The Massachusetts Canary

Maggie Mahar reports on how things are going in Massachusetts, with its much‐​touted health reform:

Uninsured citizens earning more than 300% of the poverty level are expected to buy their own insurance. Here, the state hoped that 228,000 of its uninsured citizens would sign up. So far, just 15,000 have enrolled. Apparently, they’ve done the math and decided that it would be cheaper to pay the penalty. But their premiums are needed to keep the program going. If more in this group don’t sign up, it is not at all clear how the state will be able to continue subsidizing the poor.


Yesterday’s first speaker, Robert Blendon, a professor of Health Policy in Harvard’s Department of Health Policy and Management, talked about what Massachusetts experience might mean for the national health care debate: “Massachusetts is the canary in the coal mine,” Blendon declared bluntly. “If it’s not breathing in 2009, people won’t go in that mine.”

See also this post, where Mahar writes,

But the underlying reason people in Massachusetts have become accustomed to such lavish care is not that they are naturally more demanding than people in other states. Rather, high consumption of care is driven by the fact that the state is a medical Mecca, crowded with academic medical centers, specialists and the equipment needed to perform any test the human mind is capable of inventing.

In December of 2005, in The Weekly Standard, I wrote

if I were going to pick a state in which to attempt an experimental health care financing reform, it would not be Massachusetts. Massachusetts, with its outstanding medical schools and world‐​class hospitals, is rich in the suppliers of premium medicine, and abundant supply has been shown to drive up usage.

Mahar and I are almost exactly in alignment on health care policy. We agree on the diagnosis – Americans make extravagant use of medical procedures with high costs and low benefits. Mahar and I only differ in our prescriptions. Go figure.


Go read both of Mahar’s posts. There is more worth reading than what I excerpted.