Why nobody talks about Romneycare

(Updated Oct. 1, 2012, at 1:40 pm MT)

Two Politico writers today called Romneycare “one of the greatest stories never told.” In “Big ‘Romneycare’ secret: It didn’t rein in costs,” Jennifer Haberkorn and Kyle Cheney explain why neither the Republicans nor the Democrats are talking about Mitt Romney’s health care plan in Massachusetts.

The Republicans might be expected to brag about a successful program, but of course, that would lend credence to what they disparage as Obamacare. Besides, Romneycare has not been an unqualified success. And obviously the Democrats are not going to laud a Republican’s success, or risk having their program compared to Romney’s and drawing attention to the shortcomings of both.

For starters, Romneycare did not reduce costs:

“The reality is it performed very poorly,” said Douglas Holtz-Eakin, a former Congressional Budget Office director and president of the American Action Forum. He’s one of the most vocal critics of the plan. “A huge mark against it is it didn’t control health care costs at all.”

Health care costs per capita were 27 percent higher in Massachusetts than in the rest of the country in 2004, two years before the state plan was signed, Holtz-Eakin says. By 2009, it was 30 percent higher than the national average.

Furthermore, emergency room use in Massachusetts has gone up, not down. From 2006 to 2010, during the first four years of Romneycare, ER use went up 6%, according to a recent report.

Another report, from the Massachusetts Medical Society, found that only half the state’s primary care physicians are accepting new patients, down from 70% in 2007. And the average wait to see a family practitioner has increased from 34 to 45 days since 2007.

Back in 2009, when Congress was still debating national health care reform, I expressed concerns about it and pointed to the problems in Massachusetts. Those problems worsened into what is being reported today. I wish Congress had found solutions to those shortcomings before instituting Obamacare, but they didn’t. I wish I were more optimistic about the future of Obamacare, but I’m not.

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For a doctor’s take on Obamacare, see Why ObamaCare has doctors depressed and discouraged.

10 comments

  1. I think the real reason no one talks about it is because no one understands it. This was pretty much proven by Obamacare. People seem to have opinions about it one way or another, but they never explain the actual legislation, only what they’ve heard the positive or negative results will be. Talking about Romneycare would end up with the same deep-dive into a miasmic mush of noxious details requiring intensive cerebral effort to comprehend on any level resulting in the cognition of the concepts. Will this sway a swing voter, or send them into a deep coma?

    1. I just think there’s no real up side here for either side to talk about. Or they do so at the risk of having all the warts pointed out as well. As for the “miasmic mush” (nice phrasing, btw), that’s Ryan’s excuse for not talking about his tax plan — it’s something we of lesser intelligence wouldn’t understand. I think the truth is (a) they have no plan or (b) they’re afraid we will understand.

      But yes, you’re right. The ACA was passed/forced through Congress on a last-minute vote and no one — no one — had time to read through the entire bill before they voted. Oddly, only after the vote did the budget office come out and say yes, it would cost more, not save.

  2. There were some elements of the ACA that were touted to at least slow the rise of costs if not bring them down, but the Democrats I heard were not predicting any serious cost reduction because of it. The main provision for doing that was to get some 42 million uninsured to start paying into the system. But what was really needed was either government healthcare, something politically infeasible, or the public option. I understand the Democrats tried hard to sell the public option but the GOP were firmly entrenched against it.

    The problem, I am convinced, is the for-profit structure of the Medical Industrial Complex in America. It is turning out overused scanners and monitors, surgical robots, breast reductions and liposuction, plastic surgeries, artificial hips and knees made necessary by obesity, high-tech monitors and medicines touted to off-set bad lifestyles rather than good solid preventive medicine, and it’s costing us 2 1/2 times as much as some other countries pay for the same or better results. The problem is not ObamaCare – ObamaCare is a start in the right direction. The problem is that ObamaCare reforms do not go nearly far enough.

    1. Exactly. With the public option stripped out of the bill, the basic premise of the bill was gone. As it is now, it won’t slow rising costs any more than Romneycare has. Romneycare at least got most of the people in Massachusetts signed up, but costs there are still rising. And neither plan addressed the doctor shortage. All the insurance coverage in the world is useless if you can’t see a doctor.

      I agree the profit motive is the primary problem. The ACA should have included regulations on both the health insurance companies and the pharmaceutical industry (Obama agreed to hands off Big Pharma profits before the debate even started). Both are profiteering and both have powerful enough lobbies to influence or control legislation in Washington.

      1. My doctor is one of those who says she no longer encourages young people to become doctors. Sad.

        Really, PT? Your statement leaves me wondering which of so many reasons she might have for saying that:

        1. Too much bureaucracy?
        2. Too much paperwork?
        3. Too much responsibility?
        4. Fear of lawsuits? (excess testing)
        5. Too much pressure for patient-throughput? (financial)
        6. Too little feedback on efficacy of treatment? (related to no. 5, I know.)
        7. Too much stress from responsibility? (possible, but I can’t picture a Dr. admitting it.)

        I’ve read that the suicide rate among doctors is high, probably powered by all the above. In my opinion a public option system or a just plain government system that let doctors concentrate on preventive care with no throughput pressure would do wonders for such feelings as your doctor has – all except for high pay which I didn’t list as a problem because I don’t think it is. Pay would be lower under a government system, but I’ll bet morale would be a lot higher.

        1. Too much bureaucracy and paperwork and not enough time actually seeing patients and practicing medicine. It’s the same complaint I’ve heard from all my doctors. They don’t object to the responsibility, the hard work, or the stress. They understand that occasionally doctors, usually specialists, get sued. They just want to see their patients and practice good medicine, not spend all their time jumping through government hoops and doing government paperwork, which is where the majority of their time goes now. I doubt many of them care what kind of insurance is paying the bills but I’m pretty sure none of them ever wants to be a government employee; that’s why they are in “private practice.”

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