Krugman Cites Massachusetts

Paul Krugman has another op-ed in the NY Times on health care. The part that I got a chuckle over was the bit about the experience in Massachusetts. It matches the Canadian experience, i.e. once it is in place, people (and physicians) love it. Well, almost everyone. There are die-hard ideologues who wouldn't like it if it were free and you got a free shotgun every time you used the service.

Here's the key bit:

Like the bill that will probably emerge from Congress, the Massachusetts reform mainly relies on a combination of regulation and subsidies to chivy a mostly private system into providing near-universal coverage. It is, to be frank, a bit of a Rube Goldberg device — a complicated way of achieving something that could have been done much more simply with a Medicare-type program. Yet it has gone a long way toward achieving the goal of health insurance for all, although it’s not quite there: according to state estimates, only 2.6 percent of residents remain uninsured.

This expansion of coverage has tremendous significance in human terms. The Kaiser Commission on Medicaid and the Uninsured recently did a focus-group study of Massachusetts residents and reported that “Health reform enabled many of these individuals to take care of their medical needs, to start seeing a doctor, and in some cases to regain their health and control over their lives.” Even those who probably would have been insured without reform felt “peace of mind knowing they could obtain health coverage if they lost access to their employer-sponsored coverage.”

And reform remains popular. Earlier this year, many conservatives, citing misleading poll results, claimed that public support for the Massachusetts reform had plunged. Newer, more careful polling paints a very different picture. The key finding: an overwhelming 79 percent of the public think the reform should be continued, while only 11 percent think it should be repealed.

Interestingly, another recent poll shows similar support among the state’s physicians: 75 percent want to continue the policies; only 7 percent want to see them reversed.

There were bitter battles in Canada to get universal medicare in place, but once here citizens (and doctors) loved it. Sure, the odd doctor graduating from medical school here (largely at the expense of taxpayers) has looked south at bigger pay packets and headed down there. But those people forgot that it is easy to charge big bills. However it can be a headache collecting. In Canada a doctor can focus on delivering medicine while the government makes sure he gets paid, i.e. office expenses are far cheaper and you don't need the costly medical insurance you need in the lawsuit-happy US.

It is hard for people to appreciate something new. That's why it is hard to sell people radically new technology. You have to learn to use it and appreciate it. It takes a few years of experiencing universal health insurance, but then people fall in love with it and it can never be taken away.