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Ever since the federal health reform effort became law in March 2010, critics of "Obamacare" have criticized the Massachusetts health care reform that inspired the national legislation. The critics say that even with reform (or because of it) the Bay State has the most expensive health insurance premiums in the country.
That criticism has increased in recent months as one of the architects of the Massachusetts reform - former Gov. Mitt Romney - has drawn heat from his opponents as he campaigns for president. In addition to claims about rising health costs, opponents of health care reform charge that the landmark Massachusetts law was all about expanding access to health insurance, and not about improving quality or cutting costs.
As another architect of Massachusetts' Chapter 58 health reform law, I believe that the critics are intentionally distorting the very real success of our health reform efforts in an effort to defeat Gov. Romney and to repeal the federal health reform law. I'll let Mitt Romney defend his role, but I feel compelled to demonstrate the very real success of health reform in Massachusetts while recognizing that further reform is still needed.
It is a fact, I will candidly admit, that Massachusetts does have the country's highest average health insurance premiums (and always has, even before the reform law passed in 2006). But this needs to be viewed in the context that Massachusetts also has the fourth highest income level. When we look at employer health insurance premiums as a share of household income, in both 2003 (before reform) and 2009 (after reform), we find Massachusetts is among the least expensive states when considering the proportion of one's income required to pay for health insurance.
Furthermore, if you look at the rate of un-insurance, coupled with premiums as a percentage of a family's income, Massachusetts scores extremely well in both areas. It's not that our costs are low; they are not, especially when compared with costs in any other advanced nation. The essential point is that the burden of high health care costs is not just a problem for Massachusetts. Most other states, based on real affordability, are in even worse shape, not better; and it's a big part of the reason why they have so many uninsured that need the help promised by the federal "Affordable Care Act."
Our Massachusetts health reform law did not cause an increase in health costs. In fact, the law has improved health care quality and safety so that what we do spend on health care goes a long way to making us and keeping us healthy!
One of the most important parts of the health reform effort in Massachusetts has been to promote the use of health information technology. That means moving from paper health records to electronic ones and issuing prescriptions for medication by computer instead of unintelligible doctor handwriting.
According to an annual survey by SureScripts, a leading source of health information technology information, Massachusetts ranks number one in electronic prescribing with 69 percent of physicians and 95 percent of pharmacies participating in this technology. This e-prescribing improves safety, reduces duplication and errors, and saves money for all who pay for health care.
A recent event at the State House also reported significant progress by Massachusetts physicians in moving toward meaningful use of electronic health records that will improve the quality of care and provide better coordination of our care by various providers. Massachusetts, again, leads the nation in adoption of health information technology!
Massachusetts is among the top 10 states in health care rankings - rated either first or second depending on the survey. Strengths include a low prevalence of smoking at 14.9 percent of the population resulting, in part, from expanded smoking cessation benefits included in the state's health reform law as well as the lowest rate of uninsured in the country. Another indicator is the high immunization coverage with 93.4 percent of young children age 19 to 35 months receiving immunizations and the ready availability of primary care physicians, both resulting from programs that are key part of our health reform efforts.
In the coming year, the Legislature will again develop policies aimed at containing the rate of increase, or even cutting, health care costs. The fundamental principles in this effort will be to improve the quality of care so that what we spend on care is more targeted to treatments that have proven to be effective.
As the Senate Chairman of the Legislature's Committee on Health Care Financing, I will be directly involved in this effort with my goal being to continue to lead our health care system to be more affordable while maintaining access to care and improving the quality and safety of care for everyone.
Sen. Richard T. Moore represents 14 towns in South Central Massachusetts and is one of the leading architects of health reform in Massachusetts. He is also immediate past president of the National Conference of State Legislatures representing every state legislator and legislative staffer in the United States.
The author says:
"When we look at employer health insurance premiums as a share of household income, in both 2003 (before reform) and 2009 (after reform), we find Massachusetts is among the least expensive states when considering the proportion of one's income required to pay for health insurance. Furthermore, if you look at the rate of un-insurance, coupled with premiums as a percentage of a family's income..."
These are kind of odd statistics to use in support of legistlation that has so thoroughly affected health care insurance in Massachusetts. But since they are the only statistics in the above (other than the astonishing information that doctors in Massachusetts -- the cradle of the U.S. computer revolution -- are using computers), let's look at them a little deeper.
What are "employer health insurance premiums?" What does the "rate of uninsurance" have to do with it (or anything in this editorial)? Just taking the words at their English meaning, I guess the author is saying that the amounts your employer pays for your health insurance is the same or less than before RomneyCare. Does that surprise you given that your premiums and co-pays and deductibles have been soaring?
Perhaps the author meant something else by including the word "employer" (and not "employee" or "total" or "including out of pocket costs" or something clearer) but it wouldn't matter anyways. Unless you are covered by insurance bought by you as an individual (e.g., self-employed) or a member of small group (about 10% of residents including both categories), RomneyCare had very little or no (if you're employer is self-insured) direct effect on you. And about 50% of us don't even get insurance through an employer (other than the 5%-10% of us employed by the government itself).
But you are increasingly going to be directly affected by RomneyCare's inefficiency and incoherent and meaningless regulation. (Up until now you have simply had to pay the higher premiums, sales taxes, fees, etc. required by RomneyCare while getting less state aid, support for cops and courts, state parks, etc. In fact, it is totally intellectually dishonest for the author to give credit to RomneyCare for smoking cessation -- which peaked in the 90s -- when the legislature has even been drastically cutting back on public health spending.) I am self-employed and was directly affected at the time of RomneyCare but your turn is coming. You're more and more likely to fall into the clutches of RomneyCare because over 100,000 fewer people are getting insurance through employers since RomneyCare (that's a national trend and not totally related to RomneyCare).
Despite its tone, I don't believe the author wrote this to congratulate himself. He's softening you up with scare tactics so the legistlature and bureaucrats can take over control of the healthcare delivery system (the contact between you and your doctor) with new legislation now that they have screwed up your and my insurance.