Health Care Insuance Reform

FOR IMMEDIATE RELEASE Contacts:
Aug. 11, 2008 David Himmelstein, M.D., (518) 794-8109, (617) 312-0970
(cell), Benjamin Day, (617) 777-3422, director@masscare.org , Mark Almberg, (312) 782-6006, mark@pnhp.org


Copy Massachusetts' health reform?

Not so fast, researchers say

Citing the failure of seven state-based health reforms over the past two
decades - initiatives that bear a strong resemblance to the
Massachusetts health reform of 2006 - a group of Massachusetts-based
researchers cautions that early declarations of the latter's success may
be premature.

In an article titled "State Heath Reform Flatlines," published in the
most recent issue of the International Journal of Health Services, three
researchers, two of whom teach at Harvard Medical School, examine the
experiences of earlier reforms in Massachusetts, Oregon, Minnesota,
Tennessee, Vermont, Washington state and Maine. The plans were enacted
from 1988 through 2003.

All seven reforms, which when launched were widely trumpeted by
political leaders and leading newspapers as breakthroughs in providing
universal health care, were based on the expansion of private insurance
coverage, the authors say. But in each case the plan had little impact
on the state's number of uninsured persons and produced no sustained
improvements in delivering care.

Dr. David Himmelstein, a co-author of the study, said the 2006
Massachusetts reform appears poised to follow the pattern of the 1992
Tennessee plan, which featured a large expansion of coverage under a
Medicaid-like program. "In Tennessee, the number of uninsured dipped for
two years, then rose to levels higher than ever," he said. "And the plan
proved to be unaffordable in the long term.

"According to the latest figures on Massachusetts from the National
Health Interview Survey," he continued, "the uninsurance rate has fallen
by only 2 percent, from 7.7 percent to 5.8 percent, since the reform was
passed, while the plan is already $147 million over budget."

Himmelstein, who is an associate professor of medicine at Harvard and a
primary care physician in Cambridge, Mass., said the seven failed plans
incorporated virtually all of the reform elements being advanced today
by leading Democrats, including Sen. Barack Obama. The problem, he said,
is that such reforms leave the private health insurance industry in a
dominant position.

"Politicians like to claim they've passed bold health reforms, but
they're afraid to rock the private insurance boat," he said. "So they
keep pushing gussied-up versions of reforms that have failed time after
time. Our health care system is sick to death, and our politicians keep
prescribing placebos."

The authors note that all of the failed plans included expansions of
Medicaid or similar programs for the poor and near-poor. Three states'
reforms (Massachusetts in 1988, Oregon in 1989-1992 and Washington state
in 1993) included mandates requiring employers to cover their workers,
and the Massachusetts and Washington plans also included an individual
mandate on the self-employed.

The authors analyzed Census Bureau data on uninsurance rates in each of
the seven states. Massachusetts' uninsurance rate rose from 7.2 percent
to 9.7 percent in the three years after the passage of then-governor
Michael Dukakis' universal health care reform in 1988. Uninsurance went
from 14.1 percent to 14.7 percent in the three years after
implementation of Oregon's universal health care reform in 1993. The
percentage of residents lacking coverage in Washington state increased
from 10.7 percent to 11.6 percent in the three years after passage of
its universal health care initiative.

Similar patterns occurred in Vermont and Maine. Tennessee's program
(which included the largest Medicaid expansion) was probably the most
successful, dropping the share of uninsured in the state from 12 percent
to 9 percent in its first year, before a rebound to 14 percent by year
three. (See charts in links below.)

All of the plans eventually "flatlined," or died quiet deaths, the
authors said.

According to Benjamin Day, executive director of Mass-Care, a health
care advocacy coalition based in Boston, "It's easy to build political
consensus for expanded health coverage. But experience shows that you
can't achieve universal coverage at an affordable price unless you throw
out the insurance companies with their massive overhead and profit, and
replace them with a more efficient single-payer national health
insurance program.

"Senator Obama should learn this lesson," Day said. As for Sen. John
McCain's health care proposals, "they are so obviously unworkable that
it's hard to take them seriously."

*******

The text of the study is available in PDF to the press at
www.pnhp.org/states_flatline
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=zNcwNfjJAnJf0TMLo94BkfXmr35TzF3j
Password: *himmelstein*

Additional charts in PowerPoint format are available at
www.pnhp.org/five_states
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=YNqed33VWwZ3%2FwCWnJiiV%2B8pcMbyAF%2B6

"State Health Reform Flatlines," Steffie Woolhandler, MD, MPH; Benjamin
Day; and David U. Himmelstein, MD. International Journal of Health
Services, Vol. 38, No. 3.

Physicians for a National Health Program, a membership organization of
over 15,000 physicians, supports a single-payer national health
insurance program. To contact a physician-spokesperson in your area,
visit www.pnhp.org/stateactions
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=W1SCD%2BJYJOe309bI23pT%2B%2B8pcMbyAF%2B6

or call (312) 782-6006.


*Physicians for a National Health Program*
29 E Madison Suite 602, Chicago, IL 60602
Phone (312) 782-6006 | Fax: (312) 782-6007
www.pnhp.org
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=cGQcvuaDs3pWB3gv9jboUO8pcMbyAF%2B6

| info@pnhp.org mailto:info@pnhp.org
PNHP 2008



http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=mgJJAv5YFLJ2XnjhLax%2Fe%2B8pcMbyAF%2B6








--------------------------------------------------------------------------------
Looking for a car that's sporty, fun and fits in your budget? Read reviews on AOL Autos.