Massachusetts is proud of its landmark 3-year-old health insurance law. It has brought the state’s proportion of uninsured down from around 10 percent in 2005 to only 2.6 percent ”” the lowest in the nation.
But the achievement is in jeopardy. Massachusetts has the highest health costs in the country.
“The critical point is whether or not we can begin to do something about cost control,” says Dolores Mitchell, who heads a state commission that buys coverage for 310,000 government workers and their families. “We’ve just got to do it.”
Why does this not surprise me?
The only way to make that work would be to have something akin to a nationwide VA system. The government would have to completely take over health care.
WestJ – even that won’t help. The VA is a broken system where it can take years to get treatment. My niece was medically discharged from the Army because of her shoulder. That was 3 years ago and she still has not had the surgery her doctors recommend. She has been in pain all this time. She can’t even choose which VA hospital she goes to. She lives in Odessa, but her dad lives in the Dallas area. Can she come to the Dallas VA hospital where she has family? No! She has to go to Phoenix where she doesn’t know anyone!
When Congress agrees to be bound by their program first and for a significant period of time, then I will be willing to take a second look at it. As it stands now, government run healthcare (Medicare, Medicaid, VA, BIA) is not what I want for myself or my family.
We can see the results in Oregon where a woman was denied drugs that could save her life and told that the state would help with “assisted suicide.” We see the results in Mass where they are going to start paying the doctors less. That will result in fewer doctors and, consequently, longer lines and poorer care.
Our wonderful, intelligent, and nuanced congresscritters can’t seem to get it through their heads that you get more of what you subsidize. If you subsidize health care payment, you get to pay more for health care because more people will make use of it!
YBIC,
Phil Snyder
An interesting concept, but I don’t see what will keep doctors from opting out of such a system. The will either refuse to accept payment on that matter or be forced to by the state, at which point doctors will move to another state.
The state can deny licenses to doctors who try to opt out
We should be thankful the good people of Massachusetts implemented their mandated health care program. They’ve provided us with a wonderful test case of what happens as a result…
this is only going to leave them with a shortage of doctors, much like the national plan would. welcome to the world of rationing.
government coercion can have the most surprising results for liberals, who always assume people will do what the state instructs them….
So, why would anyone consider this a failure? Costs are going up even for private companies. With a global fee, perhaps prices would go down.
Phil, for every anecdote of bad treatment at the VA, I can give you a couple about bad treatment with private health care. I imagine in some states where people are more hostile toward government, government will perform poorly. In my neck of the woods, the former soldiers I know have been satisfied with the care at their VA hospital.
Hawaii, Tennessee, and Massachusetts have all had major problems with their state-run health care. Maybe we should review and look carefully at their situations before implementing an untried plan that affects one-sixth of our economy and millions of people.
We cannot afford to provided everyone with all the health care they want. Some people will have to have less heath care than they want. The question is who will decide who gets what health care? Right now:
1) No one requiring critical care is turned away from an emergency room. However they might be turned away until they are critical.
2) Anyone get whatever health care they want if they pay for it.
3) In addition to 1 and 2 above those lucky enough to get health insurance are at the mercy of the insurance company.
4) Some are on government care (medicare, Tricare, etc) where the government decides what care you get.
For must of us the question is do you want the government or insurance company deciding what care you get?
The main problem I see is that insurance is used cover the cost associated with the risk of getting sick. Insurance companies group this risk in a group so everyone in the group pays a little, known amount to cover the risk of having to pay a lot if something covered goes wrong. Asking an insurance company to cover an existing condition is not insurance, it is a payment plan. Health insurance is a lifetime risk. Having to change coverage when you change jobs does not work. But there needs to be a way to group the risk.
Insurance or the government puts uninvolved people in the decision making process and adds more cost.
The system we have now has big problems, but I think having the government play a bigger role will make things worse, not better for most people.
Here’s the difference between a mandated single payer insurance and private insurance. If you think what you pay for your private insurance is too high, you are free to shop around for a more affordable policy. And if you’re resourceful you have a good chance of finding something.
If you think what you pay for your gov’t insurance is too high . . . tough. Nothing you can do about it and there will be nothing you can do when (not if) the decide to raise the price of said insurance. I’ve paid for National Health Insurance in England. Trust me, it’s not free and it’s not some pittance out of your check you’ll hardly notice.
And with private insurance, if you don’t like the service you receive or the coverage, again, feel free to shop around for something you like better. If you don’t like the customer service or coverage of your gov’t plan . . . . tough. Nothing you can do about it.
And what do you think is going to become of research and development in America? Is a medical device or pharmaceutical company going to spend millions of dollars and years of effort to develop a new drug or technology, only to have the gov’t dictate to them what they will pay for it, IF they will cover it at all? Certainly not.
As an M.D., this doesn’t surprise me, either. What continually surprises me is the apparent complete disregard for demographic reality that the social engineers seem to have: our population is aging, and the older you get, the more health care you tend to consume. Health care is not inexpensive, even in nationalized health economies. And, as the ratio of workers paying into whatever insurance system to retirees drops inexorably, you’re faced with a few options: raise the payroll taxes on workers, raise the taxes on everyone who pays taxes, or cut the payments going out (i.e., cut provider/hospital payments, and ration care).
I recognize that some rationing of care goes on in pretty much any system currently set up; the critics of our current hybrid public-private system (given the already sizeable Federal role in paying for healthcare through Medicare, Medicaid, Tricare, and the VA) allege that the uninsured and underinsured have their care rationed via lack of access, lack of portability, etc. This, despite the fact that I have yet to see anyone who really needs urgent or emergent care (and, a lot of elective care) be denied it; there are Federal laws preventing hospitals from turning patients away, or dumping them. And, they seem to suggest that a government agency would do a better and/or fairer job rationing care than the private insurance company reviewers. Of course, as others above point out, at least with private insurance, one has the option of shopping for the coverage that best aligns with one’s needs.
What I can guarantee that you’ll see with an even greater governmental role in payment, and with this sort of “super DRG” plan in MA, is an inexorable move to explicit rationing, ever greater pressures to contain costs through downward payments to providers, increasing dissatisfaction amongst those providers, early retirement, and an exodus of MDs from states like MA, thus compounding the access problem. Oh, but I forgot–we’ll all get “physician extenders” to provide the care, so we won’t need MDs after all.
Joshua 24:15, there’s another option to add to yours, which is charge more for the Medicare coverage. As presently constituted seniors pay less than it costs and then the government pays providers less than their cost. Health services are not inexpensive, as you say.