Massachusetts vote a referendum on health care reform

January 20, 2010

Trudy Lieberman, a long-time health care and consumer journalist, is a contributing editor to the Columbia Journalism Review and has blogged about health care for cjr.org since the beginning of the presidential campaign. The views expressed are her own.

A few year’s back, a joke on the cocktail circuit went like this:  you know the world is  topsy-turvy when the best rapper is white; the best golfer is black, and the Germans don’t  want to go to war.  Tuesday’s vote in Massachusetts that sent Republican Scott Brown to the Senate taking over the seat held by Edward Kennedy for nearly fifty years produced a new twist to the old joke.

Things are indeed upside down when the advocates for a single-payer, national health insurance system supported a Republican.  On Sunday, one of those advocates, Diane Cooper Bridges, sent a letter to the president and to his adviser David Axelrod saying:

“Democrats are voting for Scott Brown b/c MA residents know for sure how  regressive and oppressive life is under the failed MA plan, especially in this recession that is not getting any better unless you are a banker or a broker on Wall Street or a member of the U.S. Congress.  And we know that the national bills are worse than the MA plan.”

For months a small band of single-payer supporters have tried to get the attention of their elected officials, telling them that their state’s much hailed health reform law, which became the model for the national bill Congress is crafting, was not working according to the official version that sometimes appeared in the nation’s news media.  For the most part, those people were dismissed.

Specifically, they wanted them to know that the premiums for insurance that residents are required to buy are too high and unaffordable for many.  Small businesses are hit particularly hard and are facing increases of 20 to 45 percent.  To make policies affordable, families are turning to high deductible plans which make them pay the first $2000 (or more) of their medical costs before the insurance policy does.  One person who recently dropped her policy after a 30 percent increase said what was the point of paying for a policy she could not use because of its high deductible.

Policyholders are gaming the system, buying insurance and using it for a few months to pay for care and then dropping it when they are well.  That raises the price of coverage for everyone, but it is an inevitable result of the kind of reform the state passed.

And a year after Attorney General Martha Coakley, who lost the election, began an investigation into possible collusion between the state’s biggest health care system and biggest insurance company that may have contributed to high premiums, no results have been forthcoming.   A Boston Globe reporter whose expose sparked the AG’s probe told me that some of the key players had not yet been questioned.

Even though polls showed support for the reform, a close look indicates that among people most affected by the law—those who had to change coverage or buy a policy—support was much weaker, a point often glossed over in national news reports. The public knew that the law called for no serious cost control, its most serious shortcoming also mirrored in the national legislation.

Throughout the last year, my blog posts about the Massachusetts health plan on cjr.org told of cracks in the state’s health care system and how people were pissed.  Yesterday the fractures opened wide; when people had a chance to vote, they expressed their dissatisfaction, which, of course, is what democracy is all about.  Americans also don’t like arrogant or imperious politicians, and they don’t care much for flim-flam.  Eventually they make that clear at the voting machine.

The vote was a referendum on health care reform.  A Republican polling firm that conducted an exit poll found that Brown’s opposition to congressional health care legislation was the most important ingredient in his victory.  Still, it seems like Washington is not hearing the message—at least not yet. Late last night House Speaker Nancy Pelosi said: “Massachusetts has health care and so the rest of the country would like to have that too.  So we don’t (think) a state that already has health care should determine whether the rest of the country should.”

And her number two man, House Majority Leader Steny Hoyer, noted:  “The Senate bill is better than nothing.”   The voters of Massachusetts seem to disagree.  The election results will no doubt now cause the rest of the country to check out the Massachusetts model and see if it is good for Mississippi.

21 comments

We welcome comments that advance the story through relevant opinion, anecdotes, links and data. If you see a comment that you believe is irrelevant or inappropriate, you can flag it to our editors by using the report abuse links. Views expressed in the comments do not represent those of Reuters. For more information on our comment policy, see http://blogs.reuters.com/fulldisclosure/2010/09/27/toward-a-more-thoughtful-conversation-on-stories/

All Americans should visit http://www.masshealthlawtruth.org and read this from stem to stern to learn how you will probably be affected by the national health insurance mandate. The differences between the MA plan and the national bill(s) are slightly di fferent with regard to Federal Poverty Guidelines and a few other items, but all in all, the national bill(s) are more punitive, restrictive and downright in your face and life. A complete takeover. For Trudy Lieberman’s in-depth series on the MA plan, go to: http://www.cjr.org/campaign_desk/massach usetts_health_reform_ar.php

Posted by hbf | Report as abusive

People want HEALTH CARE. Not insurance patches. The people have yet to be at the heart of this debate. It’s all about who profits and who pays.

There is nothing about actual health care and the guaranteeing of that health care to the public. Instead they want to force us to buy insurance. We KNOW the insurance based model of health care is broken. So why do they want to force us to purchase it?

They do not have the interests of the citizenry at heart. They care only for money unless they’re discussing killing people in other countries. Then the money magically appears.

We ask for real health care reform and we get an insurance bill. Washington spits in the face of the citizen and tries to paint it as a victory. Both sides say that their bill is what the people want while none of them actually listen to the people.

Posted by Benny_Acosta | Report as abusive

If folks want to REALLY understand what a failure The Mass Plan is, please read this website from beginning to end:

http://www.masshealthlawtruth.org

There are several links to articles in the website written by Trudy Lieberman.

Posted by abbybwood | Report as abusive

uhhh… yeah. Great “factual” website. No opinions being shoved down your throat there.

We could start reviewing the bill here:
http://www.factcheck.org/2009/11/health- care-and-the-economy/

or look at the actual costs here:
http://www.cbo.gov/doc.cfm?index=10870

and the probably the best general information on what the rest of the world is doing.. (again, NO opinions presented, just information presented so you can make up your own mind.. unlike a certain lemming based network that starts with “F”….)

http://www.pbs.org/wgbh/pages/frontline/ sickaroundtheworld/view/?utm_campaign=se archpage&utm_medium=videosearch&utm_sour ce=videosearch

The current bill is certainly lacking, but it’s a start. Just because something becomes law doesn’t mean it can’t be changed or fixed. Weird, we have this expectations that our inept government HAS to get it right the first time on anything, and when they don’t, it’s a complete failure. By definition, our system will never get any bill in agreement with everyone, or often even with a simple majority. Very depressing….

Posted by dbarrycoyle | Report as abusive

The shame of it is that Health Care Reform go so watered down by special interests, that it is no longer worth while and should be killed.

I do find it amusing that Brown was campaigning against the Democratic plan and the taxation that it would involve.

Wait a minute, McCain’s Presidential platform also called for taxing Health Benefits. If it is wrong for the Democrats to tax Health Benefits, isn’t it also wrong for the Republicans to tax health benefits?

Posted by Robert76 | Report as abusive

Yes, we Massachusetts voters were finally able to stand up to the lock-step, corporate dictated power establishment and say “NO!”. The majority of people that I know voted for Scott Brown not for what he stands for than what he opposes. That’s very sad, but if that was the only way to have our voices be heard, so be it.

Enactment of the Massachusetts “health care reform” is simply an example of what the Feds have likewise have been paid to do. Although cloaked in benevolent phrases and euphemisms, it is not about medical attention, it is about who can swindle the most money under the cover of doing good.

A great website for in depth investigation of the failed Massachusetts kettle of fish is http://www.masshealthlawtruth.org.

Posted by stopmassmad | Report as abusive

Health insurance when I was laid off would have cost me more than my mortgage per month. We need universal healthcare. What is the market value of the life of your child? Corporate greed is no way to ensure access to proper healthcare.

IT’S BROKEN. PLEASE STOP THE INCOMPETENCE AND CHANGE IT!

Posted by KenesZwart | Report as abusive

I am just a citizen. I helped vote in the President and his party. I wanted someone who would look out for my interests. The President then cut a deal with major corporations so that the health care bill would be acceptable to them. The Congress created an obligation for me to buy health insurance from the companies that had created the crisis. My wife’s insurance is deemed too large and they decided to tax it cutting my family’s benefits. No one cares about me. I vote and they forget. I suffer and they look for more contributions. Where am I in the scheme of things. Some years ago, people were worried about just being a number. I don’t think we make it that high. As far as Washington is concerned we’re nothing.

Posted by southwerk | Report as abusive

Remind me, what does the government do well and efficiently? Nothing, right? So why on earth would we ever entrust them to enact legislation that has any bearing on our healthcare? Anyone ever been to Europe? I have and their healthcare, which costs a fortune, is terrible. Keep the government out of as much as possible. Bureaucrats with special interest lobbyists cannot make sound decisions on our behalf.

Posted by ccttl | Report as abusive

It’s not that hard…. Government employees, military employees have the best medical coverage… Why can’t we have the same…. We are citizens of the U.S… we pay taxes…. I think that all U.S. Citizens should have the same coverage that all government elected officials and military personnel have. All non U.S. Citizens will have a different policy.. Until they can become a citizen, they need to pay at a higher rate than U.S. Citizens… Maybe they will then want to become citizens instead of feeding off of ous and not paying taxes.. Elected officials are no better than any other U.S. Citizen… So why won’t that let us have the same coverage.. I would love to have it.

Posted by jw1955 | Report as abusive

I love it when people say, “I’ve been to Europe and they have terrible health care.” What were you on, a cruise or a drug? Our health care can cost you your house and your life savings and your life itself. It’s inequitable and insurance companies spend eons on salaries for employees who do nothing except find ways to deny health care for customers who get sick. Billions in profits and excessive salaries for CEO’s is where our premiums go. For-profit health care is immoral, but tell that to a right wing Evangelical “tea bagger.” What they hate is the concept of equality for all and a sense of sharing. What is the one thing the government ever got right? Social Security. Ask one of the ignorant ninny Republicans who disrupted meetings on health care if they are willing to give that up, and their fat bellies shake. The sickness in America goes way beyond the emergency room.

Posted by ndun | Report as abusive

Universal insurance is universal healthcare by proxy with additional administrative overheads. It is just a privately administered tax without the benefit of oversight.

Posted by Citizen_A | Report as abusive

Benny Acosta, post #2 told you. I am so happy to finally see Americans start distinguish the difference between insurance and care. You need HEALTHCARE, which unfortunately for the American individualism, is a social idea. Forced insurance premiums will have the same exact effect as forced auto premiums – be very expensive. Yes, the Congress betrayed its citizens, and it is trying to force you into even larger corporate profits. The very same idea that orthodox republicans were trying to convey for 30 years now may become true. Insist on reforms, not the parody of law, that currently goes on.

Amen.

Posted by Ananke | Report as abusive

So much BS! Insurance companies run the show, grease the palm of the senators on both sides of the aisle. Right now ANTHEM BLUE CROSS OF CALIFORNIA is in the process of reaming all private practice physical therapists in the state by cutting their reimbursable rates down to 75 dollars a visit! No matter what the diagnosis, how complicated the patient. How expert the services! Friends if you work California you know private practioners can’t survive at that rate and give quality care, what with the cost of doing business there. It’s a wake up call people to stand up and do something! But there is no way to get reform until you get big business out of health care. No way to get reform until you make the insurance giants part of the Sherman Act which would stop them from collusion and price fixing. No reform until you understand that doctors aren’t making decisions about your care but rather some damn bean counter on the phone! No reform when the insurance companies “compromised” and said, we won’t discriminate on diseases states but we’ll discriminate on age. Great so your 45 and can’t get insurance even if you’re perfectly healthy. No reform until you get enough people who vote, who lose their jobs to realize even the so called middle class can’t afford health care if they are out of a job 6 months or two years. Who in the hell can afford the cobra costs?
STAND UP, CALL YOUR HR DEPT. CALL YOUR SENATOR AND CONGRESSMAN and tell them you have had enough!

Posted by physio | Report as abusive

Remind me, what does the government do well and efficiently? Nothing, right? So why on earth would we ever entrust them to enact legislation that has any bearing on our healthcare? Anyone ever been to Europe? I have and their healthcare, which costs a fortune, is terrible. Keep the government out of as much as possible. Bureaucrats with special interest lobbyists cannot make sound decisions on our behalf. ====== Amen to that! I am an expat in Central Europe and we have socialized medicine; the care is horrible, hard to get in, long waiting, and to pay for this sham, they have 23% tax on everything! Yes, including used clothes, used cars, and food. Everyone hates it, rich, poor and middle class.

Posted by tenman07 | Report as abusive

Southwerk wrote, “I am just a citizen. I helped vote in the President and his party. I wanted someone who would look out for my interests. The President then cut a deal with major corporations so that the health care bill would be acceptable to them. The Congress created an obligation for me to buy health insurance from the companies that had created the crisis. My wife’s insurance is deemed too large and they decided to tax it cutting my family’s benefits.” ===== Hey, Southwerk, I don’t want to say “serves you right”. It is clear you didn’t bother to check Obama’s voting record. If you had, you would know he is an elitist, indecisive socialist who voted “present” 60% of the time in the senate. That is not just a coward, that is a person who doesn’t have integrity to take a stand and then take responsibility for their decision. What else did you expect?? That’s the trouble with the left and those on all the programs- they want the free handouts, and to penalize those evil rich people– the ones who own factories and provide jobs. There’s a reason people say “tax and spend like a liberal democrat.”

Posted by tenman07 | Report as abusive

ndun wrote,”I love it when people say, “I’ve been to Europe and they have terrible health care.” What were you on, a cruise or a drug? Our health care can cost you your house and your life savings and your life itself. It’s inequitable and insurance companies spend eons on salaries for employees who do nothing except find ways to deny health care for customers who get sick. Billions in profits and excessive salaries for CEO’s is where our premiums go. For-profit health care is immoral, but tell that to a right wing Evangelical “tea bagger.” What they hate is the concept of equality for all and a sense of sharing. What is the one thing the government ever got right? Social Security. ======== Hey, ndun, Newsflash for you. I am one of those educated, working, middle-class, conservative evangelicals, and the hypocrisy and ignorance of you and the typical left is laughable. I am an American citizen, expat [it means a non-native person working overseas]and we have socialized medicine. You should ease up on the meth and travel, or read something besides comics. We have socialized medicine and it is terrible. The care is substandard, and the waiting is horrible, and to pay for this nighmare, we have 23% tax on everything from used clothes to food and used cars. Oh, ndun, the best part is we also have forced castrations too, for sex offenders, covered by all the citizens. [Now that's a good start to real health care reform] But someone too lazy to check Barak Hussein’s voting record would be too lazy to learn a foreign langauge. Just listen to yourself — you’re defending democrats like Nobamamao, who have never led or managed anything, Martha the child molester supporter, who said that there are no terrorists in Afghanistan, or the TSA nominee sellers, who wanted to unionize the TSA. Great logic, ndun.

Posted by tenman07 | Report as abusive

southwerk and all: We can and will get Medicare for All. There is plenty of hope, but we must act in unison. We can all do it FIRST by sitting at our homes or businesses. In fact, we can get help at the first of each month that makes our individual task easy as part of being “one in a million.” SECOND we can contact others one-on-one or on the phone to tell them as part of a massive communications activity among us to know what Medicare for All (single-payer) is and what its benefits are (select “Benefits” at the website). That’s most of the steps for how to get it. To learn what the heck I am talking about sign up at http://www.medicareforall.org for how to get Medicare for All. Be part of the action. Try it; you’ll like it.

Bob the Health and Health Care Advocate

Posted by singlpayractvst | Report as abusive

KenesZwart and all: Please spend 10-15 minutes per month to help get it at http;//www.medicareforall.org

Bob the Health and Health Care Advocate

Posted by singlpayractvst | Report as abusive

ccttl: although you are wrong about Europe, based on my family’s multiple experiences there of a serious accident and a couple of serious medical condition … and on the Europeans’ much better life expectancy and ability to minimize deaths due to preventable diseases (U.S. is 19th out of 19 countries) … and no major medical bills … and no medical bankruptcies … (and there’s more) .. —- you do have one thing correct. We must reduce government involvement by having a separate public agency, not having the day-to-day debates and decision-making of U.S. politicians messing things up. We need to eliminate bureaucracy with Medicare for All. We don’t need to add to it like the Congress and President Obama are preparing to do. TAKE ACTION, CCTTL … go for what’s the best. Go here: http://www.medicareforall.org

Bob the Health and Health Care Advocate

Posted by singlpayractvst | Report as abusive

None of the respondents who claim to have experience of the health care system in Europe mention which part of Europe they know something about. “Europe” consists of more than a dozen countries, each with its own health care system. In some places, the health care is excellent, in some it is merely adequate. In all places, it is either completely free or genuinely affordable and, most importantly, available to all. And there is always the option of ‘private health care’ – i.e. doctors and hospitals outside the national system that you simply pay for yourself if you can afford it and do not wish to rely on the health care that is provided free. Likewise, there are private health insurance companies similar to those in the USA if you prefer not to rely on the universal national health insurance schemes that pay for the ‘free’ care.

Posted by jondale | Report as abusive