Deval Patrick's wisdom (and lack thereof) on health reform

Governor Deval Patrick is rightly proud of the progress Massachusetts has made in health reform. Essentially every child has health insurance and nearly every adult, too. Businesses have not dropped coverage, and the state budget has not been busted. He hits some high points in a 2-minute video interview from SolomonMcCown.

He also offers some lessons for the Administration in implementing ObamaCare –and while he makes some good points, overall the advice is not going to be a game changer.

He starts by noting that MA health reforms polls in the 70% range for favorability among Massachusetts residents, whereas the Affordable Care Act/ObamaCare is only 50%, despite being essentially the same thing. He attributes the difference to a lack of marketing by the feds.

He also notes that the in Massachusetts the coalition that invented health reform stayed together to refine it over time.

The suggestions are reasonable enough, but there are some problems with this take:

  • Actually it is rational for a person to support Massachusetts health reform but not ObamaCare. Count me as someone who supports both but is more bullish about the Massachusetts version. Massachusetts already had a high percentage of people under insurance, guaranteed issue, no medical underwriting, a high-wage economy that could support employer provided insurance, an uncompensated care fund, and generous Medicaid eligibility and benefits. It was less of a leap to reform in Massachusetts than it will be for the US as a whole, and there is room to argue for other approaches.
  • The Administration has tried to market reform, and while it could perhaps have done a better job, there is ferventĀ oppositionĀ to marketing of the program. HHS Secretary Sebelius has been subpoenaed on the topic and opponents are not above spreading misinformation
  • We had (and still have) a broad based coalition for health reform in Massachusetts. Partly it’s just the structure of the system here, where no one is trying to go to war with the other party. The Affordable Care Act ending up being a Democrat-only event. Republicans blame the President for this; I don’t really buy that. But regardless, there never really was a coalition in the first place so it’s hard to ask them to stay together on improvements. But it is a good point that we should expect to need to make refinements over time
  • Opponents of the Massachusetts health care reform law did not work to overturn the bill or sabotage its implementation
So, good for Deval Patrick for touting Massachusetts and offering to help the President. But don’t hold your breath for a sudden turnaround.
November 28, 2012

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