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Mass. health coverage.

ITEM: The New York Times for April 5 reported that the Massachusetts legislature overwhelmingly passed a bill that would make Massachusetts "the first state to provide nearly universal health care coverage," and would accomplish this feat "in a way that experts say combines methods and proposals from across the political spectrum, apportioning the cost among businesses, individuals and the government." Driving home this point, the Times quoted Stuart H. Altman, a professor of health policy at Brandeis University, as saying: "It is not a typical Massachusetts-Taxachusetts, oh-just-crazy-liberal plan. It isn't that at all. It is a pretty moderate approach." The Times also quoted Republican Gov. Mitt Romney as boasting: "This is really a landmark for our state because this proves at this stage that we can get health insurance for all our citizens without raising taxes and without a government takeover."

ITEM: The New Republic, in its issue for April 24, praised Republican Governor Mitt Romney's action, if not his motivation, saying: "He's still lending the cause of health care reform a conservative imprimatur--making the world safe for, or at least more politically hospitable to, a policy revolution." There are always some people, continued the liberal magazine, "who could buy health insurance but don't, because they would rather spend the money elsewhere. Forcing these people to pay into the health care system--as Romney's plan demands--merely asks these 'freeloaders' to carry their share of the load."

CORRECTION-" When supposed conservatives and avowed liberals get together to expand healthcare coverage and make it mandatory, with a combination of fines, taxes, subsidies, and additional regulations, the chances that anything close to a free market will emerge victorious are so slim as to be nonexistent.

This is why prominent left-wingers and backers of socialized healthcare are smiling: They see their opening and view this legislation as a potential national model. "You may well have fired a shot heard 'round the world," said a pleased Sen. Edward Kennedy (D-Mass.)--perhaps the best-known political advocate of a complete government healthcare takeover--at a Faneuil Hall ceremony trumpeting the legislation's passage. Similarly, Senator Hillary Clinton (D-N.Y.), of ill-fated "Hillarycare" infamy, also spoke about how "commendable" the new bill is because it is "bipartisan." A sympathetic Robert Kuttner noted in the Boston Globe that, "advocates of universal health coverage feel they finally have their nose under the tent."

If you are a Bay Stater who has freely chosen not to make a particular purchase--in this case, health insurance--the state government is going to twist your arm until you buy it or slap you with a fine. To make the mandatory medicine go down easier for some, there will be "help" provided by the government, which means other taxpayers will have their pockets picked for the balance. Subsidies will be provided to those making up to around $50,000 for a family of three, adjusting the cost via a formula essentially based on the Marxist doctrine, "From each according to his ability, to each according to his need."

There have been tributes galore about the compromises required for a Republican governor to obtain passage of this bill while working with a left-wing legislature. That is usually the case when conservative principles are abandoned. Yet, the battle is just beginning over many of the bill's details. As the Washington Post admits: "As simple as the idea sounds--buy insurance or else--the proposal is complex and, in some cases, still unfinished. For instance, it leaves the task of determining exactly how much some low-income residents will pay for their new, more affordable policies to a new agency that would serve as a liaison between the government, policyholders and private insurance companies."

In a nutshell, the new law requires most employers to provide health insurance or pay a fine. Individuals without insurance provided by their employer, who can afford it, must buy such coverage or be penalized via their state income taxes; subsidies will help pay for coverage for the poor and "near-poor"; and a government-chartered clearinghouse is supposed to match buyers of insurance with private providers.

In reality, much more will be involved.

Auto-liability Insurance Precedent

Since there are laws requiring automobile liability insurance in many states, proponents of mandatory health insurance built on that idea. However, as pointed out by Michael Tanner in a Cato Institute study ("Individual Mandates for Health Insurance"), even that liability mandate has not led to universal insurance coverage for drivers. In the 47 states where there are laws mandating automobile liability insurance, about 14.5 percent of drivers still remain uninsured, according to studies, with as many as 30 percent being uninsured among Los Angeles drivers.

The Washington Times is unmoved by the auto insurance comparison: "Perhaps the biggest laugher here is that we're somehow supposed to be impressed with Mr. Romney's observation that the bill simply applies the state's auto-insurance thinking to medical care. The state's auto-insurance market is an overregulated nightmare. It's so bad that even Geico and Progressive don't offer plans in Massachusetts. A lizard would choke on it."

Moreover, enforcing mandatory health insurance is bound to lead to a bigger, nosier government. Look for the state to get involved in tracing everyone's individual insurance status and cross-checking that information with income data, plus monitoring lifestyles in a "wellness program for MassHealth enrollees." Grace-Marie Turner, president of the Galen Institute, notes that the Massachusetts plan is "loaded with individual mandates that have driven up the costs of health insurance in the first place. The numbers don't add up. The plan is going to be much more expensive" than proponents claim. As noted by the Wall Street Journal: "The new Bay State law preserves all existing coverage mandates and regulations."

Previous policies helped bring about the "crisis," which led to these new mandates. In this case, one problem was the state-imposed rating regulations. Such regulations, points out Sally Pipes, president of the Pacific Research Institute, "require companies to charge the sick and healthy the same rates. The result: some people elect not to purchase it." Now, however, they will lose that choice.

Just the Beginning

The Citizens' Council on Health Care (CCHC) has been among those critical of the new Massachusetts mandates. The president of CCHC, Twila Brase, foresees "an intrusive and prescriptive bureaucracy" that will be "authorized to ration health care and make decisions about who gets what health care when. Health care decisions will be taken out of the hands of the patients and doctors as the agendas of special interests, not the needs of patients, take precedence. The legislative is extremely intrusive. State agencies will be monitoring insurance status, checking in come status, and tracking the medical care of the Massachusetts people."

The council notes some of the new creations: a plethora of new agencies; more government trust funds; and additional programs that will result in greater controls. These will include more bureaucracies covering healthcare; an official definition for "performance measurement benchmarks"; added pressure on physicians to knuckle under to the state regulations; payments based on performance, including reducing ethnic and racial disparities in care; and a state price-control schedule.

In an article in the Wall Street Journal, Arnold Kling points out that the subsidized coverage for the poor will include a $0 deductible, which will drive up demand for services. "Policies with deductibles of $0 in a state where spending per person on health care is on average $6,000 a year will have very high annual premiums--presumably over $6,000 a year.... The only way to make zero-deductible health insurance available at low cost is with a large subsidy."

As the pressures build up, look for the liberals to increase the price tag on businesses. Writing in USA Today, Sally Pipes predicts what seems nearly inevitable: "The end result of Massachusetts' 'innovative' plan will be a total government takeover of health care. Individual mandates lead to groaning about price. At the same time, the true cost to the state will explode. This will build pressure for price controls. Having already erected a government apparatus to impose price controls, regulation and rationing, the state will come to the rescue of those it stranded by imposing single-payer health care, or Medicaid, for all."

As often is the case, the slippery slope to a healthcare takeover has been paved with good intentions and greased by bipartisanship.
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Title Annotation:Correction, Please!
Author:Hoar, William P.
Publication:The New American
Geographic Code:1U1MA
Date:May 15, 2006
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