Saturday, February 21, 2009

The truth about Massachusetts' universal health program

So, every couple of months I decide I'm going to do a big, well-researched post on the Massachusetts "universal" health care system and its many failings.

This desire is typically brought on by hearing some politician or public figure praise the Massachusetts system as being "proven to work," or suggesting it should be used nationally. At this point steam starts coming out of my ears in a comical fashion and I decide to write a post that will show everyone just how misled they've been.

Then I get distracted playing video games or something.

Lucky for me, Physicians for a National Health Program have done the dirty work for me, and prepared an extensive report citing the many reasons why Massachusetts would be a crummy model. It is absolutely worth a read.

Of if you're lazy, at least have a look over their press release.

If you're too lazy to even do that, here's part of the executive summary:
The reform has been more expensive than expected, costing $1.1 billion in fiscal 2008 and $1.3 billion in fiscal 2009. In the face of a state budget crisis in fall 2008, Gov. Deval Patrick announced that he will keep the reform afloat by draining money from safety-net providers such as public hospitals and community clinics.

While the number of people lacking health insurance in Massachusetts has been reduced, several recent surveys demonstrate that substantial problems in access to care remain in the state. While the new health insurance improved access to care for some residents, many low-income patients who previously received completely free care under the state’s old free care program now face co-payments, premiums and deductibles that stop them from getting needed care.

In addition, cuts to safety-net providers have reduced health resources available to the state’s remaining uninsured, as well as to others who rely on safety-net providers for services in short supply in the private sector. These safety-net services include emergency room care, chronic mental health care, and primary care. The net effect of this expensive reform on access to care is at best modest, and for some patients, negative.

By mandating that uninsured residents purchase private health insurance, the law reinforced the economic and political power of health insurance firms. Thus, the reform augments the already high administrative costs of health care. Moreover, the agency that administers the new law (the “Connector”) adds an extra 4 to 5 percentage points to the already high overhead of private health insurance policies.

The reform failed to reduce overreliance on expensive, high-technology services. Indeed, some of its provisions such as changes in Medicaid rates and cuts to safety-net providers (who do more primary care) have further tilted health spending toward expensive, high-technology are.
A solution is also offered, though you're going to have to go at least read the report to find out what it is (hint: it rhymes with "Pringle slayer").

Now I'm off to go play video games. Later, chumps!