Health Reform in a Hand Basket

Careful observers of health reform in Massachusetts - which is being held up as a model for the nation by presidential candidate Hillary Clinton - will have noticed a long dark slide from optimism to pessimism from the state's top officials. Upon its signing in April 2006, then Senate President Travaglini commented that the people of Massachusetts "will now have equal access to the most renowned healthcare in the world." One year later Travaglini's successor, Therese Murray, was was warning that "If we do not constrain healthcare costs, the system we worked so hard to create and implement will collapse."

Last week, faced with its second round of double-digit increases in health care premiums, the Massachusetts Connector was forced to shift even more costs onto enrollees in the new state plan - increasing copayments and premiums - a move that all officials recognize won't be enough to make the new law solvent. Neither will the Governor's proposal to shift $51 million in health care costs on to state employees this year.

The Legislative Leadership's answer was the introduction of a Health Care Cost Control bill earlier this month (click here for the text of S.2526. The bill actually contains quite a lot of new spending on training new nurses and primary care physicians as well as the introduction of electronic medical records. Most measures contained in the bill are good steps for the state - particularly a requirement that all health insurers use the same billing system for hospitals and a limited ban on pharmaceutical gifts to doctors - but they are unlikely to make a significant dent in rising costs, or to make health reform any more or less sustainable. (See the Globe's editorial on Murray's bill here.)

The state, like many other states in the country, has run up against the limits of expanding access to the uninsured and underinsured without fundamental reforms to our health care system, reforms that will face strong opposition from the health care industry in particular.
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Benjamin Day is the Director of Mass-Care: The Massachusetts Campaign for Single-Payer Health Care.