The Massachusetts Health Plan: The Good, the Bad, and the Ugly
16 Pages Posted: 1 Mar 2007
In spring, 2006, Massachusetts enacted legislation to ensure universal health insurance coverage to all residents. The legislation was a hybrid of ideas from across the political spectrum, promoted by a moderately-conservative Republican governor with national political aspirations, and enacted by a liberal Democratic state House and Senate. The legislation was boosted by the Heritage Foundation on the right, and Families USA on the left, although it had detractors across the political spectrum as well.
This article considers the legislation through a theatric/cinematic lens - specifically the The Good, The Bad, and the Ugly, a classic Sergio Leone western. The article briefly describes the basic structure of the Massachusetts plan, and identifies the good (return of the states as policy-making bodies in health care; broadening the availability of the federal tax preference for employer-based health insurance; shifting the focus to getting the uninsured to purchase insurance); the bad (play or pay model; inadequacies of an individual mandate) and the ugly (ignoring out-year costs and excessive regulation of the coverage market) of the plan.
Although the legislation is not, as Professor Stuart Altman neatly put it, a typical Massachusetts-Taxachusetts, oh-just-crazy-liberal plan, there is enough bad and ugly in the mix to raise serious concerns - particularly when the desire to over-regulate the health insurance market appears to be hard-wired into the DNA of Massachusetts' health policy.
Keywords: health, insurance
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