Romney should be proud of Massachusetts health law

By Deval Patrick
April 12, 2012

It’s been six years since Mitt Romney signed the Massachusetts healthcare reform law. That law was a framework for change, a values statement about what we believe in Massachusetts: that health is a public good and that everyone deserves access to affordable, high-quality healthcare.

Six years after its passage, our experiment in universal healthcare is working, expanding coverage while helping to control costs. Mitt Romney should be proud of the law he signed. As the one responsible for implementing it, I know I am. Here’s why.

More people have health insurance in Massachusetts than anywhere else in the country: 98.1 percent of our total population. Of our children, 99.8 percent are covered. While the number of people without health insurance in America grew from 2006 to 2010, more than 400,000 people in Massachusetts gained coverage.

This isn’t because government took over. Massachusetts healthcare reform, like the national Affordable Care Act, takes a hybrid approach to increasing coverage, encouraging people to get health insurance in the private market and subsidizing the cost for those who can’t afford it. Here again, it is working. More businesses offer their employees private healthcare today than did before the law was signed. The 77 percent of Massachusetts businesses that offer their employees private insurance is well above the national norm.

Most important, people in Massachusetts are healthier and getting better care. Over 90 percent of our residents have a primary care physician, and 4 out of 5 have seen their doctor in the last 12 months. Preventive care is up: More people are receiving cancer screenings, more women are getting prenatal care, and visits to emergency rooms have decreased. After we expanded coverage for smoking cessation programs, 150,000 people stopped smoking, and a recent study by the National Bureau of Economic Research documents improvements in physical health, mental health, functional limitations and joint disorders as a result of the law. While everyone is better off, women, minorities and low-income residents saw the biggest health improvements. I have met individuals whose lives have been saved by the access to good care our model made possible.

Massachusetts healthcare reform has proved to be cost-effective as well. An independent analysis by the Massachusetts Taxpayer Foundation estimated the law was responsible for about a 1 percent increase in net state spending. Spending on our uncompensated care pool – those who receive medically necessary care they can’t afford – is down significantly since the law passed. Today, the Massachusetts Health Care Connector – our version of the “exchange” created by the Affordable Care Act – announced that it will provide private health insurance to more people than ever next year, at an average per-person cost 5 percent lower than last year, the second year in a row of premium decline. Growth in premiums throughout the market has slowed from an average of about 16 percent two years ago to less than 2 percent today.

For these reasons and more, healthcare reform remains popular in Massachusetts. More than 60 percent of our residents support it. They know it is working for them.

There is more work to do. We still must do more to control the cost of healthcare in Massachusetts and across the country. We must also be open to new technologies and payment methods to continually improve the quality of care. We are tackling that challenge next, with help from the tools of the Affordable Care Act.

But after six years, it is worth taking a moment to recognize all the good that is happening here in Massachusetts – and how it came about. A Republican governor, Mitt Romney, a Democratic senator, Ted Kennedy, a Democratic state legislature, the business community, organized labor, health leaders and patient advocates all came together to invent our model, and most then stuck together to refine it as we moved forward. They decided collectively to put a stake in the ground, acknowledging the all-in cost of poor health and inadequate access to care and resolving that in Massachusetts healthcare would be available to everyone. Each brought ideas to the table. Romney and business leaders brought the individual mandate. Legislators insisted on a way to hold accountable companies that did not provide coverage to employees. Patient advocates brought a special sensibility about affordability. Kennedy brought his subject-matter expertise and his skill at bridging partisan divides. Working together, they realized they had other choices when it comes to healthcare reform than the usual two: a perfect solution or no solution at all.

Six years after its passage, it is clear that healthcare reform has worked in Massachusetts. And there is no reason to believe it won’t work for the rest of the nation.

PHOTO: Massachusetts Governor Mitt Romney speaks at a signing ceremony for the state’s healthcare reform bill, at Faneuil Hall in Boston, April 12, 2006. REUTERS/Brian Snyder

13 comments

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What an excellent piece, Governor Patrick! I’m proud to live in a state with a governor who cares so much for the health and well-being of our citizens here and across the US. Many MA physicians also support our state and national healthcare reform; Dr. Bonnie Norton talks about what she’s seen since our healthcare laws went into effect here: http://OFA.BO/qSqrVk

Posted by EDahlPR | Report as abusive

First of all, people aren’t simply ‘encouraged’ to get health insurance. They are forced to or else incur a hefty tax penalty. As for controlling costs? That’s not been my experience. In the past 3 1/2 years my monthly premium has increased 54%! As a self employed low income person last year, I should have qualified for the MassHealth supplemental program. After filling out the 16 page application I didn’t even get a reply. I guess that’s how the state keeps it’s cost low by tossing out people applications. As for the health care itself…try making a doctors appointment… You’re lucky to 1) find a doctor accepting new clients and 2) get an appointment within the next 4 months. This health plan CLEARLY favors the billion dollar private insurance companies over citizens. Give us real ‘universal health care’, government provided health care like Canada and other countries that aren’t controlled by private corporations.

Posted by MikeyJoey | Report as abusive

Universal healthcare is inevitable. Given the irrational opposition to it among certain conservatives, it will be years in the making. But I credit Obama and Romney for taking the first steps.

Posted by AlkalineState | Report as abusive

Romneycare is a 70 page bill, while Obamacare is nearly 3,000 pages. Obamacare is a monstrosity. Romneycare did not rob Medicare of half a trillion dollars as Obamacare has. Last, Romneycare does not violate the interstate commerce clause since it only affects Mass.

Posted by moonhill | Report as abusive

If given the change Obama care will be able to do the same thing.

Posted by Susanbsbi | Report as abusive

Universal Healthcare is a given right; not an option. Therefore everyone must be required to get coverage whether you want it or not. There is no compromise.

We also need much, much MUCH higher taxes across the board…rich, poor, and all in between must pay out at least 45% of annual income in taxes so entitlement programs and healthcare subsidies for the poor can be sustained.

This isn’t rocket science. Higher taxes = more healthcare coverage and general revenue = happier, healthier citizens.

True Americans support higher/more taxes. Not to is uncivilized and un-American.

Posted by FlamingLiberal | Report as abusive

It was Reagan in 1986 who enacted the mandate that doctors must treat all emergency patients, ‘regardless of citizenship, legal status, or ability to pay.’ That mandate went into effect in 1986. It’s called EMTALA. Google it. Know it.

Curiously, Reagan provided no funding mechanism for this mandate. And in case you haven’t noticed, doctors still drive their Mercedes and own their condos in Aspen. That didn’t go away. I don’t blame them, they earn it.

So who has been paying for the uninsured when they have their heart attacks, babies, vaginal herpes, car wrecks? All of us pay. Through medicaid and through our insurance premiums. So unless you have a mandate to get the uninsured dead weight to pay into the pool, Reagan’s system is unustainable. No?

Posted by AlkalineState | Report as abusive

My father should be the one to write this. When he retired almost 25 years ago, it became obvious to him that Massachusetts tended to discourage retirees and encouraged an influx of new blood to create a young and sophisticated work force. He was told as much at a seminar for retiring professionals. To put it bluntly – the attractions of working in the Metro Boston area, the younger, less cynical but inexperienced work force, and the prestige of the employment prospects in MA, may outweigh the cost of living issues there for most of them and they are more willing to accept the compromise in their choices and freedoms.

A lot of retirees go north to New Hampshire. My father took his higher senior health care costs out of state. Patrick may not be telling the whole story. MickeyJoey isn’t a crank.

Apparently the Romney Care act was never challenged in the USSC and I think it is as vulnerable to the decision of the court as the Affordable Care Act. I don’t recall hearing of any SC challenge to it.

@FlaminfLiberal – The countries with the highest taxation overall also seem to be the countries with the smallest differences between high and low incomes. I am thinking of the Scandinavian countries. It works because everyone seems to be similar in circumstances. Reagan wanted the US to return to the gilded age and he never mentioned the slums that also existed then. The lowest incomes were supposed to benefit from the activity at the top. It wasn’t mentioned that the wealth effect was really only long term debt and the whole structure was really a form of wishful thinking.

AlkalineState may approve of the doctors driving Mercedes with health care money but does the writer also approve of the insurance executive doing the same or going for even more upscale models?

Posted by paintcan | Report as abusive

Paintcan, ultimately we will have universal healthcare. This is because private insurance is a form of socialized healthcare anyway. We’re already used to it. Everybody puts their money into the pot, sickest guy wins. That’s the way it already is. But private insurance adds a layer of inefficiency because that insurance company needs to not only show a profit each quarter, its shareholders expect to see a GROWTH in profit each quarer. How is that possible for an insurance company, if they’re paying out like they should? Insurance was never meant to make money. It’s a pool of money that gets paid back out. That’s why the first health insurance outfits were originally set up by non-profit foundations, like hospitals used to be. (blue shield, Kaiser, etc.).

That has changed and now we see the fallout.

Posted by AlkalineState | Report as abusive

A few observations:

1. We should be talking about healthcare, not health insurance.

2. Insurance is a bet. You bet you’re going to have a car accident; your insurance co. bets you won’t. That works fine for auto accidents, not so much for health care because if you bet against needing health care, you’re pretty much guaranteed to lose. And, contrary to @AlkalineState’s ideas, insurance companies have always been about making money by being sharp odds makers.

3. The current Balkanized insurance system benefits no one. The insurance companies are right about needing the base of clients. That’s not because they need healthy people to pay for the sick people so much as it is having a large enough sample space to do statistical and actuarial analyses to determine the number of people who will come down with (fill in the blank) so that they can determine their financial exposure. I have to buy my own insurance so my wife and I are a sample space of two. The insurance company is taking big risks with their bet on us. Before I retired, I worked for Boeing. 190,000 odd people are a pretty good sample space and you can gauge your risks fairly clearly. 390 odd million (the population of the US) is an even better sample space and one you will only get if you move to a single payer system – i.e. by having only one insurance company.

4. The people who are making out like bandits in all this (i.e. are making what an economist would call economic profits) aren’t the insurance companies. It’s the doctors and big Pharma. Big Pharma got a sweetheart deal out of the Republicans so that, for example, Medicare can’t compete the cost of medicines. Doctor’s pricing practices are atrocious. If your local garage charged to fix your car like a doctor charges to fix you, it’d be (a) illegal (you can’t charge different customers a different price for the same service), and (b) the price would be so astronomical that you couldn’t afford to get your car fixed (trust me, you only think the price is high now).

Posted by majkmushrm | Report as abusive

(Massachusetts resident) Are you kidding me? In the past five years since the Romneycare started taking speed, my healthcare has gone up over 52% with half the coverage, where this past week they went up 12% and added deductibles before they even start coverage- I pay $6000 a year so that I can have a $2000 deductible. If I don’t have healthcare I get penalized! They are forcing a debt onto the people which has long been proven to be illegal for the government to do. The people who love this universal healthcare are all of the people who don’t have to pay for it! Obamacare will be no different, those of us supporting half the country will have to pay for everyone else who never accomplished anything and can’t afford to pay for it themselves or work for the life sucking unions. So sick of how the government is forcing us to pay for the lazy or corrupt! I should just quit my job and stop paying my mortgage- I’d get free housing, free food, free car, free phone, free spending money that I can spend on whatever I want (EBT cards being used for alcohol and illegal drugs) free education, free healthcare- I mean I’d probably be better off in this country not contributing than trying to do something with my life and help make this country great. You sheeple that support them and what they are doing should be ashamed of yourself and don’t deserve to call yourselves American.

Posted by hmmmmmmmmmmmm | Report as abusive

The basic tenant of the Patrick Society is that most of the animals are too stupid to make financial decisions for themselves… they need a kind and benevolent firm hand to show them how life should be.

Imagine how grand the species could be with the “Intelligent Design” of people like DP?

Posted by Farkel4 | Report as abusive

I think the real issue is that ‘We the people’ will get the ‘affordable’ part and the politicians will get the ‘high-quality’ part.

If it was *really* high quality, why won’t the politicians be using it also and why is there an ‘exception’ list with many companies, unions, and others ‘opting out’?

Posted by Overcast451 | Report as abusive