A wonky debate took hold of health policy bloggers this week as they reexamined the health reform law in Massachusetts, which shares many features with the new national health overhaul law. Commentators considered new data from the state and what it might signify for the national law.
Cato’s Michael Cannon notes several disagreements with economist Jonathan Gruber’s letter-to-the-editor defending the law, then concludes: “it does not speak well of the Left’s approach to health care that in order to reduce wasteful government spending — or at least pretend to — they must first create more wasteful government spending.”
Critical Condition’s Avik Roy looks at some left-leaning writing about the Massachusetts’ reform law and disagrees: “The reason why health care costs keep rising, and the reason we face fiscal disaster, is because of subsidized insurance. Government programs like Medicare and Medicaid, which started out small, reward irresponsible utilization of health-care resources. … And, so, we end up with the death spiral of state-funded health care. As the cost of health care increases, driven there by government subsidies, fewer people can afford private insurance, leading to more cries for more government subsidies, which will drive costs up even further. Wouldn’t it be nice if we could try the opposite approach?”
Hot Air’s Ed Morrissey says the incentives for employers to cover their workers are insufficient and prospects don’t look great for the national law: “With the Senate and the White House eyeballing price controls for health insurance, the federal system will have the same perverse incentive structure as Massachusetts, and businesses will eventually respond to them in ways that will create a de facto single-payer system in the US. That appears to be more like a designed outcome than a policy mistake as Barack Obama and Congress follow the Massachusetts playbook.”
The Washington Post’s Ezra Klein emphasizes that the Massachusetts law did not target health care costs and writes: “What we can say about Massachusetts now is pretty much what we’ve been able to say about Massachusetts since the early days of its implementation: It’s been a successful attempt to expand coverage and reform the non-group market, and it was never an attempt to control costs. As such, costs in Massachusetts, much like costs nationally, are rising. Insofar as that contains lessons for the national effort, it’s that we should stick to the law and make sure to implement the cost controls and delivery-system reforms.”
Insure Blog’s Bob Vineyard responds to Klein, saying: “Ezra tells us ‘the plan’s popularity also remains quite high: The Urban Institute study found approval at 67 percent’. And why wouldn’t it be popular? When you can wait to buy insurance AFTER you get sick or injured, that’s a great deal for you. But not so for the rest of the folks who have to pay for your claims in the form of higher premiums.”
(For additional takes on the Massachusetts reform law, see the KHN opinion pieces from Austin Frakt and Grace-Marie Turner.)
And for other wonky policy posts from the last two weeks, Julie Ferguson of Worker’s Comp Insider hosts the newest edition of Health Wonk Review.
