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Matt Singer on April 19, 2006 - 11:09am
Does it take two to tangle? Two New Jersey legislators are embarking on a six-month project to evaluate whether New Jersey can copy Massachusetts' recently adopted plan. Before they start hustling around the state, they ought to take a look at whether the Massachusetts plan is even going to work in Massachusetts and also think hard about whether it should be the starting point for negotiations. As Robert Kuttner aptly summarized in The American Prospect recently:
The design of the plan was drastically constrained from the beginning by Governor Romney Mitt who started with three dubious assumptions. First, he insisted that basic health insurance could be had for $2,400 a year. As any employer or individual who actually buys insurance knows, minimally decent coverage costs around $4,000 for an individual and double that for a family. The rhetoric about basic "Chevrolet policies" versus "Lexus policies" is blarney. Any policy that costs only $2,400 has astronomical out-of-pocket payments. It simply shifts medical costs to individuals. Romney's second premise, shared by Senate President Robert Travaglini, was that "market reforms" could liberate hundreds of millions of wasted dollars to redirect to coverage. The health bill, which creates a "Connector" to re-structure insurance markets, will test that assumption. But as long as private insurers remain dominant to take their cut -- for profit, marketing, the costs of cherry-picking healthy customers, second-guessing doctors, and spewing paperwork -- the savings of market reform will remain modest. True market-reform would be single-payer coverage like Medicare, which is far more efficient than anything private insurers offer. The final dubious assumption is that health insurance is like auto insurance; government should just make everyone buy it. But you can get basic auto insurance for well under a thousand dollars. While there are an estimated 50,000 affluent people in the Commonwealth who could afford medical coverage but choose instead to play Russian roulette with their health, the vast majority of the uninsured and under-insured don't have decent insurance because their employer doesn't offer it and they can't afford to buy it. (How do you pay $8,000 for insurance on a $30,000 income?)New Jersey would be wiser to wait to see how Massachusetts deals with Massachusetts-style reform before exacting the experiment on the other state. In the meantime, there are plenty of other proposals, like Fair Share Health Care worth emulating that represent a solid first step.