Massachusetts Is No Model for National Health Care Reform

The
Massachusetts health care system, widely regarded as an example of how
to provide universal coverage and keep costs low, is in fact faltering
badly and should not be held up as a national model for reform,
according to a study released this week by Physicians for a National Health Program (PNHP) and Public Citizen.

The
study comes at a time when the health insurance industry is reportedly
weighing in heavily in secret talks on Capitol Hill in favor of an
individual mandate, a legal obligation requiring persons to have or to
buy health insurance. The insurance industry's position was described
in today's New York Times.

However,
such mandates - which have been a cornerstone of the Massachusetts
health reform - have failed to assure universal coverage, the new study
says. For example, the state's most recent figures show that it had to
exempt 79,000 residents from the mandate in 2007 because they could not
afford to buy insurance.

The Massachusetts plan has also failed to make health care sufficiently affordable or to control costs, the report says.

The groups urged Sen. Edward Kennedy
(D-Mass.) to reject his home state's approach and, instead, introduce
Senate legislation crafted after the House's United States National
Health Care Act, H.R. 676, which would implement single-payer financing
of health care while maintaining the private delivery system. The two
groups also released a letter to Kennedy signed by approximately 500
Massachusetts physicians and health professionals urging the senator to
embrace single-payer reform.

"Massachusetts physicians have the unique opportunity to observe the effects of this reform on patients every day," said Dr. Rachel Nardin,
president of the Massachusetts chapter of PNHP and lead author of the
study. "The nearly 500 doctors who have signed the open letter to Sen.
Kennedy see that the reform is deeply flawed."

PNHP's
study of the Massachusetts model found that the state's 2006 reforms,
instead of reducing costs, have been more expensive than expected. The
budget overruns have forced the state to siphon about $150 million from
safety-net providers such as public hospitals and community clinics.

Many
low-income residents, who used to receive completely free care, now
face co-payments, premiums and deductibles under the new system -
financial burdens that prevent many of them from receiving necessary
medical treatment. Since the state's reforms passed, premiums under the
state insurance program have increased 9.4 percent. The study found
that if a middle-income person on the cheapest available state plan got
sick, he or she could end up paying $9,872 in premiums, deductibles and
co-insurance for the year.

Many residents remain uninsured or have inadequate insurance.

Under
a single-payer system, doctors, hospitals and other health care
providers are paid from a single fund administered by the government.

"We
are facing a health-care crisis in this country because private
insurers are driving up costs with unnecessary overhead, bloated
executive salaries and an unquenchable quest for profits - all at the
expense of American consumers," said Dr. Sidney Wolfe,
director of Public Citizen's Health Research Group. "Massachusetts'
failed attempt at reform is little more than a repeat of experiments
that haven't worked in other states. To repeat that model on a national
scale would be nothing short of Einstein's definition of insanity."

The
study reported that a national nonprofit single-payer system could save
Massachusetts about $8 billion to $10 billion a year in reduced
administrative costs. Currently, Americans spend 31 cents of every
health care dollar on administrative costs, by far the highest rate in
the world and much higher than the 17 cents spent in Canada, which has
single-payer universal health care.

"Big
hospitals and insurers have gotten rich off reform, but a survey shows
that more people directly affected by it have been harmed that helped,"
said Dr. Steffie Woolhandler,
a PNHP co-founder and associate professor of medicine at Harvard
Medical School who helped prepare the study. "We're seeing patients who
now can't afford vital medications and treatments that they've been on
for years because of the new co-payments and deductibles imposed by the
law."

Read the report, "Massachusetts' Plan: A Failed Model for Health Care Reform."

Read the letter to Sen. Edward Kennedy.

Read the labor letter to President Barack Obama.

Read personal stories from Massachusetts patients.