Monday, April 10, 2006

Health Care for All: Massachusetts style

Yepsen’s recent columns are all over the place, from state budget deals to government cronies gone bad to the national players floating in and out of Iowa.

Sunday's column highlighted the current popular guy -- we'll call it Mitt-fest 2006, -- and the revolutionary effort in Massachusetts to provide health care access for all its citizens. The extremists on both sides of this issue don't like it; radical liberals think it doesn’t give enough to the conveniently-defined poor and the bootstrap conservatives are annoyed that we have to do anything for anyone outside of securing a free market.

Shrill debate aside, the bipartisan effort in Massachusetts to provide access to health insurance is a policy victory for everyone, particularly Massachusetts’ uninsured. There are a number of people taking credit for the work and that's okay, but sometimes it's nice to point out the unsung heroes.

John McDonough, former Massachusetts state representative turned storytellin' policy wonk turned professor turned health care reform crusader, has been in this fight for years. He was one of the original innovators of the CHIP program, known in Iowa as HAWK-I, and is the current Executive Director of Health Care For All. John also blogs and is posting informative critiques of the Romney et al health care plan.

A little cut & paste from John’s A Healthy Blog:

April 5, 2006

MA Health Reform In Context -- Early Thoughts

Time to begin putting this reform effort in context. Some early thoughts.

It's been going on for a while. Gov. Romney began his deliberations in 5/03; HCFA started our reform deliberations leading to the 12/04 creation of the ACT Coalition in 9/03; Sen. Pres. Travaglini announced his interest in 11/04; House Speaker DiMasi showed his hand 10/05 -- and what a hand! We predicted in '03 that '06 would be the year of opportunity in this decade for major reform. Back in '03 we labelled this our "'o6" project. Here we are.

Give Gov. Romney His Due. We've had more than our share of disagreements. Still, Gov. Romney's commitment to reform was unwavering. And his key insight -- using safety net dollars to expand coverage -- is the cornerstone of this reform.

Give Speaker DiMasi his Due. Without the Speaker's leadership, there would be no employer responsibility in the new law. He stuck with the goal of expanding coverage and never wavered. He and his team produced the stunning policy innovation -- combining employer and individual responsibility. Never underestimate this guy again!

And thanks to Rep. Pat Walrath and the incredible staffers in the House. You guys rock!

Give Pres. Travaglini His Due. The Senate Pres. made certain that the existing safety net institutions would be adequately protected in reform - - and they have been. The Senate was also the source of many new policy innovations in the law.

And thanks to Sen. Moore and the great staffers in the Senate.

And Give Advocacy Our Due. The ACT! Coalition pushed the boundaries of possibility beyond where most thought we could go, forced employer responsibility as an issue, and provided a genuine voice for the public in this dense and complex policy environment.

Respect the Power of the Ballot Initiative. Once again, the Ballot Initiative has been proven a useful and powerful tool in pushing the legislative process beyond where it would otherwise go. A rough and blunt tool, but respect its power.

Business Still Holds the Key. In modern history, no major health reform law has passed with unanimous business opposition. Still true today. Special thanks to all those business leaders, especially Phil Edmundson, who spoke the truth and held firm and faithful to their conviction. Bless them!

Providers Get Their Due, and No More. By our count, about 15% of the resources in the new law will go to improve provider rates. This is an access law with new funds for providers -- it's not a provider bill.

A Cost Sharing Line in the Sand. Gov. Romney's vision of low premium plans is revealed to include sky-high deductibles and cost sharing. Thanks to the Legislature for rejecting this. We've drawn a line in the sand on cost sharing, and this battle has only begun.

Will History Repeat? Twice before, MA reforms triggered national repercussions. The 1988 universal health care law triggered reform activities in at least two dozen states in the early 1990s. The 1996 law inspired Sen. Kennedy to start the process leading to the creation of the federal Children's Health Insurance Program which has provided coverage to more than 5 million uninsured kids. Both times, MA led the way and turned the tide.

Let's do it again!

This is the best political round up I’ve seen on the Massachusetts health care plan.

One more thing: McDonough wrote Experiencing Politics, it’s a great read and educational, too. He manages to interrelate meat & potato politics with policy theory (unbelievably, we do have theory for all of the stuff that happens under the 51 domes) using stories about the ins & outs of Massachusetts state politics.



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