Did Mass Voters Reject the Massachusetts Health Reform Model?

Some Boston-area reform advocates see the apparent demise of the Senate health reform bill as a way to re-open discussion about single-payer and the high cost of premiums and co-pays for those buying insurance through the state.

Blogging for The New York Times, Steffie Woolhandler and David Himmelstein, the two Harvard docs at the front of the effort to promote single payer, say it is time.

The president can regain his footing by reconnecting with the hopes of Americans who elected him and rejecting the sordid corporate compromises that signify Washington politics as usual. A single-payer, Medicare-for-All reform would lower costs, cover the uninsured, and upgrade coverage for most insured Americans. Leading a crusade for such a plan, he’d mobilize vast popular support; enough to overwhelm Republican obstructionism. But instead, he seems intent on looking for light at the end of the same old tunnel.

During his campaign, President Obama declaimed that he’d back single payer – if we were starting from scratch. One thing’s clear from the recent Massachusetts election upset: it’s time to start from scratch.

Marcia Angell  suggest the same on HuffPo

Liberals are wrong to think that opposition to health reform is a rejection of big government. If health reform consisted of extending Medicare to everyone, people would be delighted.

Blue Mass Group points out that the California Senate just passed a Medicare for All bill.

Others say that one reason people dumped the Democrats is that they are having a hard time affording the premiums and co-pays that come with mandated insurance. From Trudy Lieberman in the 1/22 Columbia Journalism Review

Wednesday on WNYC’s Brian Lehrer Show, Richard Parker, who lectures at Harvard’s Kennedy School, talked about his son’s hockey coach, a third-generation Cambridge fireman who voted for Obama in 2008 but went for Brown this time. The fireman, like most public sector workers, has very good insurance—a so-called Cadillac plan with good benefits that the Washington health care cognoscenti want to tax into oblivion. “They’ll screw my system if we don’t stop them,” the coach told Parker. The anecdote raised an important question—how affordable will insurance be when national reform is fully enacted? Parker said that people in the state perceive national reform as all about expanding coverage, not affordability, which he called “the poison pill at the heart of the bill.”

Still, the possibility of a global payment system is on the table here in Mass and some advocates are lining up behind it. (Under the system, doctors and hospitals would be paid per episode – like a heart attack – or per patient. Now, they are paid for each service they deliver – hospital stay, anesthesia, specialist consults Reformers say the current system leads to much waste and unnecessary treatment.)

Health Care for All, a local group that supported the Obama plan, has set up a new organization to make sure patients have a role in that effort – The Massachusetts Campaign for Better Care

Payment reform can both improve the quality of health care and lower costs. Changing the payment system will not be easy, but we can get there through patient-centered care. To do this we need to reduce waste, give patients more control and free up doctors from time-consuming paperwork so they can be there for you…

Improving your care can drive down the price of health care. We need to make your co-pays and premiums more affordable so that everyone can get the care they need.

For more on the Mass proposal for global payments see:  The Recommendations of the Special Commission on the Health Care Payment System.