Mitt Romney

RomneyCare Is a Mess. But It Might Still Represent the Best Case Scenario for ObamaCare.

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Here's what we know about RomneyCare, the 2006 Massachusetts health policy overhaul signed by Mitt Romney that served as the model for President Obama's 2010 reform law: Insurance coverage in the Bay State were already high relative to the rest of the states, but since the law passed, coverage rates have gone up further, to somewhere between 94 and 98 percent, depending on how it's measured. Following the coverage expansion, utilization of various health care services has gone up, and so, in turn, has the cost of health care and the price insurance. At this point, many, perhaps most, experts agree that the current cost trajectory for the state is unsustainable.

A new study on the Massachusetts overhaul by health policy researchers at Harvard and the University of Minnesota confirms all of this, and puts it into worrying perspective: This may be the best possible outcome for a RomneyCare/ObamaCare-style health policy overhaul.

The study, which was published in the journal Health Affairs, used evidence from annual phone surveys of Massachusetts residents. It found that following the passage of RomneyCare, utilization of many health services increased: Adults under the age of 65 were more likely to have made multiple doctor visits, seen a doctor for preventive care, or found time to see a dentist or health care specialist. Costs, accordingly, have gone up. "Massachusetts continues to struggle with escalating health care costs," the authors write, "reflecting the decision to defer addressing costs in the 2006 legislation so as not to hold up the expansion in coverage."

Given the similarities between RomneyCare and ObamaCare, it's worth noting that while it's true that the legislation did little to control costs, that wasn't what was promised when it was passed. Then-Gov. Romney's public pitch promised that the law would provide "affordable health insurance" and that "the costs of health care will be reduced." But as the study reports, health care costs in the state continue to grow faster than inflation, and there is "reason to be concerned about employer-sponsored insurance premiums"—employer sponsored insurance being the state's main vehicle for coverage—"because health care costs in the state continue to rise."

Yet despite all this spending, the study reports only weak evidence to suggest that anyone is getting healthier:

The survey used for this study had a single question about health status: "In general, would you say that your health is excellent, very good, good, fair, or poor?" … We found strong and sustained gains in the share of nonelderly adults in Massachusetts who reported their health as very good or excellent, with an increase from 59.7 percent in 2006 to 64.9 percent in 2010.

This doesn't tell us much of anything. Increases in self-reported health are not the same as increases in objective health measures. As we know from an ongoing study of Medicaid in Oregon, the newly covered are likely to immediately report feeling healthier, even if they've received no medical benefit from the coverage at all. This suggests that much of the increase in self-reported health comes from the psychic benefits of coverage rather than from significant objective improvements in health.

And unlike the Oregon Medicaid study, there's no evidence to suggest that the law is reducing the amount of people who are having trouble paying medical bills. The authors report that "in 2010 the share of adults who reported problems paying medical bills was not significantly different from 2006, at nearly one in five adults." While there were minor fluctuations over the years, "there was no sustained improvement in problems paying medical bills."

Meanwhile, the program is on the road to fiscal ruin. Failure to deal with the larger cost problem means that the system simply doesn't work as is:

Going forward, the success of health reform under the Affordable Care Act in Massachusetts, and in other states, will depend on the ability of policy makers and stakeholders to come together to take on the considerable challenge of reining in health care costs. Massachusetts has the opportunity to lead the way here, as the state did in the push toward universal coverage. The pre-2010 status quo is not a sustainable option for Massachusetts or the nation. [bold added]

Here's the kicker: RomneyCare was enacted in a favorable political environment with some measure of bipartisan support. Most polls still show that a majority of the state's residents support the law. And yet year after year, the state has struggled to pass the sort of reforms that various health wonks and RomneyCare boosters think could save the system. And year after year, those efforts have failed. (This leaves aside the growing evidence that such reforms may not work at all.)

The contrast between the Bay State's amenable reform environment and the negative national reaction to the law is important. "Massachusetts's 2006 reform effort was built on many years of incremental reforms, with bipartisan political support, strong commitment to reform across stakeholders, and a strong economic environment," the study says. That should serve as a warning for those who an easy road ahead for President Obama's federal version of the law. As the authors note, "Few—if any—states, including Massachusetts, are starting to implement the Affordable Care Act in such favorable conditions."

In other words, RomneyCare isn't sustainable without substantial reform. But even in the most favorable plausible political environment, those reforms have yet to prove viable. Despite its many failures, RomneyCare may represent the best case scenario for ObamaCare. And it still isn't working.

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  1. Increases in self-reported health are not the same as increases in objective health measures.

    Were the election to be held today, would you be more likely to vote for Mitt Romney or Barack Obama?

    1. None of the above?

    2. No, I wouldn’t

      1. Nice.

    3. Better prep for 2016 bitches

      1. Jeb Bush is waiting in the wings.

    4. I would vote for Ron Paul. I would write him in if necessary.

  2. In other words, Romneycare and Obamacare are doing exactly what they were designed to do: grease the skids for “single-payer” (fuck; why don’t they just call it government-run?).

    1. Indeed. It’s the tried and true liberal playbook: inremental government interventions in a market that together distort and eventually detroy said market, blame destruction on the market itself, argue that total government control is the only answer to the government-caused problems.

    2. “why don’t they just call it government-run?”

      This is a rhetorical question I assume? The statists like to use language to cloak the nature of their policies – that is the only way they can hoodwink the human race.

      1. Obamacare is a deficit reduction bill, we swears it!

        1. Indeed. This is what Orwell called blackwhite. From 1984: “…this word has two mutually contradictory meanings. Applied to an opponent, it means the habit of impudently claiming that black is white, in contradiction of the plain facts. Applied to a Party member, it means a loyal willingness to say that black is white when Party discipline demands this. But it means also the ability to believe that black is white, and more, to know that black is white, and to forget that one has ever believed the contrary. This demands a continuous alteration of the past, made possible by the system of thought which really embraces all the rest, and which is known in Newspeak as doublethink.”

      2. This is a rhetorical question I assume?

        Yeah, really more an irritated rant. I really hate the way statists use cutesy euphemisms to try to cloak the reality of what they’re doing.

    3. Single payer sounds good to us

    4. What happened to “socialized medicine”? I know we’re 2/3 of the way there, but that used to be how we referred to such things. Like, you know, in other countries with socialized medicine. Or socialised medicine.

      1. Let’s not go all Limey now, alright? That island needs to sink already.

        1. We’re following in their footsteps.

    5. Single payer is just one kind of government run healthcare. Most countries with national universal healthcare programs do not have single payer systems. Just the worst ones like the UK and Canada.

      1. These differences you speak of. They seem meaningless.

  3. better alt-text: Bend ovah!

    1. Ben, huh, what’re you in for, Ben?

  4. “In general, would you say that your health is excellent, very good, good, fair, or poor?”

    This is a scientific question, how?

    1. Does “It sort of sucks” count as fair or poor?

    2. “yes”.

    3. I don’t know what you mean by scientific, but it’s an important question. People who are generally in good health but feel like they’re sick are going to use more medical resources.

      1. People who are generally in good health but feel like they’re sick are going to use more medical resources.

        So how would this survey extract that data? And at the same time we could also say that people who say they “feel” fine about their health but actually have serious medical conditions may end up using more medical resources because by the time they need them the services are going to be extensive and expensive.

        It’s a really dumb question in which to extract any meaningful data, is what I’m saying.

  5. “the newly covered are likely to immediately report feeling healthier, even if they’ve received no medical benefit from the coverage at all. This suggests that much of the increase in self-reported health comes from the psychic benefits of coverage rather than from significant objective improvements in health.”

    That and the worry you won’t lose everything you own

    http://www.msnbc.msn.com/id/68…..kruptcies/

    1. In the world of medicine this is known as the placebo effect. We should just pass out sugar pills to everyone – it would be cheaper.

      1. In the real world, it is known as limiting the prolonged high levels of cortisol which leads to heart disease and other negative health concerns:

        ?Proper glucose metabolism
        ?Regulation of blood pressure
        ?Insulin release for blood sugar maintanence
        ?Immune function
        ?Inflammatory response

        1. You are saying the world of medicine is not the real world? Then why are you arguing for government-run health insurance?

          Belief can have a power effect, but it is usually not “real” which is the whole point of double-blind studies.

          In any case, the reason medicine is as expensive as it is is because of government regulations – regulations I oppose. Here are five simple things that would make health care more affordable right away:

          Allow insurance plans to be sold in more than one state or region.

          Allow self-employed who buy their own insurance the same tax benefits as people with employer-based coverage.

          Expand availability of Health Savings Accounts which give the consumer greater control over spending.

          Legalize the re-importation of medications

          Reduce government regulations and red tape on the insurance industry. Heavy regulation creates an “iron triangle” effect enabling the largest companies to set the rules through their influence over politicians.

          1. Or, we could just require doctors to publish their rates, their disciplinary history, and their negotiated agreements with insurance companies on the net, and naturally available in their waiting rooms; I prefer to let insurance companies fuck themselves

            Medical care is the pricing equivalent of seat tickets in the airline industry.

            1. Or you could refuse to do business with any doctor who does not publish his or her rates, disciplinary history and negotiated agreements. Medical savings accounts are one way to make people less dependent upon insurance companies.

              1. I see you know dick about MSA’s too. An MSA is a payment vehicle; insurance is the primary payer; not the same function

        2. Practioners of the White Tigress Teachings also report increased health.

          Jus’ sayin’

    2. Better to let the entire country go bankrupt, which it is.

    3. But RomneyCare, at least, doesn’t seem to have had much effect on that: According to the study, “in 2010 the share of adults who reported problems paying medical bills was not significantly different from 2006, at nearly one in five adults.”

      1. Let’s not forget that the whole “medical bills causing a huge increase in bankruptcies” is a pretty weak argument to begin with.

        http://www.theatlantic.com/bus…..udy/18826/

      2. “According to the study” you mean a telephone survey? LOL

        1. How would you suggest a survey be conducted? Through SurveyMonkey?

          1. A telephone survey is as valid as your medical expertise

            1. How would you suggest a survey be conducted? Through SurveyMonkey?

              1. a study is a study and a survey is a survey; I don’t give a fuck how you do your survey
                -it means shit

    4. Um, you don’t lose everything you own when you go into bankruptcy. That’s why such a thing as bankruptcy exists.

      1. Another mind ruined by Wheel of Fortune.

  6. A new study on the Massachusetts overhaul by health policy researchers at Harvard and the University of Minnesota confirms all of this, and puts it into worrying perspective: This may be the best possible outcome for a RomneyCare/ObamaCare-style health policy overhaul.

    “Hey, bud, I’m new at this…. Is it true that in prison they rape you?”
    “Yes and it does happen, but that would be the worst case scenario while being here.”
    “Oh, my God! Well, what would be then the best case scenario?”
    “You could be shived.”

  7. A DeKalb County police “Officer of the Month” who was charged with stealing from people he had arrested has been fired, the department said Thursday.

    Officer Ghayth Abdul-Mughnee, on the force for four years, was arrested Wednesday on a warrant charging him with theft by taking, possession of marijuana and violation of his oath of office. He was taken to DeKalb police headquarters in handcuffs.

    Asked if he stole, the 30-year-old Abdul-Mughnee told Channel 2 Action News, “No, I’m innocent.”

    “My girlfriend is setting me up,” he said.

    Additional charges were pending, police said.

    The investigation against him began when officers responded to a domestic call shortly after 2 a.m. Monday at Abdul-Mughnee’s Lithonia home. The officer’s live-in girlfriend, Shawte White, told police about the alleged thefts as she was being arrested for simple assault.

    Police said Abdul-Mughnee would bring items home from work that belong to people he arrested. Investigators found in the officer’s home “evidence … about his involvement in theft activities,” said Mekka Parish, DeKalb police spokeswoman.Parish said detectives believe Abdul-Mughnee stole items including “electronics, credit cards and identification cards.”

    The 33-year-old White also told investigators her boyfriend brought home marijuana he had seized from suspects, police said.

    A police car Abdul-Mughnee had been allowed to take home as part of his Officer of the Month commendation for December was impounded as evidence.

    http://www.ajc.com/news/dekalb…..17351.html

    1. “The bitch set me up.” Best defense ever.

      1. Speaking as the former rep from Ward 8 I can tell you the feds ain’t buyin!

    2. The officer’s live-in girlfriend, Shawte White,

      Seriously? Her parents named her Shorty?

      A police car Abdul-Mughnee had been allowed to take home as part of his Officer of the Month commendation for December was impounded as evidence.

      They impounded their own car?

      1. Parents are weird; I knew a dad who had a tat on his back that he got as a punishment from his wife

      2. Funny how all of these guys are Officer of the Month/Year/Century.

  8. The best possible outcome for Obamacare is for it to be repealed and its proponents jailed, tried, and exiled to Harlem.

  9. “”The American people will never knowingly adopt socialism. But, under the name of ‘liberalism,’ they will adopt every fragment of the socialist program, until one day America will be a socialist nation, without knowing how it happened.”

    – Norman Thomas, U.S. Socialist Party presidential candidate 1940, 1944 and 1948, pinko mother-fucker extraordinaire

    1. Unfortunately, there’s no evidence that Norman Thomas ever said that: http://www.snopes.com/politics…..ialism.asp
      Seems like the most he might have ever said is that both parties borrowed elements of the Socialist platform. Anyway, in general we should always be wary of quotes of the form, “Ha ha! Those suckers will be tricked into falling for my real agenda!” because they almost always end up being fabrications meant to reinforce the prejudices of the listeners.

  10. Alt text:

    “bend over, Newt. I’m gonna see just how deep your conservative convictions really are.”

  11. “Most polls still show that a majority of the state’s residents support the law.”

    I would be genuinely fascinated to know about samples used in them. Even given Massachusetts political lunacy, who exactly are those people who support such sweeping damage?

  12. Two by two, hands of blue!

  13. Are you saying that Romney is a fudge packer?

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