Wednesday, November 24, 2004

Is $41.4 Billion Enough?

Massachusetts Governor Mitt Romney has announced a program for reducing the number of people in the Commonwealth (estimated to be in the range of 450,000 to 650,000) who do not have health insurance. Details have not yet been announced, but the preliminary indication is that there will be four main elements. One is a stripped-down, presumably more affordable health insurance package that excludes things like treatment for substance abuse, chiropractic services, and rehabilitation. Second is a group of carrot-and-stick incentives for employers to offer health insurance coverage. Third is an effort to get all those eligible into Medicaid. Fourth is the funneling of patients seeking free services into an “aggressively managed system of care.”

There is also some rhetoric about electronic medical records, reducing paperwork, hiring more nurses, and the like.

All of this is to be done with no increase in taxes.

Predictably, the liberal health care gurus (of which Boston has an abundance) are pooh-poohing this proposal by a Republican governor as being ineffective. They say that in order to achieve anything approaching universal coverage, the Commonwealth will have to put up serious money.

The Governor’s response is that the $41.4 billion Massachusetts is already spending annually for health care ought to be enough. Referring to that number, Ronald Preston, his Secretary of Health and Human Services, asked “How can you be contemplating spending a whole lot more money no matter who pays for it?”

Sounds to me like a reasonable question.

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