Should we have a President Obama next year, all eyes will indeed be on Massachusetts with regard to health care. As the article mentions, Obama's plan is essentially the framework of the Massachusetts plan — minus the personal mandate. The Washington Post has a nice write-up of the evolution of the law in MA.
In a nutshell:
- Free/subsidized care does indeed get people covered. It's also expensive to the state.
- The website/”consumer experience” of buying insurance through the Connector is vastly improved from the previous chaos. (This is not a small matter.) It's relatively easy to buy, except …
- The premiums are very expensive for those who have to pay.
- Connector chief Jon Kingsdale thinks the personal mandate makes a big difference. (Health care wonk Jacob Hacker says it ain't all that — at least not immediately.)
- It's a work in progress.
I think the bottom line is that it's been quite successful at getting people covered, but very expensive. After all, the law was not designed with controlling costs in mind at all, but rather to get everyone covered. And even its success in getting people insured has uncovered some serious structural problems, such as the lack of primary care docs.
Two other thoughts:
- The evolving-if-qualified success of the law has everything to do with the current administration, and legislative leadership. Patrick, DiMasi, and Murray all really want this to work. They're finding the money; they're keeping the political coalitions together; they're making it work administratively. Tough work, and they're doing it; they should get credit.
- Regarding national implications, I hope a prospective President Obama would incorporate Hillary Clinton's idea of a national health Best Practices Institute, which might get to the heart of how we can spend so much money and get such lame health results.
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