The ongoing discussion of the relevance and lessons of Massachusetts health reform for national reform keeps on going. But maybe now there will be some clarity.
Yesterday a thoughtful voice entered the conversation and tried to set everyone straight. Anthony Wright, Executive Director of Health Access California, settles the issues in Is Massachusetts a Model, a Mirage…or Moot?. As the leader of the attempt in California to pass comprehensive reform that met his state’s needs, Anthony brings a perspective that understands the different contexts of different states:
The vibrant discussion on the Massachusetts reform by Jon Cohn, Diane Archer, and Jonathan Gruber is obscured because the debate is mixing up two different questions: Is the Massachusetts reform succeeding? And is Massachusetts a model for national reform?
….
Gruber and Cohn are right that the big lesson from Massachusetts is not any specific policy component, but that health reform and coverage expansions are possible; Archer is right in her policy recommendations of what is needed in a federal reform, including the public health coverage option. Some of that is based on the needs of the nation, which face a different set of challenges that what Massachusetts did. So let’s not get distracted in refighting past battles in Massachusetts when there’s a far more significant fight brewing over the future of federal reform.
Yes. Case closed. (you think?)
Brian Rosman
Truth time is here with more to come! It starts with connecting the dots. Can’t wait for Part II.
http://www.cjr.org/campaign_desk/health_reform_lessons_from_mas.php?page=all
I am an uninsured Massachusetts resident who cannot afford the “affordable”health insurance.Anthony Wright should speak to the citizens of Massachusetts.The law is discrimination based on income and age.The law is a rip-off to the citizens and only benefits insurance companies.High cost plans with high deductable.Why is that never mentioned?
No, Brian, case is not closed. On the national level, the same class of people will be harmed as in MA – 200 percent FPL up to about $60,000 gross, maybe higher due to the constant increases in property taxes, food, energy, vehicle gas, etc.
The proposed nat’l plan will not address this class of people – those thrown into the subsidized will not, in most cases, be able to afford what the gov’t had decided is affordable and won’t be able to afford the copays which is exactly what is happening in MA.
Those thrown into subsidized plans won’t be able to find a doctor in many, many regions, much less have a choice or be able to stay with the doctor who has been treating them for many years.
Those thrown into subsidized plans will have to intentionally lower their incomes or keep their incomes low so they won’t be bounced from plan to plan or can get into a lower-priced plan. This is oppressive for the individual and certainly doesn’t help the economy. It just creates a new group of low-income citizens and forces the poor into staying that way.
Those thrown into subsidized plans will be faced with determination of eligibility based on a different income than those not going into these plans. This is outright discrimination.
And those thrown into subsidized plans will face estate recovery and real estate liens.
The contract that MA has with its residents to purchase health insurance is unfair and unequitable and, in a court of law, would probably be voided. It is unequitable in more ways than I can write in this blog.
The contract that the nation will have with its residents will be the same, unfair contract – unjust enrichment.
As for those in the higher income brackets who are not eligible for a subsidized plans – they will be faced with the same crappy coverage that the cheapest plan will have unless they can afford a better plan. In the cases of people I know, they can’t even afford the cheapest plan, nor can they afford to use it.
As in MA, Obama – the buck stops there – will be selling us out to the highest bidder. He compares it to having motor vehicle insurance – right out of the MA playbook. Just how stupid do all of you think we are? If you can’t afford mtr. vehicle ins., you don’t drive. If you can’t afford health insurance, you get out of the country.
[comment edited to remove personal reference]
I’ll lend my “thoughtful voice” to the chorus of well-deserved criticism of Chapter 58, the MA mandatory purchase of private insurance law. It’s a bad deal for almost all of us here in Massachusetts. That does not mean some benefit but in full measure it is a very bad deal at a time when the state and it’s residents and taxpayers cannot afford yet another bad deal. Bringing attention to this so that corrective action can be taken here in MA and so that our mistakes are not repeated elsewhere is forward-looking.
Correcting a grave misdeed–the unfair financing and other raw-deal aspects of Chapter 58 –is not “fighting a past fight”. National reform will take at least a year to get a bill passed and enacted. MA residents and taxpayers deserve positive changes to the MA Mandated purchase of private insurance law long before then. And whether Mr Rosman wants to aknowledge it or not, the MMM (MA mandated model) is indeed being referred to quite regularly as a model for national reform–especially by the private insurers and Republicans–now that speaks volumes about whose interests were put first in the MA law.
In case readers missed it, here’s a valuable comment on HealthyBlog from an ordinary citizen about the MMM aka Chapter 58:
Scott Says:
March 25th, 2009
The MA. mandated insurance is an absolute abomination-period. See http://www.hr676.org/index.html to learn how America could do much better than the MA. mandate. Did you know the architects of the Massachusetts mandated healthcare and similar plans have done studies showing that government provided insurance would be far more equitable and efficient, yet in every case have opted for MA. style mandates citing “political feasibility”? It’s a polite way of saying the insurance companies own our politicians-completely. Did you know the far right think tank, The Heritage Foundation, was invited into Romneys office to devise our mandated healthcare plan for this, the most Democratic of the states? Or that the Ma. mandate plan, all 80 pages of it, landed on legislators desks the day before they were to vote on it? Now big insurance hopes to do to the nation what they’ve done to MA. residents. If successful, it will be the single greatest redistribution of citizenry cash into private industry pockets and to assure sycophantic Senatorial complicity we have this : http://news.yahoo.com/s/ap/20090324/ap_on_he_me/insurers_sick_people
Supporters of the MA. mandate here and elsewhere are part of a well financed spin machine and do a great job. It’s all rather obvious- this machine will sell the American public out to the highest bidder while hiding behind shameful “coverage for all” antics. The irony is they are all Luddites advocating an anti-American anti-progress agenda on behalf of their big money insurance masters. I’m a Massachusetts resident living under the MANDATED healthcare that our “elected” 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 both cost and covered when purchased with the negligible bargaining powers of an individual. 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.”