Friday, January 1, 2010

The Massachusetts Model

Let's watch this space, budgetarily as well as politically. Ezra Klein, writing in the WaPo:

The bill that just passed the Senate was effectively the Massachusetts reform plan brought to national scale. It had more cost control, and more delivery-system reforms, but those were the main differences, and none of them were the controversial differences.

Klein, of course, supports the current bill.

But here's another take on the legislation, from Sarah McIntosh, writing for the Heartland Institute, also drawing on the Massachusetts precedent:

The potential costs of the health care bills under consideration on Capitol Hill continue to rise as mandates, regulations, and subsidies boost the total cost to taxpayers.

Initial estimates by the Congressional Budget Office of the health care bill added up to $1.1 trillion over 10 years, but the version ultimately passed by the House of Representatives is now projected to total more than $1.7 trillion in costs.
Gregory Schneider, a policy analyst at the Flint Hills Center for Public Policy, a Kansas-based think tank, believes the total price tag could run even higher.

“The sticker price could be as much as $3.3 trillion,” said Schneider. “The accounting gimmicks in the bill are such that the great bulk of the costs come later.”

And then McIntosh continues, using this headline: "Mass. Disaster Instructive":

Schneider points to Massachusetts as an example of unanticipated costs and inaccurate estimates. When Massachusetts enacted its broad health care reform package in 2006, the cost was projected at around $1.6 billion per year. The Commonwealth Care subsidies, the largest part of the plan, were projected to cost about $725 million per year.

By 2008, projections rose for Commonwealth Care to about $869 million for the following fiscal year, a 20 percent increase. Projections increased to $880 million for FY2010.

“Now, officials are saying it could be even $100 million higher than these estimates,” said Schneider. “Massachusetts has exceeded its cost estimates, and now, while having more people insured, has longer waits, rationing, and higher health care costs, which has burdened the state budget.”

As noted, watch this space--watch the budget.

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