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Gaming the System in Massachusetts

July 12, 2009

The WSJ has a great short piece on what is happening in Massachusetts with health insurance reform.

I agree with the authors that all health policy experts and politicians should pay attention to what is going on in Massachusetts.  What has happened in the Bay State is that superficial health reform was superimposed on existing insurance structures resulting in perverse incentives for consumers.  Unfortunately, I believe the same thing is likely to happen on a national level.  Congress and the White House are trying to force through health care reforms without thoughtful analysis of possible consequences and without addressing the worst problems with the American health care system–namely ever-increasing costs.

However, I am skeptical of this article’s assertion that everything should be left to the free market.  (Little surprise the WSJ came to that conclusion.)  Unfortunately, these authors miss out on a golden opportunity to call for more state-based experimentation.  The unfortunate reality of health care reform is that we have no idea what really works.  No clue.  But, we can use individual states as testing grounds for innovative approaches to health reform.  Massachusetts has showed us one way of going about health care reform that doesn’t work very well.  Now, let’s try different approaches in 49 other states to see what will work.  The only problem with this plan is that it leaves out national politicians…and they don’t like to be left out of anything.

The bottom line is that until we figure out how health care reform actually works in the real world–through state-based experimentation–we should not enact anything on a national level.

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