Health care in Massachusetts: a warning for America

The Bay State’s mandatory insurance law is raising costs, limiting access, and lowering care.

By Paul Hsieh
The Christian Science Monitor
September 30, 2009

SEDALIA, COLO. – In his recent speech to Congress, President Obama could have promoted healthcare reforms that tapped the power of a truly free market to lower costs and improve access. Instead, he chose to offer a national version of the failing “Massachusetts plan” based on mandatory health insurance. This is a recipe for disaster.

Three years ago, Massachusetts adopted a plan requiring all residents to purchase health insurance, with state subsidies for lower-income residents. But rather than creating a utopia of high-quality affordable healthcare, the result has been the exact opposite – skyrocketing costs, worsened access, and lower quality care.

Under any system of mandatory insurance, the government must necessarily define what constitutes acceptable insurance. In Massachusetts, this has created a giant magnet for special interest groups seeking to have their own pet benefits included in the required package. Massachusetts residents are thus forced to purchase benefits they may neither need nor want, such as in vitro fertilization, chiropractor services, and autism treatment – raising insurance costs for everyone to reward a few with sufficient political “pull.”

Although similar problems exist in other states, Massachusetts’ system of mandatory insurance delivers the entire state population to the special interests. Since 2006, providers have successfully lobbied to include 16 new benefits in the mandatory package (including lay midwives, orthotics, and drug-abuse treatment), and the state legislature is considering 70 more.

The Massachusetts plan thus violates the individual’s right to spend his own money according to his best judgment for his own benefit. Instead, individuals are forced to choose from a limited set of insurance plans on terms set by lobbyists and bureaucrats, rather than those based on a rational assessment of individual needs.

Because the state-mandated health insurance is so expensive, the government must also subsidize the costs for lower-income residents. In response, the state government has cut payments to doctors and hospitals. With such poor reimbursements, physicians are increasingly reluctant to take on new patients.

Some patients in western Massachusetts must wait more than a year for a routine physical exam. Waiting times for specialists in Boston are longer than in comparable cities in other states and have gotten worse. Some desperate patients have even resorted to “group appointments” where the doctor sees several patients at once (without the privacy necessary to allow the physician to remove the patient’s clothing and perform a proper physical exam). These patients all have “coverage,” but that’s not the same as actual medical care.

The Massachusetts plan is also breaking the state budget. Since 2006, health insurance costs in Massachusetts have risen nearly twice as fast as the national average. The state expects to spend $595 million more in 2009 on its health insurance program than it did in 2006, a 42 percent increase. Those higher health costs help explain why the state faced a $5 billion budget gap this summer. To help close it, lawmakers raised taxes sharply.

The op-ed continues at CSM.

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