Keith T. Pryor
Director, Leadership Advisory Services
Health Strategies & Solutions
You have to hand it to Massachusetts. The state really keeps trying. Twice in the last 20 years the state’s favorite sons have run for President against a man named Bush—and each lost in different, but equally frustrating ways.
And now twice in that same period the Commonwealth has passed comprehensive healthcare coverage. The first was in 1988; its champions included one Michael Dukakis, and as Eileen McNamara pointed out in her April 5, 2006 piece in The Boston Globe, the nationally trumpeted plan was not implemented because it was never funded.
But the bill passed this past week—this looks pretty good. Frankly, from this angle it looks politically brilliant. The funding is somewhat complex, in that many parties share the costs. And that may be a major difference between 2006 and 1988. And why this looks like it just might work.
Companies will need to either offer health insurance, or pay a charge per employee. The poorest will not pay for insurance. Low income citizens will pay on a sliding scale. Those individuals who can afford insurance but don’t buy it will be fined. It is a financing plan that should appeal to the liberal members of this most liberal state as well as those of the “let them pull themselves up by their bootstraps” conservative lot.
A brilliant compromise. Whoever designed this ought to be leased out to the geniuses working diligently on tearing the country apart on immigration legislation.
Undoubtedly there is a long way to go here. Lots of things will go wrong. Without question the original funding estimates will be too low. The legislation will clearly be seen as treating some communities unfairly. We know the legislation has not been exhaustively studied. These broad scale economic initiatives always seem to have unintended consequences.
But it certainly looks better than Medicare Part D.
