Ten years after its passage, the Massachusetts health care reform law has largely done its job in assuring that residents are insured. It is has fallen short elsewhere for reasons that go beyond the state.
According to a Blue Cross Blue Shield of Massachusetts Foundation survey, 95.7 percent of working-age Massachusetts adults have health insurance (Eagle, March 24). This is a remarkable achievement, and means that the vast majority of state residents won't be bankrupted by a catastrophic illness, hurt financially by a lesser one, or be forced to let minor ailments go unattended until they turn into major, perhaps fatal, ones.
The same survey, however, found that half of all working-age adults are facing high health care costs or difficulty finding a health care provider who will accept new patients. A shortage of doctors, especially primary care physicians, is a serious problem in the Berkshires, one that is being addressed in part by the presence of more physicians' assistants. The problem of high health care costs is a knotty one to solve at the state level because it is closely linked to rising costs nationally.
The 2006 Massachusetts health reform law is nicknamed "Romneycare" after Mitt Romney, who as governor was instrumental in its passage. This should still be a proud achievement for the governor, but he was forced to distance himself from it after evolving from a moderate governor to a "very conservative" Republican candidate for president. Perhaps someday he will be able to take some deserved credit for the law.
The Massachusetts law was in part the model for the federal Affordable Care Act or "Obamacare." Recent federal surveys attest to its success in helping uninsured Americans but it too has not been able to successfully address rising health care costs. Some of these rising costs can be attributed to little more than naked greed, such as in the astronomical price tag on some prescription drugs.
Advocates of "Medicare for all" or single-payer legislation made their case Wednesday at a hearing of the Joint Committee on Health Care Financing. Government-financed health care, which works so well in Canada and much of Europe, is clearly the way to go at a federal level here as well. However, Vermont's unsuccessful attempt to institute single-payer raises doubts that it can be pulled off at the state level given its dramatic differences with a federal system with which it must be integrated.
Regardless, efforts at improving health care must continue in Boston and Washington DC — if at all possible. Progress has been made in providing insurance for all in the state and nation, but so much more needs to be done.