Curing the System - New York TimesThe Massachusetts plan seems very much like the Clinton plan, or at least something that would evolve to it. The employer burden is interesting, I assume it's there so employers don't ditch health care coverage en masse.
By ATUL GAWANDE
Published: May 10, 2007
....Experts have offered half a dozen more rational ways to finance all this than the wretched one we have. But we cannot change everything at once without causing harm....
...Option 1 is a Massachusetts-style reform.... Enacted statewide last year, the law has four key components. It defines a guaranteed health plan that is now open to all legal residents without penalty for pre-existing conditions. Using public dollars, it has made the plan free to the poor and limited the cost to about 6 percent of income for families earning up to $52,000 a year. It requires all individuals to obtain insurance by year end. And it requires businesses with more than 10 employees to help cover insurance or pay into a state fund.
The reform gives everyone a responsibility. But it leaves untouched the majority with secure insurance while getting the rest covered. As a result, it has had strong public approval. Experience with delivering the new plan is accumulating. And best of all, it offers a mechanism that can absorb change. The guaranteed health plan may cover 5 percent of the state at first, but as job-based health care disintegrates, the plan can take in however many necessary...
The "shared responsibility" part sounds like a political slogan. In any event this is consistent with my prediction of how it will all turn out.