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12. Massachusetts Miracle or Massachusetts Miserable: What the Failure of the "Massachusetts Model" Tells Us about Health Care Reform
- Author:
- Michael Tanner
- Publication Date:
- 06-2009
- Content Type:
- Policy Brief
- Institution:
- The Cato Institute
- Abstract:
- When Massachusetts passed its pioneering health care reforms in 2006, critics warned that they would result in a slow but steady spiral downward toward a government-run health care system. Three years later, those predictions appear to be coming true: Although the state has reduced the number of residents without health insurance, 200,000people remain uninsured. Moreover, the increase in the number of insured is primarily due to the state's generous subsidies, not the celebrated individual mandate. Health care costs continue to rise much faster than the national average. Since 2006, total state health care spending has increased by28 percent. Insurance premiums have increased by 8–10 percent per year, nearly double the national average. New regulations and bureaucracy are limiting consumer choice and adding to healthcare costs. Program costs have skyrocketed. Despite tax increases, the program faces huge deficits. The state is considering caps on insurance premiums, cuts in reimbursements to providers, and even the possibility of a “global budget” on health care spending—with its attendant rationing. A shortage of providers, combined with increased demand, is increasing waiting times to see a physician. With the “Massachusetts model” frequently cited as a blueprint for health care reform, it is important to recognize that giving the government greater control over our health care system will have grave consequences for taxpayers, providers, and health care consumers. That is the lesson of the Massachusetts model.
- Topic:
- Health, Human Welfare, Markets, and Governance
- Political Geography:
- United States
13. Does the Doctor Need a Boss?
- Author:
- Michael F. Cannon and Arnold Kling
- Publication Date:
- 01-2009
- Content Type:
- Policy Brief
- Institution:
- The Cato Institute
- Abstract:
- The traditional model of medical delivery, in which the doctor is trained, respected, and compensated as an independent craftsman, is anachronistic. When a patient has multiple ailments, there is no longer a simple doctor patient or doctor-patient-specialist relationship. Instead, there are multiple specialists who have an impact on the patient, each with a set of interdependencies and difficult coordination issues that increase exponentially with the number of ailments involved.
- Topic:
- Economics, Health, and Human Welfare
- Political Geography:
- United States
14. Halfway to Where? Answering the Key Questions of Health Care Reform
- Author:
- Michael Tanner
- Publication Date:
- 09-2009
- Content Type:
- Working Paper
- Institution:
- The Cato Institute
- Abstract:
- Although neither the House nor the Senate passed a health care bill by President Obama's August deadline, various pieces of legislation have made it through committee, and they provide a concrete basis for analyzing what the proposed health care reform would and would not do. Looking at the various bills that are moving on Capitol Hill, we can determine the following: Contrary to the Obama administration's repeated assurances, millions of Americans who are happy with their current health insurance will not be able to keep it. As many as 89.5 million people may be dumped into a government-run plan. Some Americans may find themselves forced into a new insurance plan that no longer includes their current doctor. Americans will pay more than $820 billion in additional taxes over the next 10 years, and could see their insurance premiums rise as much as 95 percent. The current health care bills will increase the budget deficit by at least $239 billion over the next 10 years, and far more in the years beyond that. If the new health care entitlement were subject to the same 75-year actuarial standards as Social Security or Medicare, its unfunded liabilities would exceed $9.2 trillion. While the bills contain no direct provisions for rationing care, they nonetheless increase the likelihood of government rationing and interference with how doctors practice medicine. Contrary to assertions of some opponents, the bills contain no provision for euthanasia or mandatory end-of-life counseling. The bills' provisions on abortion coverage are far murkier.
- Topic:
- Government, Health, Human Welfare, and Markets
- Political Geography:
- United States and America
15. Yes, Mr. President: A Free Market Can Fix Health Care
- Author:
- Michael F. Cannon
- Publication Date:
- 10-2009
- Content Type:
- Working Paper
- Institution:
- The Cato Institute
- Abstract:
- In March 2009, President Barack Obama said, “If there is a way of getting this done where we're driving down costs and people are getting health insurance at an affordable rate, and have choice of doctor, have flexibility in terms of their plans, and we could do that entirely through the market, I'd be happy to do it that way.” This paper explains how letting workers control their health care dollars and tearing down regulatory barriers to competition would control costs, expand choice, improve health care quality, and make health coverage more secure.
- Topic:
- Economics, Health, and Markets
- Political Geography:
- United States
16. All the President's Mandates: Compulsory Health Insurance Is a Government Takeover
- Author:
- Michael F. Cannon
- Publication Date:
- 09-2009
- Content Type:
- Policy Brief
- Institution:
- The Cato Institute
- Abstract:
- The most hazardous health reform measure before Congress is not the so-called "public option," but proposals to make health insurance compulsory via an individual or employer mandate. Compulsory health insurance could require nearly 100 million Americans to switch to a more expensive health plan and would therefore violate President Barack Obama's pledge to let people keep their current health insurance. In particular, the legislation before Congress could eliminate many or all health savings account plans. Making health insurance compulsory would also spark an unnecessary fight over abortion and would enable government to ration care to those with private health insurance.
- Topic:
- Government, Health, and Markets
- Political Geography:
- United States and America
17. Mandatory Health Insurance: Lessons from Massachusetts
- Author:
- Craig J. Richardson
- Publication Date:
- 10-2009
- Content Type:
- Journal Article
- Journal:
- The Cato Journal
- Institution:
- The Cato Institute
- Abstract:
- What lessons can be learned from the implementation of mandatory health insurance? As the Obama administration contemplates enacting far-reaching health care reforms that increase the role of government, the case of Massachusetts is worth serious study. Massachusetts' three-year experiment with mandatory health insurance (known as Chapter 58 legislation) has been judged by some health economists to be a qualified success, since it reached a primary goal of lowering the number of uninsured in the state (Gruber 2009, Long and Masi 2008). On the other hand, Tanner (2008: 5) argues that previously uninsured citizens signed up for health insurance because it was free or heavily subsidized, not because of the mandate itself. Official state statistics claim the number of uninsured in the state dropped from 11 percent in 2005 to less than 3 percent in 2009 (Massachusetts Health Connector 2009). Tanner (2009) disputes this number and suggests the number is closer to 5 percent, using Urban Institute and Census surveys as evidence. What supporters and foes of mandatory health insurance both seem to agree on is that the number of uninsured has fallen in the state since Chapter 58, and yet there remain between 150,000 and 200,000 uninsured citizens.
- Topic:
- Health
- Political Geography:
- United States
18. Bending the Productivity Curve: Why America Leads the World in Medical Innovation
- Author:
- Glen Whitman and Raymond Raad
- Publication Date:
- 11-2009
- Content Type:
- Working Paper
- Institution:
- The Cato Institute
- Abstract:
- The health care issues commonly considered most important today — controlling costs and covering the uninsured — arguably should be regarded as secondary to innovation, inasmuch as a medical treatment must first be invented before its costs can be reduced and its use extended to everyone. To date, however, none of the most influential international comparisons have examined the contributions of various countries to the many advances that have improved the productivity of medicine over time. We hope this paper can help fill that void.
- Topic:
- Health, Human Welfare, and Markets
- Political Geography:
- America
19. WHO's Fooling Who? The World Health Organization's Problematic Ranking of Health Care Systems
- Author:
- Glen Whitman
- Publication Date:
- 02-2008
- Content Type:
- Policy Brief
- Institution:
- The Cato Institute
- Abstract:
- The World Health Report 2000, prepared by the World Health Organization, presented performance rankings of 191 nations' health care systems. These rankings have been widely cited in public debates about health care, particularly by those interested in reforming the U.S. health care system to resemble more closely those of other countries. Michael Moore, for instance, famously stated in his film SiCKO that the United States placed only 37th in the WHO report. CNN.com, in verifying Moore's claim, noted that France and Canada both placed in the top 10.
- Topic:
- Health, Human Welfare, Humanitarian Aid, and International Organization
- Political Geography:
- United States
20. The Grass Is Not Always Greener: A Look at National Health Care Systems Around the World
- Author:
- Michael Tanner
- Publication Date:
- 03-2008
- Content Type:
- Working Paper
- Institution:
- The Cato Institute
- Abstract:
- Critics of the U.S. health care system frequently point to other countries as models for reform. They point out that many countries spend far less on health care than the United States yet seem to enjoy better health outcomes. The United States should follow the lead of those countries, the critics say, and adopt a government- run, national health care system.
- Topic:
- Government and Health
- Political Geography:
- United States and Europe
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