Debating the Massachusetts Health Plan

Tuesday the 23rd at noon, on Capitol Hill. I will be one of four participants. Details here.


My challenge will be to prioritize what I want to say. I have lots of criticisms of the Massachusetts plan, but I think I should stick to the most important ones. These are:


1. It doesn’t add up.


2. It leaves the elephants in the room. The two elephants in the health care room that no one wants to talk about are (a) the unfunded liability in Medicare and (b) what I call “gray‐​area medicine” (procedures that are long on cost and short on benefits). These elephants in the room are ignored in most discussions of health care policy, but they are addressed in Crisis of Abundance, a must‐​have book that incidentally makes a great gift.


3. Instead of freeing private insurers from its regulatory stranglehold, Massachusetts is creating a government‐​sponsored enterprise whose main advantage, if any, will be that it is exempt from some of the regulations that ordinary insurance brokers face.


4. Rather than bipartisan political compromise at the state level, I would prefer to see clean experiments. A single‐​payer approach in states that lean that one way, and a relatively unregulated and unsubsidized approach in states that lean the other.


But the interesting thing about the live event won’t be my planned remarks. It will be the interaction with the other panelists and the audience.