The Massachusetts Univeral Health Care Plan

According to Pam Belluck in the New York Times...

Massachusetts is poised to become the first state to provide nearly universal health care coverage with a bill passed overwhelmingly by the legislature Tuesday that Gov. Mitt Romney says he will sign.

The plan is a complex mixture of mandatory coverage requirements, tax incentives, and although Ms. Belluck tries desperately to avoid using the term, tax increases. Here's a few specifics culled from the news article...

The bill, the product of months of wrangling between legislators and the governor, requires all Massachusetts residents to obtain health coverage by July 1, 2007.

Individuals who can afford private insurance will be penalized on their state income taxes if they do not purchase it. Government subsidies to private insurance plans will allow more of the working poor to buy insurance and will expand the number of children who are eligible for free coverage. Businesses with more than 10 workers that do not provide insurance will be assessed up to $295 per employee per year...

The Massachusetts bill creates a sliding scale of affordability ranging from people who can afford insurance outright to those who cannot afford it at all. About 215,000 people will be covered by allowing individuals and businesses with 50 or fewer employees to buy insurance with pretax dollars and by giving insurance companies incentives to offer stripped-down plans at lower cost. Lower-cost basic plans will be available to people ages 19 to 26.

Subsidies for other private plans will be available for people with incomes at or below 300 percent of the poverty level. Children in those families will be eligible for free coverage through Medicaid, an expansion of the current system...

Individuals who fail to get health insurance by July 2007 will first lose their personal exemption on their state taxes. In subsequent years, they would have to pay a penalty that could be as high as half of what an affordable health care premium would cost.

Losing an exemption on state taxes is a tax increase. A penalty is a tax increase. Tax increases aren't inherently bad, but let's be honest on what this program is doing -- raising taxes on young people to pay for universal health insurance.

An aide to Governor Romney explains the focus on the young...

Eric Fehrnstrom, the governor's communications director, said that for those people with incomes above 300 percent of poverty, "our assumption was that these would be mostly single mothers who just did not have the wherewithal to get insurance. It turned out it was mostly young males. In some cases they are making very attractive salaries. These are people who just don't imagine themselves needing care, but of course when they break a leg when they're out bungee jumping they go to the hospital and we end up paying for their care anyway."

This explanation should raise an immediate red-flag. Apparently, to initiate this program, the government needs to immediately grab a bunch of money from young people who don't use much healthcare and transfer it to others who do.

The problem is that the windfall of dollars added to the system is a one-time-only event that contributes nothing towards controlling costs. Once everyone is forced into the system (that has helped to create the problem by limiting the choices that people have), there's no one else left to tap, and measures like dropping treatments from coverage and even rationing become the only options as costs continue to rise. Ultimately, the Massachusetts plan does more to delay necessary reform of health insurance than it does to solve the problem.

Incidentally, today's OpinionJournal editorial mentions one of the simpler solution that would give people more control over their healthcare...

Congressman John Shadegg (R., Ariz.) has a bill to let Americans purchase affordable health insurance from any of the 50 states, thus bypassing state mandates that drive up insurance costs in New York and many other places.