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Public Option will lead to a Single Payer System


NCPA, May 19, 2009

Massachusetts's 2006 attempt to cut health care costs and increase the number of insured through a government mandate requiring individuals to purchase insurance has become an object lesson in what not to do in reforming health care, three Harvard Medical School professors report.

Drs. Rachel Nardin, Steffie Woolhandler and David Himmelstein say the Bay State's effort to change the health care market by increasing government regulation has cost far more than anticipated while resulting in higher costs and lower-quality coverage for low-income Massachusetts residents.  They report their findings in "Massachusetts' Plan: A Failed Model for Health Care Reform."

Three years ago then-Governor Mitt Romney (R) collaborated with the majority-Democrat legislature to achieve so-called "universal" health care by government dictate. This meant squeezing every resident into either compulsory private health insurance or expanded government programs, using both tax hikes and subsidies. Massachusetts had one of the highest rates of insured residents at the outset of this program and it's still costing a tremendous amount of money and going far over budget.

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.

Source: Joe Emanuel and Colleen Watson, "Study: Massachusetts Reform Not a Model," Heartland Institute, June 2009.