Saturday, January 23, 2010

What Is Wrong With Massachusetts?

I put up a video of Scott Brown in a short discussion with a voter about health care reform.

My first personal complaint about what he said was at the beginning of the video when he says:

"We're past campaign mode"
i.e. I no longer have to lie to win. I guess now that he is elected he can afford to be honest. A real confidence builder in his basic integrity.

Then some folks at Classical Values were saying that I'm asking too much of Brown.

So let me reprise what Brown said in the video. The quotes may not be exactly exact. They are close.

1. Every one is going to get some kind of care

Do I have to?

2. Offer a basic plan for everyone

Isn't that what insurance companies already do?

3. Should we raise taxes?

Hell yes. The economy is doing way too well.

4. Or cut half a trillion from Medicare?

Sure. The plan already has too many doctors. No doctors no patients. I can see vast savings from that. It might also help keep Social Security solvent. A Twofer.

5. Affect veterans care.

VA hospitals are already too good.

Here is his position on health care from his recent US Senate campaign.
I believe that all Americans deserve health care coverage, but I am opposed to the health care legislation that is under consideration in Congress and will vote against it. It will raise taxes, increase government spending and lower the quality of care, especially for elders on Medicare. I support strengthening the existing private market system with policies that will drive down costs and make it easier for people to purchase affordable insurance. In Massachusetts, I support the 2006 healthcare law that was successful in expanding coverage, but I also recognize that the state must now turn its attention to controlling costs.
i.e. in a rich state like Mass. the plan they have is not affordable.

So has he Got Plan? Oh. Yeah. Raise taxes, or cut Medicare, or lower standards at Veterans Hospitals. Or some combination. Sounds like a plan to me.

So how is the Massachusetts Plan doing?
When enacted, MassHealth was touted as the answer to correcting the problem of the uninsured in Massachusetts. Healthcare providers (i.e., hospitals) and insurers were compelled to take cuts in reimbursement upon implementation of the program several years ago.

Today we find that earlier assumptions about cost and utilization were wrong and that enrollee benefits have to be reduced and providers have to take further cuts. Payments to hospitals and physicians for 2009 are deferred until 2010, and 2010 payments until 2011.

According to recent news reports, MassHealth explained that the shortfall is due to increased enrollment, higher utilization of services, and changes in savings estimates that were assumed in the original budget for the program.

The experience in Massachusetts with healthcare reform is frighteningly similar to the battle being waged today in Washington when it comes to healthcare reform.

A recent article points out that states can be useful as laboratories when it comes to new policy. The author points out that “Massachusetts has provided us with an example of a failed experiment in healthcare policy that should be a warning to all Americans as Democrats push to impose something similar on the rest of the nation.”
Scott had to know the State plan was in trouble and instead of suggesting a better National Plan we got vague promises during the election. Fine. He is elected. Can't he think of Something better than to raise taxes? Or cut backs in Veterans Care?

There is more on how the Mass. plan is failing.
* Although the state has reduced the number of residents without health insurance, 200,000 people remain uninsured. Moreover, the increase in the number of insured is primarily due to the state's generous subsidies, not the celebrated individual mandate.

* Health care costs continue to rise much faster than the national average. Since 2006, total state health care spending has increased by 28 percent. Insurance premiums have increased by 8–10 percent per year, nearly double the national average.

* New regulations and bureaucracy are limiting consumer choice and adding to health care costs.

* Program costs have skyrocketed. Despite tax increases, the program faces huge deficits. The state is considering caps on insurance premiums, cuts in reimbursements to providers, and even the possibility of a "global budget" on health care spending—with its attendant rationing.

* A shortage of providers, combined with increased demand, is increasing waiting times to see a physician.
Skyrocketing costs and a shortage of doctors. Something to look forward to I suppose.

Say. I have an idea. How about we look at the National Republican Plan.
What Americans want are common-sense, responsible solutions that address the rising cost of health care and other major problems. In the national Republican address on Saturday, October 31, 2009, House Republican Leader John Boehner (R-OH) discussed Republicans’ plan for common-sense health care reform our nation can afford. Boehner’s address emphasized four common-sense reforms that will lower health care costs and expand access to quality care without a government takeover of our nation’s health care system that kills jobs, raises taxes on small businesses, or cuts Medicare for seniors:
* Number one: let families and businesses buy health insurance across state lines.

* Number two: allow individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do.

* Number three: give states the tools to create their own innovative reforms that lower health care costs.

* Number four: end junk lawsuits that contribute to higher health care costs by increasing the number of tests and procedures that physicians sometimes order not because they think it's good medicine, but because they are afraid of being sued.
I don't get number three, but all the rest make good sense. I can think of one or two more that might help. Make Medical Savings accounts cumulative so that anything not spent in one year can be rolled over to build a cushion over time. In addition catastrophic coverage plans that cover anything above the out of pocket expenses that the Medical Savings Account would cover.

We can try that for a few years and see if changes or additions need to be made. It might also be a good idea to tighten the borders to reduce hospital's unfunded costs.

But Mr. Brown mentioned none of those. Even after his election.

Cross Posted at Classical Values


Neil said...

I came up with an idea that might help prevent this sort of back-tracking on campaign promises.

The first component is a two-term limit for any office. It seems to work well enough for the Presidency, but there is a reasonable fear that Congressmen, particularly, would be eagerly searching for bribes if their political career were likely to be so short.

Therefore, the second component is a massive pension, indexed for inflation, awarded on completion of the second term. I do mean massive, too--let's say $500K per year. If you don't win the second term, then no pension.

In other words, I want it set up such that anybody who gets elected to Congress is absolutely set for life--so long as a) the government remains solvent and b) they please the voters well enough to get elected twice. If our Congress-critters are going to be bribed anyway, let's make sure that it's we the people doing the bribery.

Unknown said...


letting the government try to out-pay businesses will of course only benefit the congress- and senate-critters. Graft and corruption is an eternal effect of having power to influence government policy.

How about limiting the ability of the 'critters to wield power in a way that benefits others, thereby limiting the others' incentives to purchase the 'critters?

This of course would render government fairly ineffective by the standards of today, and may be closer to what the original writers of the constitution intended.

If this would be a good thing or not is of course debatable.


Neil said...

How about limiting the ability of the 'critters to wield power in a way that benefits others...

Not possible. Any power the government has can be made to benefit somebody who's willing to pay. The obvious answer is to make sure that it's the nation that's the high bidder. My bid might actually be too high. Have you ever noticed how SMALL the actual bribes are? These clowns are willing to put in an earmark worth nine figures, for a payoff to the Congressman of five figures.

I forgot one other wrinkle--if the Congressman is ever convicted of a felony, the pension goes away. That ought to help reduce the criminalization of normal behavior.