Health care reform: Mass fail

Gov. Mitt Romney

Mitt Romney appeared on one of today’s Sunday morning talk shows and was bragging yet again about the great success of the state health care plan instituted when he was governor of Massachusetts.

Considering the current debate in Congress over health care reform, his comments were particularly galling and more than a little misleading. The Massachusetts plan is not a huge success, not by a long shot. In fact, it is rapidly going broke. If anything, it stands as a lesson to Congress in how not to do health care reform and universal coverage.

Massachusetts physician Susanne King wrote in March about all the ways in which her state’s plan falls short, and I’m inclined to think a doctor is in a particularly good position to evaluate a health care plan.

She concludes, as many analysts do, that Medicare is actually a very good model. And I can attest that, in many ways, it is. There are down sides, however, that I have not heard addressed. For example, doctors don’t have to accept Medicare as payment in full. And if they don’t, the patient pays the difference. Also, doctors don’t have to accept new patients, or can refuse to accept Medicare patients. You can’t blame them for not wanting to accept a patient whose insurance is not going to pay the going rate, but if enough doctors do that, a government insurance plan isn’t going to do the newly insured masses any good. They still won’t be able to find doctors to treat them.

It’s one thing to insure hundreds of thousands of people who currently don’t have insurance; it’s quite another to produce enough new doctors and medical facilities to treat them. And no one is talking about doing that. Doctor shortages, particularly of primary care physicians, already exist in many parts of the country. Where’s the logic in insuring all those people if you don’t have the resources to treat them?

As for universal coverage … how do you achieve that? If people can’t afford insurance now, they won’t suddenly be able to afford it just because some law gets passed.

A logical, workable plan for health care reform would be great; we certainly need it. But I’m not holding my breath waiting for Congress to produce it.