The Blues have joined  the health care for all bandwagon in Minnesota. The state's Blue Cross Blue Shield is endorsing a bill based on the Massachusetts model of achieving health care for all through compelling the purchase of insurance, highlighting both a key strength and a key weakness of the model. The mandatory nature of the law builds bridges to new interested parties: insurance firms well positioned to benefit from a law requiring that the public purchase their product.
But self-interested stakeholders should be treated with skepticism. Minnesota is currently home to 400,000 uninsured. Blue Cross's plan, modeled on the Massachusetts/Romney model, would cost $911 million a year -- roughly $2300 per uninsured Minnesotan. The state Health Department ran its own estimates earlier this year and predicted that MinnesotaCare could insure the uninsured for $663 million, almost one-third less the cost.
The savings of public v. private programs is unsurprising. An independent study  found that a single payer system in California would generate enough savings through increased efficiency to extend health insurance universally in the state at no net increased cost statewide. BusinessWeek recently declared  the Veterans Administration the most efficient health care system in America, another example of the benefits of integrated health care delivery.
Blue Cross Blue Shield of Minnesota is a non-profit. And new members in the coalition for health care for all are welcome. But the priority in crafting public policy needs to be attaining the goals of affordable quality coverage for all.
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