Ignoring Failure

Originally published in the Calvert Recorder, May 14, 2010

I've had an odd reaction to the letters I've read in your paper embracing President Obama's health care overhaul. I opposed Obamacare, but when I read these letters, my reaction was not "anger" or "incivility" as one writer put it, but compassion. I fear the expectations will not measure up to reality, and many will be disappointed.

I campaigned for health care reform in 2006 before it was cool. The first step to successful health care reform, I argued then, is to address costs and access to quality care before coverage. Otherwise, you will dump scores of new patients onto a health care system that's not prepared for them, and the consequences would be catastrophic.

Massachusetts enacted a health care overhaul that provided the foundational blueprint for Obamacare. Jonathan Gruber, a Massachusetts Institute of Technology economist who helped draw up the state plan, said, "If any one person in the world deserves credit for where we are now, it's Mitt Romney [former governor of Massachusetts]. He designed the structure of the federal bill." The Associated Press says "the national health care overhaul Obama recently signed into law ... was modeled on the 2006 Massachusetts law."

That's the reason why federalism is a good idea — the states try out solutions and the federal government is better informed by the results before enacting laws that affect the entire nation. But that didn't happen here.

Massachusetts today has the highest health insurance premiums, and the longest wait times to see a primary care physician, in the nation. Since the law was enacted, health care costs have risen an average of 10 percent a year. Overcrowded waiting rooms and heavy workloads on primary care physicians have worsened. Doctors are still in short supply, and the state is facing a budget crisis because a program they originally projected to cost $725 million a year is going to cost $1.35 billion a year by 2011.

Dr. Jeffrey Flier, the dean of Harvard Medical School and a resident of Massachusetts, said of Obamacare that, while more people would have insurance coverage, "the trade-off would be an accelerated crisis of health-care costs and perpetuation of the current dysfunctional system — now with many more participants." That was precisely my argument in 2006. To paraphrase another writer to your paper, given a choice between believing the Congressional Budget Office and believing the dean of Harvard Medical School, a professional who's devoted his life to medicine, sorry, but I choose the dean. The CBO estimates are meaningless if the data they're given is flawed, or data is omitted, and they're based on assumptions, not facts. No federal government medical program — Medicaid, Medicare, SCHIP, VA — has met or fallen below initial cost estimates — ever.

We're about to add 30 million new customers to a broken health care system. I'm genuinely sorry some of your readers feel they've been treated uncivilly for their positions on Obamacare, but ignoring the lessons of Massachusetts means my government is either incompetent, criminal, or has a hidden agenda, and that should make all of us angry.