As many in Massachusetts know, I am a long time health reform advocate and a nurse who is a very vocal critic of the Massachusetts Model. I view our “landmark law” largely as a sham of grand proportion. This is because it does not reform our health care system. What the law does is as described by the authors of this HA blog entry (but I do question if their figures of “hundreds of billions in nonbenefit dollars” is meant to read “millions”?) and these things do not constitute health system reform. It is true that some of the so-called “Commonwealth Choice” plans (saavy marketing isn’t it, what they named some of the insurance products that residents are forced under the law to purchase?) do indeed have very high deductibles and co-pays of $2K for individual, $4K for couple or family. In the interest of relevant disclosure, Brian Rosman who is a stalwart defender of the law, works for an organization that receives significant funding from the private insurance industry in Massachusetts.

The misleading spin put on the Massachusetts insurance law by its architects (largely the insurance industry and the politicians who choose not to challenge the abuses of that industry) has been appalling, to say the least. Contrary to being meaningful reform of the system, the Massachusetts insurance law simply mandates purchase of private health insurance for all state residents except those who are granted permission from the state to remain uninsured. Yes, it does create MInimum Creditible Coverage (MCC) benefits–but not for “youth” who get serious illnesses, too. MCC makes sense, but in the absence of enacting serious cost controls it is not reform.

The law relies on massive amounts of new public dollars to subsidize purchase of private insurance policies for many. This has led to many other worthy public programs being starved for funds–public health, education, and on and on. These are the reasons why countless others in the state and across the nation who know the law’s details and who are not on the dole of the insurance industry also have concluded that the Massachusetts Plan is a give-a-way to the private health insurance industry in the state. Mr Rosman’s comment here references “An independent review found the charge of uncontrolled costs to be a “myth.”” but what he does not state is that the “independent review” was crafted by a group, the Massachusetts Taxpayer’s Foundation, that has Blue Cross and Blue Shield on its board of trustees; this begs the question: What are the funding sources for the group conducting this so-called “independent review”?

Due to being a health professional and health reform advocate in Massachusetts, I have had the benefit (or the curse, many might say) of following the law’s creation closely over years of careful groundwork that was laid out by Massachusetts Blue Cross and Blue Shield Corporation and their joined-at the-hip partner, the BCBS of Massachusetts Foundation. Brian Rosman’s organization and just about every other “advocacy” group in the state has come to rely on a stream of regular funding from Blue Cross and Blue Shield, this being one part of the careful groundwork that paved the way for a law establishing mandatory purchase of private health insurance with no cost controls.

Thankfully, people are smartening up and paying attention to the details as our national reform process moves forward; there’s a groundswell opinion among both the general public and health policy experts that an improved Medicare Part E (for Everyone) for all who want it is what will provide America the health system reform we so urgently need. - Ann Eldridge Malone, RN