Massachusetts leads on health care while Maine regresses
Posted Aug. 23, 2012, at 4:43 p.m.
Massachusetts, the first state that attempted to offer health care to all its residents and provided the template for national health reform, recently took the inevitable and much more difficult next step.
It passed a law intended to restrain future growth in total statewide health care costs. Once government has adopted a policy of achieving universal health care, it must then take steps to maintain affordability.
For the past 50 years, our national health care policy has been one of relentlessly expanding our system’s capacity. In the mid-1950s, the Internal Revenue Service made employer-provided health benefits tax exempt. In 1965, building on the legacies of Presidents Roosevelt, Truman and Kennedy, President Johnson prodded the Congress into enacting Medicare and Medicaid, thereby infusing billions of public dollars into our health care system for direct care of the poor and elderly.
During the following decades, under both Democratic and Republican administrations, Congress further expanded our health care system, creating community health and mental health centers, the national health service corps and expanding health benefits for federal workers, the military and their dependents, as well as veterans and Native Americans.
Congress also provided support to increase the numbers of doctors, nurses and other health care professionals and to construct hospitals and other health care facilities. Federal support for basic biomedical research was massively expanded through the National Institutes of Health.
That support subsequently spurred unprecedented innovation through the conversion of publicly funded scientific knowledge into commercially viable products and the capability to use them. With the help of sophisticated marketing techniques, these products and services are now being relentlessly promoted in an effort to increase demand.
So our public policy regarding health care has been to spend trillions of dollars to expand our capacity to provide services, personnel, facilities and innovation. These efforts have been hugely successful. Per-capita health care spending (in constant dollars) has increased by about six times since 1966, when Medicare was implemented, and we’re now at about twice the spending level of other wealthy countries.
But despite our high spending, we have the highest percentage of population without adequate access to health care, the poorest health outcomes and the least popular health care system of any advanced country.
Elizabeth Warren on health care and religion
In my column today, I noted that I had interviewed Elizabeth Warren, the Democratic candidate for the U.S. Senate in Massachusetts. In the course of the interview, Warren offered what I thought were particularly interesting thoughts about the Affordable Care Act, and also about the role of her religious faith in her public engagement. I share a partial transcript of the interview here.
Medicare takes over as main issue in congressional races
Both Democrats and Republicans see their path to the congressional majority through Paul Ryan's vision for Medicare.
WASHINGTON — The addition of Rep. Paul D. Ryan to theGOP presidential ticket has upended the congressional campaigns as the battle for the House and Senate swiftly focused on one main issue: Medicare.
As the architect of the GOP's Medicare overhaul hit the campaign trail alongside presumed presidential nominee Mitt Romney, the complicated policy issue was catapulted into the national spotlight.
Suddenly, Americans began hearing Ryan's vision to change the healthcare safety net for the next generation of seniors at a volume that had not been reached before — despite multiple House and Senate votes on the budget proposal.
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