More on Mass

After reading dozens of opinions and articles on the Mass Health Reform Bill, I want to put in some additional two cents.

I think people are being too harsh on this in general.  So what if Romney is running for president?  As Ezra excerpted (originally from Jon Cohn) over at TAPPED:

And while it will undoubtedly annoy some progressives who don't love the plan or think he's taking credit for an idea (and favorable circumstances) that fell into his lap, they should be thankful for this development.

Thankful, because nationally the most important impact of this new law may be on politics, not policy. Once Romney starts boasting about how he achieved universal health coverage in Massachusetts, it will become that much harder for conservatives to demonize the very concept as "big government." Oh, they'll try--and they'll have at least some success. But now Democrats will have this retort: If a Republican governor and leading presidential contender with strong conservative credentials thinks universal health care is a good idea, how radical an idea can it be?

Progressives are also screaming "follow the money!", which strikes me as ridiculous.  Is coverage only good if it comes from a "pure" place?  Is it more important to have insurers out of the equation NOW, or to get everyone covered affordably?  To me, it's obvious.  In an ideal world, private insurers would be out of the equation.   But this is far from an ideal world, and a world where we can get everyone into insurance without bankrupting ourselves seems good enough for me.  Keep in mind this is a state initiative, and compromises here are much different that what we'd want for a national system.  These reforms are laying the road to universal care, not the building. 

I also disagree with Joe Paduda that there will be a huge rise in demand.  Only 11% of Massasschussetts is uninsured; and they have huge free care pools.  There will probably be a small increase, but no rash of people all of the sudden having tons of elective procedures and crowding specialists.  There just aren't enough people without insurance to do that.

That being said, I have a few concerns:

• There is no dedicated funding source.  This program will absolutely fail if there isn't enough money for it.  State budgets don't have the ability to absorb cycling costs like the Fed.  This could prove problematic.

•  The penalty for not insuring employees is terrible.  It is much, much too low to be any kind of disincentive for dropping insurance.

• It's unclear what will happen with the number of employers dropping care.  This statement over at Ezra's is making me think.  I'm unsure whether we'll see that.  And without a stiffer penalty, we well might.  But taking it a step further -- what happens if employers do drop care?  There's the affordable option being subsidized by the state so they'll still be covered.  But costs to the state will greatly increase unless there's a new source of funding dedicated toward this problem.  It won't work if employers drop coverage and just pocket the money, or funnel it toward other expenditures.  The state won't be getting any more money to deal with the increased cost.

There will be many lessons learned from this experiment.  It's a major change, and it will give much insight into the "right" and "wrong" ways to reform.  I know we'll all be watching eagerly.

Comments

[Rick]

"The state won't be getting any more money to deal with the increased cost."

Yes, they will. If an employer drops coverage of an employee, or a bloc of employees, he loses the tax credit he claims for insuring those employees. Employers get a tax credit for their premiums. Without that credit, there will be more taxes flowing to state coffers. So there should be enough money, without a tax increase, to cover the cost of more people in government-provided health coverage. This actually moves the ball a little further down the field toward single-payor, if that's what you prefer.