Negative narratives about the crippling expense of publicly funded health care coverage are as plentiful as mushrooms after a rain. Most of them have little, if any, merit — and, according to an editorial in today’s Boston Globe, the one about Massachusetts’ plan being a fiscal nightmare is flat-out wrong:
Pundits and politicians who oppose universal healthcare for the nation have a new straw man to kick around – the Massachusetts reform plan that covers more than 97 percent of the state’s residents. In the myth that these critics have manufactured, this state’s plan is bleeding taxpayers dry, creating nothing less than a medical Big Dig.
The facts – according to the Massachusetts Taxpayers Foundation – are quite different. Its report this spring put the cost to the state taxpayer at about $88 million a year, less than four-tenths of 1 percent of the state budget of $27 billion. Yes, the state recently had to cut benefits for legal immigrants, and safety-net hospital Boston Medical Center has sued for higher state aid. But that is because the recession has cut state revenues, not because universal healthcare is a boondoggle. The main reason costs to the state have been well within expectations? More than half of all the previously uninsured got coverage by buying into their employers’ plans, not by opting for one of the state-subsidized plans.
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It will be proportionately more expensive nationally to provide coverage for the uninsured than it has been here simply because the state began the task with a much lower rate of uninsured, 7 percent, compared with the US rate of 17 percent. But a national plan that relies, as Massachusetts’ does, on both government-subsidized insurance and a mandate on employers to offer insurance or pay a penalty (in Massachusetts’ case, a very small penalty) should be able to cover nearly everyone without busting the budget.
Ezra Klein points to the key reason the Massachusetts plan has worked (the first link, which I bolded):
It’s been convenient for critics of health-care reform to assail the Massachusetts effort. But the Massachusetts effort — which was focused on coverage, not cost — worked. It has been a success. It has radically cut the number of uninsured residents. It has come in at about the cost predicted. It has proved popular. And it has given Massachusetts the courage to contemplate much more aggressive cost control than anything that’s being consider at the national level, or in another state.
That last bit is important: Doing coverage actually pushed Massachusetts to begin addressing cost. If national health-care reform has a similar effect, it will have been wildly successful.
Of course, we could do what Republicans and other conservatives want to do — which is essentially nothing — and wait until the number of uninsured gets to 25%, or higher. Then it will be even more expensive to insure most of the uninsured, and the GOP can use that as an excuse to throw up their hands.
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