Health reform in Massachusetts has been held up as a possible template for national reform. Our state requires all but small employers to offer coverage. In any case individuals are responsible for maintaining coverage. If they can’t afford it they’re subsidized. There had been talk about tackling costs before pressing for universal coverage, but eventually people got impatient and said let’s tackle coverage first since nothing seems to be happening to control costs.
This is one of the only states that could conceivably make it happen. States like California considered similar plans but found they had too many uninsured to start with and too many low-wage workers whose employers could never afford health insurance. I’ve never advocated the Massachusetts model for nationwide adoption and it concerns me when others do it. The costs would be astronomical and there’s almost no one left who can afford to absorb them.
So I read the USA Today article (Vermont could be guide on health care) with some interest. According to the article, Vermont has focused on cost reduction first, with the idea that improving affordability would ultimately increase the percentage of those with health insurance. Vermont doesn’t attempt to achieve universal coverage but does focus on prevention, wellness, and health IT. There’s a public/prviate health plan, too. It’s too early to tell if it’s all going to work, but it seems a better model on the national level than the Massachusetts plan.
July 27, 2009
“The biggest thing that worries me at the national level,” [Dr. Kirk] Dufty says, “is that the debate has been about payment reform. We have to figure out how to change care so we can afford it.”