RomneyCare Motivates Massachusetts Lawmakers to Control Costs

When they aren't screaming about death panels and the end of our Constitutional republic, Republicans occasionally offer the rational complaint that the Patient Protection and Affordable Care Act doesn't do enough to control health care costs.

Never mind that adding more provisions on cost control would have fueled the fallacious GOP complaints that the 906-page bill was too long (and that somehow, long legislation is inherently flawed). Never mind that the Administration can point to some PPACA provisions aimed at lowering costs. Never mind that House Republicans voted in March to repeal one of the PPACA's cost-control measures.

And never mind that Mitt Romney can't win the cost-control argument, either. When he passed the template for the PPACA in Massachusetts in 2006, he didn't do a lot on cost control, either. Now Mass. Gov. Deval Patrick is pressing the cost-control issue (what is it about Republicans enacting law, but leaving it to Democrats to ride in to deal with costs?):

Before the Massachusetts Legislature adjourns on July 31, chances are good that lawmakers will pass a bill to enact cost controls on health care in the state, according to a series of interviews in Boston's Beacon Hill. The measure -- which Democratic Gov. Deval Patrick is expected to sign -- would be the long-awaited follow-up to the health-care overhaul approved in 2006 by the Democratic-dominated Legislature and signed by Republican Gov. Mitt Romney.

The Romney bill—widely viewed as the model for Obama's ACA—was aimed at broadening coverage to previously uninsured residents. But the 2006 law was not aimed at controlling costs, which pose a particular problem in Massachusetts, the state with the highest per capita spending on health care in the nation.

Massachusetts has even more of a vested interest in curbing costs than most states do, since the 2006 law instituted state-funded subsidies to help the uninsured buy coverage. "The state now has a strong incentive to control health care spending, and that explains why Massachusetts has moved further in the cost control debate than other states," said Jonathan Oberlander, a health policy professor at the University of North Carolina School of Medicine [Louis Jacobson, "Massachusetts Tackles Health-Care Reform (Again)," Governing, 2012.07.12].

Ah, so get the state to buy into covering all of its citizens, and you build the political motivation to get a grip on costs. That feels like putting the cart before the horse, but legislators are strange critters, and we may need to do strange things to get them moving in the right direction.

We're spending over 17% of our national wealth on health care, compared with the 10-12% other Western nations spend, and we're getting broker, not healthier. We need to bring that percentage down and free up more of our wealth to spend on education, roads, houses, and rocketships. The political impact of RomneyCare shows that ObamaCare can lead us in that positive direction.