Belmont Club

The House of the Rising Sun

Forbes and the Washington Post both describe the disastrous Massachusetts health care system — with which the Obama care models share similarities — and the post begins with a warning from the Commonwealth’s treasurer.

Some have asked, as national healthcare reform works its way through Congress, is there anything we can learn from the Massachusetts experiment? Yes, according to the state’s treasurer, interviewed today on CNBC: Whatever you do, don’t do what we did. In a blisteringly frank interview, treasurer Tim Cahill laid out some jaw-dropping stats, which eviscerated the plan and excited every conservative’s worst fears about government getting further into the health insurance business:

— The program has so far cost 30 percent more than anticipated.
— It already has a $9 billion shortfall projected over the next two years.
— Costs have risen 41 percent since the program’s inception, well outpacing the rise in healthcare costs nationwide, which stands at 18 percent.
— We thought this program would mean fewer people would go to hospitals, which is the highest cost any insurance plan has to pay. In fact, fewer people are not going to hospitals.
— A Harvard study shows 60 percent of state residents are unhappy with the plan. The most unhappy? Those whom it should be helping the most — those making $25,000 to $50,000 per year.
— To cut costs, the program is now having to kick out legal immigrants.

The bottom line, to misquote Lincoln Steffens, is that we have seen the future and it sucks. It was probably easier to acknowledge the mistakes because it was a bipartisan disaster and there’s enough blame to go around. Democrat Deval Patrick was the health program’s champion, but Republican Mitt Romney signed it into law. So, with both their hands tainted with the failure, the way lay open to performing a public post-mortem on the cadaver of the program without the pathologists stabbing at themselves. How did they get it so wrong? Because they put on a set of blinkers from the outset. The basic problem was that Massachusetts health care advocates wanted their outcome so badly they sold what they simply could not deliver. The Forbes article explains.

The big lie in Massachusetts was that costs and taxes would not increase. … It could be the bait-and-switches that have Massachusetts residents cranky. They were promised affordable coverage. The plans were so expensive that 20% of the uninsured were exempted from having to purchase them. … Bay Staters were told they wouldn’t have their current arrangements disrupted. Yet thousands of residents have had to purchase more expensive coverage after the new bureaucracy deemed their existing plans inadequate. … three years in, the successor uncompensated care pool is still spending hundreds of millions of dollars. Emergency rooms are more crowded than ever. …

Whether Romney believes his hype is unknown. There can be little doubt that his Democratic partners, including Sen. Edward Kennedy, D-Mass., viewed the Massachusetts experiment as a “no-lose” proposition. If it somehow worked, great. But if the scheme failed, Democrats understood that they would have moved the state one step closer to government-run health care, with thousands more hooked on subsidized coverage.

Indeed, Jon Kingsdale, the person in charge of the Health Insurance Connector, recently wrote that it is a better strategy to expand access first, let costs run and only then worry about containing spending.

Tim Cahill warned the national public not to do what Massachusetts did. A cynic might observer that for precisely that reason it is all the more likely to be emulated. In government, nothing succeeds like failure. Costs are costs, after all, only to people that pay them; from another point of view they’re revenues. Looked at the right way, it’s always a “no-lose” proposition.

Now the only thing a gambler needs
Is a suitcase and a trunk
And the only time hes satisfied
Is when he’s on a drunk.

He fills his glasses up to the brim
And hell pass the cards around
And the only pleasure he gets out of life
Is ramblin from town to town

Oh tell my baby sister
Not to do what I have done
But shun that house in new orleans
They call the risin sun

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