We'll call this a Massachusetts Case Study. Here's a little background info before we get to today's main point: dragging the business community along with us kicking and screaming.
When Massachusetts passed its major health care reform law, it wasn't quite as revolutionary as many people thought. Instead of trying to fix the systemic problems of health care, Massachusetts went after a bad symptom: the hundreds of thousands in the state without Health Care. Why? It's a politically popular thing to do, and HMOs enthusiastically supported the idea because who could pass up a little government corporate welfare in the quest to insure those who otherwise couldn't afford it? The Mass Health Care plan was a dream come true for the insurance industry.
However, as Ezra Klein notes, addressing health care access before you address health care costs adds perhaps insurmountable problems to the system, as the costs rise way above the rate of inflation and suddenly the state can't afford the new coverage. More on that here.
Now it's time to talk about the real point of this blog - how the business community must learn to live with a little disappointment, if we're to save the Massachusetts Health Care system. Governor Patrick's released a plan to bridge the gap in the system and get it out of the red, calling on the business community to finally kick in something a little closer to a 'fair share,' to make this great experiment work, at least for a little longer. However,
Business and insurance industry leaders are opposed to Patrick's plan, saying it is unfair to ask them to pay more, especially during an economic downturn.
Sheesh, tell that to the people who have been paying 10% more each year for their health insurance, for around an entire decade.
How ridiculous are their complaints?
Lord said the proposal would hit retailers especially hard, because many of them face such high turnover that they do not typically offer health insurance to full-timers until after 90 days.
Absurd. We're supposed to feel bad for them because they don't offer their employers insurance for an inordinately long time (and then typically make it too expensive for their employers to afford)? Extra bonus points because many of these employers <span style="font-style: italic;">want </span>their employees to have a high turnaround, just look at Walmart - a company that decided too many people were sticking around long enough to accrue raises and health care benefits. How do you resolve that situation? Create company policy that messes with their job descriptions, making sure everyone has to stock the shelves and do the manual labor, not just stand at the register all day. It was a good way to get the less healthy to quit! (Update: here's the link, pdf style.)
The worst about all this is the HMOs are going all 9/11 on us. Apparently, Governor Patrick's plan is unpatriotic or something.
Patrick's plan would raise another $33 million from an assessment on insurance companies' reserve accounts. But Dr. Marylou Buyse, president and chief executive of the Massachusetts Association of Health Plans, said that the money is needed by the companies to cover catastrophic health costs in the event of a flu pandemic or a terrorist attack.
First, does anyone believe the HMOs for a second? Record profits... they can deal with that $33 million to keep Massachusetts insured (which surely affords them with far more than $33 million in profits). Rest assured, MAHP, in the event of a flu pandemic or terrorist attack, Beacon Hill will step up to the plate and release new funds to make sure everyone's covered. I have a funny feeling they'd have done that irregardless of this $33 million. However, it's surely a low point in American history when corporations are throwing out the 9/11 card to avoid a small tax increase. Shame on them.
Almost as bad is Mass Hospital Association.
The state's hospitals are supporting the request for more money - $28 million from hospitals - with a caveat. Hospitals are willing to pay more to make near-universal healthcare work, said Lynn Nicholas, chief executive of the Massachusetts Hospital Association, but she tied the organization's support to the defeat of an unrelated measure pending in the Senate. That bill would set minimum nurse staffing requirements and require hospitals to hire more nurses.
Apparently, they'll support this policy... with a quid pro quo. Who needs more nurses anyway? It's not as if anyone wants high quality health care! Still, though, at least they're not throwing out the 9/11 card.
Now for the people who really matter:
Consumer groups are enthusiastically supporting Patrick's plan. "Consumers have already stepped up to the plate," said the Rev. Hurmon Hamilton, president of the Greater Boston Interfaith Organization... "I would strongly urge the business community, insurance, and hospitals . . . to come forth and do their part."
The bottom line is that, according to the Harvard School of Public Health, three-quarters of the population said they support making sure businesses have to contribute more if they don't offer insurance - a cornerstone of Governor Patrick's plan. 61% favored insurance companies kicking in more, as well. The people are speaking; the Government would do well to listen. It's what we have to do to save the Mass health care gains long enough to fix the systemic problems in health care that are increasing costs. It's not the long-term solution, but it will do in the medium term so long as we're investigating true ways to lower health care costs - even if that means single payer.
Note: the text below the fold is largely crossposted on my daily Mass politics blog, Ryan's Take.