July 19 2010
Massachusetts Preview: A Horror Story
The Massachusetts healthcare system was the model for the nation's recently-enacted one-and Robert Samuelson, one of the most no-nonsense of economic writers, points out today that it's not working:
Emergency rooms remain as crowded as ever; about a third of the non-elderly go at least once a year, and half their visits involve "non-emergency conditions." As for improvements in health, most probably lie in the future. "Many of the uninsured were young and healthy," writes Long. Their "expected gains in health status" would be mostly long-term. Finally -- and most important -- health costs continue to soar.
Aside from squeezing take-home pay (employers provide almost 70 percent of insurance), higher costs have automatically shifted government priorities toward health care and away from everything else -- schools, police, roads, prisons, lower taxes. In 1990, health spending represented about 16 percent of the state budget, says the Massachusetts Taxpayers Foundation. By 2000, health's share was 22 percent. In 2010, it's 35 percent. About 90 percent of the health spending is Medicaid. ...
Attacking unpopular insurance companies is easy -- and ultimately ineffectual. The trouble is that they're mostly middlemen. They collect premiums and pay providers: doctors, hospitals, clinics. Limiting premiums without controlling the costs of providers will ultimately cause insurer bankruptcies, which would then threaten providers because they won't be fully reimbursed. The state might regulate hospitals' and doctors' fees directly; but in the past, providers have often offset lower rates by performing more tests and procedures.
Our country was put through great turmoil and saw Congress behave in undemocratic and unsavory ways to give us...a healthcare system similar to the disaster in Massachusetts.