda?
Each of these individuals and their families have benefited – physically, mentally and emotionally – thanks to health reform.
Don’t tell me you’d rather have the status quo.
Lindsey Tucker
I just noticed your disclaimer at the bottom of my first post that says “comment edited to remove personal attacks.” The text that you removed from my original post had no personal attacks any more so than Scott’s comment or others that have been posted on HCFA throughout the past several years. I believe you can’t take the references I made to some truthful statements such as, Get over yourselves, as well as what I point out in my second post, if you actually put that up with no edits.
Obama spoke of hope and change. I don’t see it, not when he agrees with a scam like this. I listened carefully to his campaign rhetoric as it changed along the way – some in MA are worse off than before – that was made at the table with Tim Russert in winter 2007 – and other times when he referenced MA again saying pretty much the same thing – people in MA are paying penalties and still have no insurance – while Kennedy and Patrick were standing behind him. Then he stopped referring to MA and started using other language to conflate HR676 Medicare for All with his “Medicare-like” plan. It was so obvious. Too bad that he allowed someone to shut him up b/c this action alone does not represent change, and health care reform based on the MA model does not represent hope.
It represents oppression, and will be, in the end, more of the same.
Golly, gee. You edited out parts of my post. What’s the problem? Did you think that people don’t realize the MA plan appears to be gov’t-sanctioned coercion and collusion? Maybe, you just got tired of seeing this point mentioned so many times on your blog, and now that people in this country have started to shout out that the MA plan is a failure, the truth is beginning to irritate you? btw, did you listen to the Congressional Forum that took place in the Rayburn Office Building in D.C. on Feb. 25? Standing room only. That must have been REALLY annoying to all of you b/c you didn’t post a link to it on your site like you did for the Brian Williams’ broadcast re the MA plan.
When Dr. Susanne King’s opinion piece, “Mass. healthcare reform is failing us” was published in the Globe on March 2, 2009, the next day or so, Brian Rosman – to name just one on the team of usual suspects – came out in defense of this nightmare per usual. We figured the Globe published Suzanne’s piece to give all of you an opportunity to quell the truth, and, of course, the many LTEs that agreed with her were not printed.
Obviously, you can’t handle the reference to the specific time in history that I broadly hinted at, but here’s some breaking news: many equate the MA terror to the Third Reich in somuchas it has SIMILAR (but not all) aspects. Some equate it to “Let them eat cake!” If I had made reference to Marie Antoinette, would you have taken out that paragraph? You reveal your need to defend yourselves by what you choose to edit!
What you, your friends in the industry and the politicians who march in lockstep with leadership (refusing to hear the cries of their contituents) have done by supporting this so-called “experiment” even though YOU ALL KNOW it is exploiting and harming people is similar to MANY events in history that have targeted a certain class of people. This MA mess wasn’t an experiment to find out if the scheme would work – had that been the case, the powerbrokers and Gov. Patrick et al would have said, Hey, this isn’t such a good idea – it’s harming many, it’s not fiscally responsible, etc. But, alas, the real goal was to put something in place that could be used as a marketing tool so it could be sold to the public and members of Congress in D.C. as a model for the nation – something that would insure profits for the industry which has paid multi-mega bucks to “insure” (LOL) this will happen. A single-payer system would remove profit, and the fact that the majority of people in this country want an equitable, fiscally responsible model of health care (which single-payer would deliver) must scare the heck out of the industry.
Whether it’s 95, 97 or 100 percent, having an insurance card doesn’t provide access to GOOD CARE that is AFFORDABLE and EQUITABLE. That is why America has a health care crisis, and the MA model only serves to perpetuate the status quo with one change – we will ALL be sold down the river to the profit-driven insurance companies – the dollar signs in the eyes of the CEOs of these companies glow in the dark as they smack their lips and drool all over their shoes.
Is it fair to force people into crappy insurance plans they can’t afford or, worse, can’t afford to use? Is it equitable to determine eligibility and affordability based on line 22 for some, but line 37 for others? This is discrimination. Is it equitable to force people into subsidized plans, thereby giving them no choice of doctors (if they can even find one who will take them within a 50-mile radius) b/c the reimbursement rate is so low and the paperwork so onerous, the docs don’t want anything to do with Commonwealth Care? Some can’t stay with the docs they had which is very discouraging, especially for patients who were being treated for an ongoing disease – people are fussy about who treats them, and the subsidized plans remove choice. Is it good business practice to mandate that people sign a contract that clearly states the terms might change after the person has signed, but b/c the insurance is complusory, if the terms do change they don’t have a right to drop the policy? Stop trying to hide behind the text “Under current practice this does not apply to Commonwealth Care.” Our attorneys have looked at that and roll their eyes. That is outright trickery and is unconscionable. Is this what U.S. Sen. Max Baucus (D-MT) refers to as “uniquely American?” Guess so!
Speaking of Mr. Baucus, he should recuse himself from any health care financing reform leadership position because during 2003-2008, he received $588,185 from the insurance industry and $523,313 from the pharmaceutical/health product industry according to the Center for Responsive Politics. How can anyone including a U.S. Senator be an objective health care policy reformer when he has received over a million dollars from insurer and pharmaceutical organizations? The answer to the question is that HE CANNOT be objective and should be removed or have the integrity to resign from any health care reform leadership position. The same goes for all who were involved with the concept and implementation of the unfair MA mandated health insurance law. Someone should explain the term Conflict-of-Interest to all of you.
As for HCFA-MA, what it boils down to is none of you can handle the heat – you have all been bought and paid for by the insurance industry or you drank the Kool-Aid. Scott’s comment above hits the nail on the head as do the posts of many others over the past two-plus years. What is going on in MA only promotes hatred by those who are being exploited and/or harmed, and the numbers are growing. When this sucker is rolled out across the nation, the people in the heartland – people like Ron, Scott, me and thousands of others in MA – won’t stand for it once they figure out what hit them.
So, in the name of fair and balanced – a/k/a all points of view whether you like them or not – let’s try again:
There are some in MA who are running a protection racket for friends in the industry. Buy the insurance and nobody gets hurt! Why don’t you just round up all the uninsured and cart them off to a Camp for the Uninsured? You could put a sign over the gate that reads: Health Insurance Macht Frei. We can work on some of the shovel-ready projects for free, and the money the state saves can go toward refunding the senior prescription drug coverage program that Patrick slashed in his last round of 9c cuts.
To MA. MANDATED insurance supporters,
You’re part of a well financed spin machine and do a great job. It’s all rather obvious- this machine will whore the American public out to the highest bidder while hiding behind shameful “coverage for all” antics. The irony is you are all Luddites advocating an anti-American anti-progress agenda on behalf of your big money masters. I’m a Massachusetts resident living under the MANDATED healthcare that our health insurance foot soldiers in Boston rolled out across us all. Now Washington hopes to do the same to all of America. In MA. a healthy 49 y.o. couple with $42,500 GROSS, not net, redistributes around $7000 yearly to insurance companies profit lines with 20% co-pays, $2000 deductible and a policy full of holes. There is no middle ground when you so blandly go about destroying the financial future of those you purport to protect.
I do not want something for nothing-we bought our own coverage for years-but what has been foisted upon MA. residents here is extortion and on the grandest of scales. I know what coverage cost and covered. When you consider MA. Mandated insurance was negotiated thru collective bargaining as coverage for millions it can ONLY be viewed as an absolute disgrace in depth and cost. Look around the globe and you’ll see comparatively what a disaster our healthcare system is, that our own leaders would toss us into this abyss as they have in MA. is unconscionable. Mandated insurance is a scam and you are part of the heist. “Who listens” matters a great deal when those talking are studiously ignorant they’ve become part of an industrial machine meant to exploit those being spoken to. This is no surprise as those with a vested interest in Mandated care assume the shape of that to which they cling-look in the mirror to see what you’ve become.
People are worse off than they were before, and I, too, along with Dr. Himmelstein, Ron Norton and others will continue to fight anything that looks like the MA fraud disguised as health care reform. The stress this law has caused us is very bad for our health, and we have suffered physically, mentally, financially and emotionally. So, how about Jackie, Darlene, Terry, Scott, Fran, Ken, Ron, Elisa and many, many more I know who were better off pre-Chapter 58 including several small business owners who are personal friends?
It strikes me as odd that an organization that calls itself Health Care for All is only interested in personal stories of those who have BENEFITED physically, mentally and emotionally – Nanda, Jorge, Mario, Erica and the others you mention in your post. Do the sources of the butter on your bread require hiding the rest of the deal in MA? If so, you do a great disservice to all Americans who deserve to know what might hit them smack in the face and change their lives – and for far too many, not in a good way if the nat’l plan resembles the MA terror. This is why we refer to your nonprofit as Health Care for Some.
If all of you are proud of what you have done to the more than 300,000 residents who have been and continue to be gravely harmed by this poorly thoughtout decree, then you are broken souls. To claim success when a large segment of the targeted population is being exploited shows just how desperate you all are, and it is you who have failed if you believe that coercion, intimidation and squelching the truth is rendering service to the residents of MA and the citizens of this nation. Unfortunately, the large contributions you receive from the vested interests, and the collusion of the latter with government and the media has provided plenty of censorship. I profusely thank Dr. Himmelstein and many others who have a big microphone and are willing to speak out.
Massachusetts mandated health insurance and any national program modeled on this scheme does not incrementally lead to Universal Health Care. It leads in the opposite direction as it continues to fill the profit coffers of your friends in the medical industrial complex and does not provide access to AFFORDABLE, EQUITABLE, QUALITY CARE for ALL as we have CLEARLY seen here in the Bay State.
Oh, by the way, your numbers are wrong. The 97 percent insured MA residents is more like 95 percent, and is not 95 percent of MA residents but 95 percent of the 86 percent or so who filed a tax return for 2007 AND a completed Schedule HC claiming they had coverage. Big difference.
[comment edited to remove personal attacks]
Charley,
I really don’t know anyone who has been helped by Chapter 58. I do, however, know plenty of folks who will be penalized for declining to purchase insurance that they can’t afford. I also agree that single payer is the best scenario. This is part of the problem, Chapter 58 stands as an impediment to real progress. It has not accomplished any of the stated goals. It hasn’t lowered costs, there is no evidence it has improved the quality of care, and many of the newly insured can’t find physicians who will treat them. Essentially all the law does is throw huge sums of money at a failed system. I’m not for denying anyone care. I’ve been a healthcare provider and medical educator for the past thrity years. I know how dysfunctional our deliver system is. I am also an employee of the Commonwealth, but I am not eligible for insurance through my employer because of my 03 status. It is tremendously hypocritical for the state to deny me coverage on the one hand, and fine me for not having it on the other.
Charlie,
I assume you have health insurance?I do not,I cannot afford it.I am a 58 year old homemaker,my husband is retired.(forced to retire because of health issues)he has medicare for $96.00 a month.What we have in this state is discrimination against the uninsured by income and age.I don’t know your financial situtation but most people that are middle income and do not work for a big company cannot afford the insurance.When we had health insurance through my husband’s work was the only time it was affordable.We cannot afford the high cost plans with high dedutables but noone in this state seems to care.
I personally know many people who have been covered or otherwise helped out under the new law. Himmelstein’s assertion that the status quo would be better is flatly insane. Single-payer would be good; he and I agree on that. But he is a fanatic and an ideologue — more concerned with concepts than with flesh and blood — if he really thinks we’d be better off without Ch. 58.
That last sentence should read: You wealthy, insured propagandists…
Ms. Meredith,
HCFA is a virtual organ of the insurance industry at this point. Perhaps you are willing to write off the fact that thousands of Bay State citizens are being harmed by this law (the tax fine steals food from my daughter’s mouth), but I will continue to speak the truth about Chapter 58 and its colateral damage such as my family. You wealthy insured propandists can continue to repeat the lie that this scheme is working I’ll keep telling it like it is!
What I appreciate most about HCFA’s work in health reform is their commitment to a universally held community value that everyone deserves adequate quality affordable health care.
And they have remained consistent to that value one incremental increase in access one step at a time. It’s been a tough slog for an underfunded organization working on 6 or 7 different health campaigns from improving access and quality to addressing disparities to implementing outreach and retention to payment reform to oral health to mental health to private insurance reform.
And the most disheartening to me, and I should be used to it by now, is all the negative energy that is spent trivializing and disrespecting the advances HCFA has made.
Lindsey has more important work to do than defend HCFA from this nonsense.
I will share with her and the readers here Barney Frank’s story about the young Rabbi who asked a senior Rabbi how to cope with all the complaints about his carefully prepared thoughtful, but still not quite perfect sermons. The answer from the senior Rabbi?
“Who listens?”
Let’s not forget that HCFA is a beneficiary of this program. The Comm. of Mass gave them over $100,000 last year. All of the Mass. ICs are listed as donors.
The majority of the beneficiaries of this program are paying little or nothing for their care. This essentially isn’t any different from Mass Health or Free Care. What this has done is force the healthy and young into buying insurance to make these programs free or nearly free. How many of the 440,000 pay $75 or more per month for coverage?
You still have the vast middle class of individuals and small businesses that are forced to make hard decisions. I am meeting later today with a business with 45 lives that is seriously considering dropping coverage completely. 45 lives at about 8K per year is about $360,000 a year. They pay 75% of the bill or 270K. They are dropping to 50/50 or dropping coverage, or laying off 20% of their work force.
Lindsey if the choice is between forced poverty for those of us unduly coerced into buying lousy private insurance products or the status quo, I’ll take the latter. What you have done at HCFA is enslave the middle class to the insurance industry, and supported draconian fines for noncompliance. You’ve expanded coverage for a portion of the population and handed the rest of us the bill. The MA plan is a wasteful and expensive scam and should not be considered as a national model.