From Romneycare to Single-Payer in Massachusetts?
The Obama administration’s former chief of Medicare and Medicaid is running for Governor of Massachusetts, and hints that his goal is to turn Romneycare into a single-payer system.
“It is time to seriously explore the possibility of a single payer system in Massachusetts,” declares Donald Berwick’s campaign website. (Emphasis in the original) “I will work with the Legislature [to] assemble a multi-stakeholder Single Payer Advisory Panel to investigate and report back within one year on whether and how Massachusetts should consider a single payer option.”
Along with achieving this goal, Berwick makes a series of other promises that seem breathtaking when one considers the amount of information, oversight and control necessary to fulfill them. Again, all bolded words appear the same way on the site.
· I will personally lead a statewide initiative to make Massachusetts the healthiest state in the nation, through smoking cessation, obesity prevention and reduction, and specific programs to curb domestic and physical violence.
· We will stop the obesity epidemic in Massachusetts.
· We will reduce substance abuse and suicide rates by 50% in Massachusetts in the next decade.
· Massachusetts will be the national leader in patient safety.
I do not dispute that Americans in general – and apparently Massachusetts in particular – are suffering from very serious problems like obesity, substance abuse and suicide, along with all the ancillary problems that follow in their wake. But how is it sensible to assume, as Berwick’s manifesto does, that politicians can solve these deeply personal problems – abetted by a nihilistic culture – through bureaucratic fiat?
Moreover, who is going to pay for all this? Nowhere does Berwick mention the massive increases in state spending his plan implicitly calls for, since Massachusetts will now need an army of public employees to collect data, push ad campaigns and fine or penalize those who don’t change their behavior.
Joshua Archambault outlines other problems with Berwick’s platform, among them the myriad technical difficulties facing a state trying to operate a stand-alone single-payer system.
Berwick is no shoe-in to win the Democratic nomination for governor, but his ideas about single-payer are gaining ground in Massachusetts politics. As Archambault notes, 20% of the state’s heavily Democratic state senate are on record as supporting a single-payer system. That’s not surprising since the Bay State was the first to impose a health insurance mandate on individuals in 2006. As costs have grown, so have calls for more government control.
It bears remembering that President Barack Obama has said repeatedly that Romneycare was a model for Obamacare. If Berwick’s ideas manage to transform the former into a single-payer system, national health care policy may soon have a new maxim: As goes Massachusetts, so goes the nation.