Massachusetts health reform plan, which has helped to guide Democratic thinking on health care, is now encountering severe problems in meeting its goals of providing affordable, universal care.
The program was predicated on a strong individual mandate to purchase insurance, subsidies for the poor to cover them, and trivial fines for employers who refuse to supply health insurance.
But like other at least six other state-level "universal" plans that soon collapsed the
Massachusetts plan lacks effective cost controls. Thus, as insurers raised rates, the state began to experience a severe pinch on its ability to subsidize care for low-income people.
As a result, the
Massachusetts reform is failing to deliver on promises that are very similar to those offered by backers of the emerging Democratic plan. Dr. David Himmelstein of HarvardMedicalSchool put lined the situation to a House Health, Labor, and Pensions Subcommittee (4/23/09):
"Prevention, disease management, computers, and a health insurance exchange were supposed to make reform affordable."
"Instead, costs have skyrocketed, rising 23% between 2005 and 2007, and the insurance exchange adds 4% for its own administrative costs on top of the already high overhead charged by private insurers. As a result, one in five Massachusetts residents went without care last year because they couldn’t afford it. Hundreds of thousands remain uninsured, and the state has drained money from safety net hospitals and clinics to kept the reform afloat"