The Patient Protection and Affordable Care Act signed into law by President Obama is modeled after changes done to Massachusetts’ healthcare system in 2006. But have Massachusetts’ “reforms” really worked? Washington Post columnist Robert Samuelson recently analyzed what has happened in the four years since the Massachusetts plan was implemented. Samuelson wrote that although the state’s individual mandate has decreased the number of uninsured residents in the state, the program has had consequences:
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.
Samuelson goes further:
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.
Unfortunately, Samuelson says nothing about expanding Medicare to everyone as a superior alternative to the Massachusetts model. He doesn’t even suggest forcing insurance companies to become not-for-profit, as they are in Europe. Astonishingly, Samuelson believes attacking the insurance industry as the main source of America’s healthcare woes isn’t the way to go. Instead, he says we should first limit the costs of healthcare providers, something he believes would be politically unpopular anyway.
Yes, fee-for-service does contribute to overtreatment and higher costs. But it’s the expensive, for-profit health insurance industry that is the main reason why costs are exploding. Eliminating insurance companies would save the United States billions of dollars per year. The fact that Samuelson ignores the solution that has worked well in other developed countries shows how frustratingly insular and myopic discussions about healthcare have become in American mainstream media.