Thursday, April 13, 2006

The Massachusetts miracle: healthcare reform

Most of the times I talk about America's problems with inequity and adapting to globalization, I mention the need to break the connection between employment and healthcare. Health care insurance should have nothing to do with employment status, irregardless of whether the delivery mechanism is single payor governmental care, medical savings accounts, or traditional insurance plans.

I figured this was unlikely to happen in the US barring a populist uprising in the 2008 elections. I knew there were rumbles from Massachusetts, but I didn't pay enough attention to them. My mistake ... (emphases mine):
Massachusetts Legislation on Insurance Becomes Law - New York Times

BOSTON, April 12 — In a ceremony full of pomp and political backpatting, Gov. Mitt Romney signed Massachusetts' landmark health care legislation Wednesday, setting the stage for the state to be the first to provide health coverage to virtually all of its citizens.

... Mr. Romney is considering running for president in 2008, and the success of the bipartisan health care plan could become a major selling point of his candidacy.

... "This isn't 100 percent of what anyone in this room wanted," Mr. Romney said. "But the differences between us are small."

Mr. Kennedy said, "You may well have fired the shot heard round the world on health care in America. I hope so."

The law is projected to provide coverage for about 515,000 of the state's 550,000 uninsured people and leave less than 1 percent of the population uncovered. It goes further than those of any other state.

It requires residents to obtain health insurance by July 1, 2007. People who can afford insurance and do not buy it will be penalized on their state income taxes.

The law takes the $1 billion in the state's free-care pool, which paid for medical care for patients without insurance, and uses it to subsidize insurance for people who cannot afford it. The legislation also makes it possible for more individuals and businesses to buy insurance with pre-tax dollars, saving them money. And it includes a system to encourage insurance companies to provide more affordable plans with fewer benefits or higher deductibles.

... The legislation, months in the making, almost fell apart over disagreements about whether businesses should be charged and how much if they were. Mr. Romney wanted no business fee. Mr. DiMasi wanted a much higher business assessment of 5 percent of a company's payroll,

... Mr. DiMasi, in an interview last week, said: "I see a significant commitment of businesses to contribute in some way to the insurance costs of the uninsured. I see this as a significant principle, whatever the dollar figure is."...

DiMasi, the democrat, is wrong. Romney, the alleged republican, is right. We need to break the relationship between employment and healthcare, not perpetuate it.

Even if McCain hadn' t mutated into an anti-evolution social conservative Bush clone, Romney would now have displaced him as the tolerable Republican candidate. Fortunately for whoever gets the Democratic nomination, there's no way in heck Romney will survive the GOP's nominating process.

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