People have a lot of questions about the proposed federal health care reforms. But the most important question we should ask – perhaps the only one – is will “ObamaCare” work?
Judging from experience, the answer is “no.”
The proposals being considered in Congress are modeled after efforts in Maine, Massachusetts, Tennessee, Hawaii and elsewhere to provide universal coverage. In every instance, those efforts have failed.
Maine enacted its version of universal health care in 2003. To cover the uninsured, lawmakers greatly expanded the state’s Medicaid program and today Maine families earning up to $44,000 a year get taxpayer subsidies. One out of every five people in the state is on Medicaid, roughly twice the national average.
Then, Maine created its version of the public option, known as DirigoChoice, to compete with private insurers. Started with $50 million in federal money, the public plan offered taxpayer-subsidized premiums and was to pay for itself with savings and efficiencies in the health-care system.
How well did it work? It didn’t. After just five years, it’s a mess.
Instead of saving money, DirigoChoice has cost taxpayers $155 million and costs are still rising. A program that was supposed to save money by reducing health-care waste and inefficiencies has seen a 74 percent increase in premiums. But even those inflated payments can’t keep the program out of the red. As a result, lawmakers broke their promise and imposed new taxes. Now enrollment is capped, and there’s a waiting list.
Massachusetts implemented its universal coverage program in 2006. It began as an insurance exchange where private insurers would compete side-by-side, but the program was soon weighed down by government mandates, taxes, fines and lawsuits. In the three years since it began, costs have skyrocketed, patients can’t find a doctor, taxpayers have revolted, emergency rooms are overwhelmed, they’ve dropped coverage for 30,000 people and officials are talking about rationing health care.
Despite its disastrous results, the Massachusetts program is the model for the current federal health reform proposals.
Hawaii’s effort to provide universal coverage for children derailed in record time, lasting only seven months before it collapsed due to high costs.
Our state is struggling with its own efforts to expand health coverage. Washington’s Basic Health Plan was created to provide basic coverage for low-income residents. But when costs rose, officials announced that, rather than boot 40,000 people off the program, they would simply raise rates by 70 to 100 percent and give folks the “choice” of whether to drop out.
Proponents of federal health reform say these state efforts failed precisely because they were not national in scope. National health care, they say, would succeed.
Single-payer systems in the United Kingdom and Canada are great, until you get sick. Patients often wait months to see a specialist and effective treatment can be hard to come by, either because a facility lacks high-tech equipment or because the life-saving drugs that have been banned by government authorities are too expensive.
Instead of replicating these failures, Congress should replicate success:
• auto insurance companies compete across the entire country, which keeps prices in check. However, current law prohibits people from purchasing health insurance across state lines. A University of Massachusetts study says changing this one rule would provide more choices and greater competition, allowing 12 million uninsured to afford health-care coverage.
• allowing a tax deduction has proven to help employers provide employee health coverage. Individuals should get a similar deduction for their health-care premiums.
• after Texas implemented comprehensive lawsuit reform, doctors and insurance companies flooded into the state, increasing competition and reducing prices. But the current federal proposals don’t include meaningful lawsuit reform.
Some in Congress are turning a blind eye to the evidence and seem determined to impose a health-care system that has failed everywhere it has been tried. At some point, the president and Congress must ask why? Hopefully, political ideology has not become more important than the health of America’s citizens.
Don Brunell is the president of the Association of Washington Business.