| I'm hearing a fair amount of grumbling that recent cuts in the state's health care coverage point to the law's "failure". I've even promoted some of it, since it's valuable to honestly discuss its shortcomings. But please -- "failure"? This kind of commentary is awfully premature. Yes, health care is expensive; covering people with subsidies and free coverage is expensive; costs are still going up. No, the 2006 Massachusetts law did not deal with costs; it was not intended to do so. It was an access law. We are in a historic budget crisis. The state is cutting a lot of things -- not just health care. Is Massachusetts K-12 education a failure because we have to cut $79 million this year? Is respite care a failure because it's getting cut by $9.6 million? Come on. That's crazy. (Almost as crazy as thinking of health care as a "luxury".) The law has some notable successes. First of all, 97% of Massachusetts residents have coverage, shielding them from financial catastrophe -- though, as we've seen, certainly not from debt and crippling expense. From 2006 to 2008, say researchers, "access to care improved markedly." Believe it or not, the executive branch, legislature, and AG continue to work on the cost issue with some seriousness. In 2008 cost control legislation was passed, and there continues to be legislative ferment in cost control. The executive branch is indeed working on both the current financing, and in realigning incentives for quality of care, not quantity ("payment reform"). The Attorney General has a relatively new health care division, which deals with consumer issues and fraud. So, good-faith criticisms should be acknowledged and taken to heart. Some markers of access and affordability have begun to backslide somewhat. That is indeed a great concern, and that's why health care reform is an ongoing project. It was not, was never, could never have been, the "make everything perfect for all time" law. The law was a way, a framework, for trying to make things better. It's not done. |
