Advice to a President: Don't Adopt Massachusetts Health Care Model - On The Record| David Scribner's column from the Berkshire Record

Advice to a President: Don't Adopt Massachusetts Health Care Model

By David Scribner

Dear President-elect Obama:

It is certainly refreshing that you have placed universal health care for Americans as one of the top priorities of your administration. If you can pull it off, we will at last join the other civilized countries in the world who regard excellent medical care as a right of citizenship - not a privilege for the wealthy, as we currently do.

Who knows. By the end of your first term, the United States might actually be in the top tier of countries providing health care rather than our current ranking near the bottom, as we now are, despite spending more money per capita on health care than any other nation. We rank 29th in infant mortality, 48th in life expectancy and 19 out of 19 among industrialized nations in preventable deaths.

For a nation as well endowed with medical expertise as we are, this is scandalous, right up there with pre-emptive wars, warrantless snooping, and the disappearance of the middle class whose falling wages, in real terms, can't afford the miserable and overpriced health coverage they're offered.

Mr. Obama, I'm certain you read the recent Washington Post analysis of our national health care system. Although $2.3 trillion is spent annually on health care, "we're not getting what we pay for," the Post quoted Denis Cortese, president of the Mayo Clinic, as concluding.

To get more health for the buck, it will be tempting to adopt and modify an existing model of health care coverage. But I urge you, Mr. President-elect, don't consider the so-called health care reforms adopted in Massachusetts. They are fundamentally flawed in concept, and unsustainable in practice. Reputable economists are predicting that Commonwealth Care has so drastically underestimated the costs of health care that it will either have to curtail coverage, reduce enrollment or substantially increase premiums - or all three -- in order not to overwhelm the state budget.

When I visited the Advocacy for Access office at Hillcrest Hospital - where folks with problems getting coverage from the state's plans go for help - I learned that the advocates' case loads had not decreased one bit since the Massachusetts "universal" coverage plan had become law last year. One woman seeking assistance had racked up thousands of dollars in medical bills she was personally responsible for because Commonwealth Care had neglected to record it had received - and cashed - her premium check. She thought she had coverage, but she didn't - and the New Jersey outfit that handles receipts refused to admit its error.

The problem with the Massachusetts system is that, in deference to the insurance industry, it outsourced the public interest to the private sector. And in this case, as in so many other cases, it doesn't work. They don't have the same objectives. Ever wonder, for instance, why if your monthly premium payment to Commonwealth Care is a couple of days late, you're automatically removed from health care coverage until payment clears? Think how much money is saved by benefits that don't have to be paid during that week that you and thousands of others like you are temporarily suspended from coverage. That tactic stinks. Even a bank gives you a grace period for a mortgage or car payment.

There are far better strategies for universal health care than the Massachusetts approach. The obvious one is Medicare, which provides far more cost-effective coverage for the elderly than private insurers do for the young and healthy. Similar programs are available to veterans and - of course - federal and state workers.

Mr. Obama, consider the single payer health care system, modeled after Medicare, a proven approach. And keep the private companies out of it. All they think about - and spend millions trying to implement - is how not to pay for medical care while collecting exorbitant premiums to do so.

I know, the free-marketers will yowl that you're introducing socialized medicine. But tell them it's not socialized medicine. It's socialized insurance - that is, insurance that everyone pays into, and benefits from, thereby creating a huge insurance pool that will keep costs down. People will still be able to see their private physicians who will still work in private practices. And they can buy additional private insurance to supplement the single-payer coverage, if they so desire.

Single payer means that every American is entitled to it - young and old, rich and poor, married, unmarried, with large family, with a small family, employed or out of work, in small businesses and large.

And remind your critics, Mr. Obama, that had America adopted a universal health care system, as other industrialized countries have, our manufacturers and businesses would have been far more competitive. They would not have had to bear alone the costs of providing health benefits for their employees. And the specter of the presidents of the Big 3 automakers begging Congress for billions to bail them out of a financial crisis and blaming the health care benefits they owe their workers as one of the causes would have been a bad dream rather than reality.

So Mr. President-elect, if change is to be the hallmark of your administration, find a way to change the nation's attitude toward health care. It is time to drop the fiction that only the private sector can operate effectively and efficiently. The health of the nation depends on it.

This column originally appeared in the Berkshire Record.

6/30/2009
As a resident of Massachusetts (Taxachusetts) I feel that I live in a "third world country" when it comes to healthcare quality. And, don;t let them fool you if you think that it is free or cheap for everyone in lower incomes. For example, you still have to pay $116 per month if you are singlem out of a job and collecting unemployment insurance of $525 per week which they annualize to $27,300 to determine your monthly Commowealth Care premium.

I do not know many unemployed people who can afford that $116 dollars per month given the increase of food and utilities since last summer. But our politicians still call it "healthcare for all"....... What a bunch of hypocrites.....

If Massachusetts Commonwealth Care is an example of what universal healthcare will bring to America, then we - the citizens of this great country of ours - are "doomed" to inferior quality of healthcare.

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