Someone needs to write an honest evaluation of the first health care system in this country that had an individual mandate, meaning you were required by law to have health insurance.
First, it's not the end of the world, or capitalism, nor has it turned Massachusetts into a socialist gulag, a place where the classes wage war, or where bureaucrats rule on every interaction with your doctor. For most people, the healthcare law has barely caused a blip.
Unlike most of my posts, this one won't discuss the financial impacts of Romneycare because I couldn't find clear sources for that information. I can't answer some important questions like how much it costs the state, and whether it has lowered or raised costs. I can report that it's pretty popular in Massachusetts, with 63% approval.
When it was first implemented, I heard complaints where I worked from people who were going without health insurance and now had to buy it. Maybe I should be more sympathetic or more libertarian, but I've been convinced by the economic argument behind the universal requirement. (Here's the capsule version: the pooling of risk doesn't work financially unless low-risk people are required to join the pool. So suck it up for the greater good. That's what we do with taxes.)
Now my 20-something daughter is benefiting from the program. She signed on to the health insurance exchange website, and figured out relatively easily which policy she wants. It's affordable, perhaps subsidized, and she didn't have the anxiety of being turned down. I'm glad she lives in a state that makes it this easy.
Some critics have decried that--what motivation will people have to get good jobs if there's subsidized health insurance? Probably nearly the same motivation as in the standard case (the paycheck, interesting work, self-sufficiency, being useful to society), but without the anxiety that a medical issue can send her into a modern version of the Minotaur's labyrinth.
So how bad is Romneycare? Well, I'm happy with it.
I'm aware that arguments based on anecdotes aren't reliable. Arguments that ignore fiscal concerns are even worse. It would be good to be able to report the extra savings or expense due to Romneycare, but I couldn't find the statistics. Perhaps that's because it's incredibly hard to sort out the confounding factors, such as unpaid medical bills, higher state costs, costs offset by federal Medicaid payments, a sweetened deal for MA by Medicaid, and personal costs of insurance premiums or patient-paid medical bills. So I'm left with only the anecdotal evidence, which is decidedly pro-Romneycare.
- Romney's concept vs signed law.
- Fast-rising demand and costs, then slowing down.
- Libertarian Cato Institute informs me that I must be wrong--there's nothing good about Romneycare.
- CNN lists problems that arise from Romneycare being a good plan. Balanced article.
- The AMA critique which is a nice brief summary.
- The MA and Utah health exchanges. Try the MA health insurance exchange. The MA Affordability page.
- Conservative praise for Romneycare before it became poison. Note the dates.
- A 2012 site explaining why Romneycare is OK.