The EFM Feature

I’ve spent most of the last week jetting around the country for my day job, but I wasn’t so preoccupied that I didn’t notice this editorial — in the Boston Globe, of all places — extolling the virtues of Governor Romney’s health care reforms. It begins:

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.

Read the whole thing, but I also liked the ending:

here 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.

So let’s get this straight. Governor Romney helped crafted a market-based health plan that insures more than 97% of Massachusetts residents, has barely made a dent in the state budget, and is extremely popular? In fact, it’s so good that his mortal enemies on the editorial staff of the Boston Globe have no choice but to extol its virtues. Conservatives should be proud of this, right? We should be able to point to Governor Romney as a guy who can carry our banner in the health care debate, right?
Well, no. Some conservatives really just seem to hate the Massachusetts reforms. Take this article from NRO’s Peter Robinson. He begins with an odd kind of flip-flop claim, arguing that the Governor “seldom” mentioned his health care plan during the primary campaign but is now extolling its virtues.
During the campaign, the Governor spoke of his program frequently, including in televised debates, and it has always been a key part of his political biography. But — and here’s the key thing — health care was not the dominant concern in the Republican primary. Ahhh yes, the Republican primary — dominated as it was by discussions of Iraq and “true conservatism” — it had very little room for a debate about universal coverage. But now? Well, that’s only the dominant topic in our entire national political discourse. So I think it’s safe for the Governor to weigh in.
After taking that potshot, Peter then quotes an economist who says that per capita spending on health care in Massachusetts has increased faster than the national average for “seven of the last eight years.” But this doesn’t tell us much at all. In fact, the program was only signed into law three years ago. Additionally, individuals living in a wealthy state that features some of the nation’s premier hospitals might — just might — choose to spend money on health care. The Massachusetts plan did not take choices away from individuals.
On cost, the question is always “compared to what?” In fact, each of the statistics that Peter cites beg the question “compared to what?” Of course spending on subsidized health insurance has gone up. After all, it’s essentially a new budget category created by the plan itself, and we’re in the midst of a recession. But again, compared to what? At least the Globe editorial is citing a study that attempts to control for various costs and measure the net budget impact. After all, it’s simply not the case that if the government wasn’t spending money on subsidizing insurance that it wouldn’t be spending that money on health care at all.
Is the Massachusetts health care plan perfect? Of course not. Multiple provisions of the plan were adopted over his veto. But a record of 97% (or more) residents insured, with private choice maintained, and very little net effect on the budget is, quite simply, a very nice record indeed.
One final aside, there is simply no way for any health care plan to be perfect. We’re dealing with an incredibly complex system that depends on layer upon layer of choices by imperfect people making often irrational decisions. It is always going to be costly, and people will always be falling through the cracks. That’s just the way life is, and we conservatives should know that better than anyone. So you will always be able to find sob stories and bad statistics with any sort of system. The question is not “Is this working for everyone?” but instead “Is this working better than the old system?” When it comes to Massachusetts, the Governor’s health plan is an improvement. How many states can make the same claim about their attempted innovations?


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