March 24--BOSTON -- Seven years after ordering near-universal health insurance coverage for its residents, Massachusetts is still struggling to contain spiraling health care costs.
The Massachusetts health reform "experiment," signed into law by former Gov. Mitt Romney, is widely viewed as a precursor to President Barack Obama's Affordable Care Act.
But if there's one thing that can be learned from Massachusetts, it's that "access" alone to health care is not a panacea for fixing a broken health care system. Perhaps that's why Romney, the Republican presidential nominee, did not endorse the Affordable Care Act as a cure for the nation's health spending woes.
Mandating health insurance coverage for most all citizens has had little success in reining in Massachusetts' medical spending. The Boston area, for instance, remains one of the nation's costliest places to obtain health care.
"On a per capita basis, we have one of the most expensive health care systems in the country," Andrew Dreyfus, president and chief executive of Blue Cross Blue Shield of Massachusetts, told a recent conference in Boston of the Association of Health Care Journalists. "If we do nothing, we're going to bankrupt this state."
Massachusetts' politicians and health industry leaders have taken the next step. Several months ago, as a follow-up to its 2006 law mandating health insurance coverage, the Massachusetts state legislature passed a new law that sets goals for cost controls for hospitals, health systems and insurers.
This law provides a glimpse into the fierce struggle that federal officials are sure to face in attempting to cut health care costs on a national level.
Massachusetts politicians now speak of the Massachusetts Health Reform Law of 2006, which was implemented in 2007, as simply the opening salvo in a series of legislative skirmishes that are necessary to reform a dysfunctional health system.
The 2006 law established the Commonwealth Health Insurance Connector Authority, a state agency that acts as an insurance broker to offer private health insurance plans to residents. The state imposes financial penalties on individuals who do not obtain insurance, and also penalizes businesses with 10 or more employees who do not offer health coverage.
Mass. Gov. Deval Patrick, a Democrat, told the journalists' conference that both major political parties worked together to create health care reform in his state but, more importantly, "stuck together to implement it."
The governor said that 98 percent of Massachusetts residents now have health insurance; more than 90 percent of residents have a primary care physician; and 76 percent of businesses in the state offer health insurance to their employees.
And, he added, expanding health insurance coverage to uninsured residents added only about 1 percent to the state's health care costs.
Still, the governor and others emphasize that "cost containment" is the next goal in Massachusetts' ongoing health reform initiative. In August, Patrick signed a health care cost control bill whose aim is to slow the state's rapid growth of health spending.
Massachusetts state government, which is required by law to pass a balanced budget, has experienced cuts in most other spheres of activity. But health care costs continue to grow exponentially -- squeezing other parts of the state budget and outstripping new tax revenue.
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