Massachusetts insurance commissioner: MassCare will be "a train wreck"

If you want to know what ObamaCare will look like in a few years, you don’t need to look any further than Massachusetts. As Joseph Rago notes in the Wall Street Journal, President Obama himself pointed to the Massachusetts model and said his reforms were “essentially identical.”

Since the Massachusetts health care system is what we can expect from ObamaCare, how’s it been working out? According to career state insurance commissioner Robert Dynan, Massachusetts’ health care system is in his words “a train wreck,” or several of them actually:

As events are now unfolding, the Massachusetts plan couldn’t be a more damning indictment of ObamaCare. The state’s universal health-care prototype is growing more dysfunctional by the day, which is the inevitable result of a health system dominated by politics.

In the first good news in months, a state appeals board has reversed some of the price controls on the insurance industry that Gov. Deval Patrick imposed earlier this year. Late last month, the panel ruled that the action had no legal basis and ignored “economic realties.”

In April, Mr. Patrick’s insurance commissioner had rejected 235 of 274 premium increases state insurers had submitted for approval for individuals and small businesses. The carriers said these increases were necessary to cover their expected claims over the coming year, as underlying state health costs continue to rise at 8% annually. By inventing an arbitrary rate cap, the administration was in effect ordering the carriers to sell their products at a loss.

Mr. Patrick has promised to appeal the panel’s decision and find some other reason to cap rates. Yet a raft of internal documents recently leaked to the press shows this squeeze play was opposed even within his own administration.

In an April message to his staff, Robert Dynan, a career insurance commissioner responsible for ensuring the solvency of state carriers, wrote that his superiors “implemented artificial price caps on HMO rates. The rates, by design, have no actuarial support. This action was taken against my objections and without including me in the conversation.”

Mr. Dynan added that “The current course . . . has the potential for catastrophic consequences including irreversible damage to our non-profit health care system” and that “there most likely will be a train wreck (or perhaps several train wrecks).”

Well, this is not at all what Barack Obama, Nancy Pelosi, and Harry Reid said ObamaCare would be like. They insisted that their health care reforms would bring the American people nothing but rainbows and unicorns.

Anyone who has any knowledge of economics knows that when you expand coverage, you can’t contain costs unless you do some serious rationing, which is what is now happening in Massachusetts and what will inevitably happen throughout the entire country with ObamaCare. Which means the only way the Democrats could pass the thing was to use the oldest scheme in the book: bait and switch (emphasis mine):

“If you’re going to do health-care cost containment, it has to be stealth,” said Jon Kingsdale, speaking at a conference sponsored by the New Republic magazine last October. “It has to be unsuspected by any of the key players to actually have an effect.” Mr. Kingsdale is the former director of the Massachusetts “connector,” the beta version of ObamaCare’s insurance “exchanges,” and is now widely expected to serve as an ObamaCare regulator.

He went on to explain that universal coverage was “fundamentally a political strategy question“–a way of finding a “significant systematic way of pushing back on the health-care system and saying, ‘No, you have to do with less.’ And that’s the challenge, how to do it. It’s like we’re waiting for a chain reaction but there’s no catalyst, there’s nothing to start it.”

In other words, health reform was a classic bait and switch: Sell a virtually unrepealable entitlement on utterly unrealistic premises and then the political class will eventually be forced to control spending. The likes of Mr. Kingsdale would say cost control is only a matter of technocratic judgement, but the raw dirigisme of Mr. Patrick’s price controls is a better indicator of what happens when health care is in the custody of elected officials rather than a market.

Technically, the bait and switch scheme didn’t work since the vast majority of the American people saw through their scheme and were overwhelmingly against the bill from the very beginning. But the Democrats passed it anyway in an act of outright defiance.

Interestingly, it seems the Democrats led by their ridiculous leader Nancy Pelosi are planning on running their reelection campaigns on health care reform using the same bait and switch tactics they used in the run up to the vote. We’ll have to wait and see if it works this time. Their facing an uphill climb with polls today still showing at least 60 percent of the American people want ObamaCare repealed.

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