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Globe Editorial

Mass. bashers take note: Health reform is working

August 5, 2009

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PUNDITS and politicians who oppose universal healthcare for the nation have a new straw man to kick around - the Massachusetts reform plan that covers more than 97 percent of the state’s residents. In the myth that these critics have manufactured, this state’s plan is bleeding taxpayers dry, creating nothing less than a medical Big Dig.

The facts - according to the Massachusetts Taxpayers Foundation - are quite different. Its report this spring put the cost to the state taxpayer at about $88 million a year, less than four-tenths of 1 percent of the state budget of $27 billion. Yes, the state recently had to cut benefits for legal immigrants, and safety-net hospital Boston Medical Center has sued for higher state aid. But that is because the recession has cut state revenues, not because universal healthcare is a boondoggle. The main reason costs to the state have been well within expectations? More than half of all the previously uninsured got coverage by buying into their employers’ plans, not by opting for one of the state-subsidized plans.

This should be exciting news for those fiscal conservatives, including both Republicans and “blue dog’’ Democrats, who claim to support the goal of universal coverage while despairing over its budget impact. But that’s not what you hear from the Massachusetts bashers. Trying to scare off the nation from helping the uninsured get coverage, Fox News host Bill O’Reilly said recently, “You don’t have to look any further than the universal healthcare mess in Massachusetts to see disaster ahead.’’ New York Times columnist Ross Douthat on Monday accused President Obama of “pushing a health plan that looks a lot like the system currently hemorrhaging money in Massachusetts.’’

The Republican governor of Minnesota, Tim Pawlenty, has also gotten his licks in. Costs in Massachusetts, he wrote in the Washington Post Monday, “have been dramatically higher than expected.’’ Pawlenty’s purpose in attacking this state’s plan might be both to discredit a national plan and to score points against former governor Mitt Romney, one of the architects of what Massachusetts has accomplished. Romney, of course, is a possible rival of Pawlenty for the GOP presidential nomination in 2012.

Whether out of ignorance or convenience, all three bashers have it wrong. Unlike the Big Dig, health reform came in on time and under budget. It will be proportionately more expensive nationally to provide coverage for the uninsured than it has been here simply because the state began the task with a much lower rate of uninsured, 7 percent, compared with the US rate of 17 percent. But a national plan that relies, as Massachusetts’ does, on both government-subsidized insurance and a mandate on employers to offer insurance or pay a penalty (in Massachusetts’ case, a very small penalty) should be able to cover nearly everyone without busting the budget.

In Massachusetts, cost estimates for the reform plan before its passage in 2006 were so low that Romney and the reform law’s Democratic supporters in the Legislature were able to get away without creating a new tax to fund it. After the costly Wall Street bailout and the $787 billion stimulus package, that option is not open to President Obama and Congress. But Congress should not allow itself to be buffaloed by false claims about Massachusetts into fearing a tsunami of red ink.

There is one other statistic about the Massachusetts plan that politicians, in particular, should appreciate. According to Robert Blendon of the Harvard School of Public Health and the Kennedy School of Government, the law’s approval rating in June 2008 was 69 percent. That is a figure officeholders can only dream about.

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