House passes cojmpromise Resolution giving Dems everything they wanted, ex. Obamacare

[Hoffstra]

next year the House will submit a bill that pays for everything...but Medicaid and SNAP.

what should the Senate do? just go along and be good boys?

 

[Steven_R]

Maybe try to come up with a compromise so that both sides get something instead of just showboating for the rubes back home?

Nah, that'd never work.

 

[daveman]

Oh, and those of you pointing to the success of MassCare -- it's not a success.

Mass. mess: ObamaCare?s ugly future | New York Post

When the Bay State passed its health-reform law in 2006, 9 percent of non-elderly adults lacked insurance; that’s now down to 5 percent. The law didn’t reduce expensive emergency-room use as predicted. Instead, emergency-room visits have climbed by 9 percent, or about 3 million visits, from 2004 to 2008. But it’s bankrupting the state, while the pressures on small businesses and on health-care insurers and providers continue to build toward the breaking point.
Health care now consumes 35 percent of the state budget, up from 22 percent in 2000. Patrick recently asked Washington for $473 million to help make the Massachusetts reform work — on top of the $1.2 billion in support the feds have already kicked in over three years, more than $3,000 per person in the state.
Whenever the federal help stops coming, the Bay State will have to either hike taxes further to fund its program, or start cutting benefits. Reimbursements are already so low under the state-subsidized plans (most of whose 152,000 enrollees pay nothing) that doctors are already refusing to accept new patients with that “coverage.”
Yet small businesses are clearly finding it necessary to dump their employees on the public health plans. The Boston Globe recently reported on a broker who helps firms do just that; his practice is booming. He’s seen about 90 business owners terminate their plans since April.
What’s forcing up costs so much? Part of it is simply the increased demand for care, now that more people have insurance. But part of it is the “gaming” of the rules that force insurers to offer coverage to all comers, regardless of health status.
The maximum fine for not buying insurance is $1,116, far below the cost of a private plan. So some people are plainly waiting until they face a major medical expense to buy — and then dumping the coverage as soon as the problem’s resolved.
The state says that the number of short-term insured tripled from 3,508 in 2006 to 17,177 in 2008 — and that the problem adds up to 1.5 percent to the cost of insurance for everyone else. Patrick and his allies are looking at limiting the periods when anyone can enroll to once or twice a year.

Don't believe them? Let's ask MassCare itself:

Report: Massachusetts Health Reform in Practice | Mass-Care

Four years after full implementation of the law, Massachusetts has not achieved universal coverage, although one-half to two-thirds of the previously uninsured now have some type of insurance policy. Most of the gains in coverage have come from expansions in publicly subsidized insurance. This largely represented a shift of patients from the state’s former Free Care Pool, which compensated hospitals and community health centers directly for care of the uninsured, to private insurance plans, which is a more costly way to provide care. The reform did not lead to a sustained increase in employer-sponsored coverage, but did slow declining employer coverage. Instead of dropping coverage, employers in Massachusetts have increased cost sharing, shifting costs on to employees, leading to rapidly rising underinsurance after health reform. The use of high-deductible plans more than tripled for residents with private insurance, and good insurance coverage at small businesses all but disappeared over a few short years after reform.

Reform has had a positive impact on access to care in the state, but this impact has affected a modest share of residents, and for some patients has been negative. For example, some low-income patients who previously received completely free care under the state’s prior free care program faced new co-payments and premiums after becoming insured, which impeded their access to care. Reform has not reduced the burden of medical bills and medical bankruptcy on Massachusetts’ families.

The growth of residents with insurance coverage has exacerbated a primary care shortage in Massachusetts by increasing wait times for appointments and decreasing the portion of physicians accepting new patients, creating access problems even for those with coverage. Reform did not reverse growing use of the state’s emergency departments for care, despite expectations that expanding insurance coverage would reroute patients through primary care offices. There is no evidence as of yet that expanding insurance coverage has had an impact on health outcomes or disparities in health outcomes. Reform has also created a financial crisis for safety net providers that specialize in care for low-income communities and the uninsured, by shifting resources away from safety net providers while patient demand for safety net care has actually increased.

The public cost of reform has been high, exceeding $800 million in fiscal 2009 for a state with a total budget of $32.5 billion. However, federal taxpayers paid for the bulk of the law’s public expenses. The state has made a broad range of cuts to the original law in order to its keep costs down, cutting back coverage for over 30,000 documented immigrants, curtailing some benefits, increasing cost sharing, and increasing the share of enrollees required to pay premiums. Substantial funds from the federal stimulus bill were also used to sustain the reform law, but this was a short-term fix only.

Public payments account for only a portion of the reform law’s costs. A central premise of the law was that the state, employers, and individuals would all have to sacrifice financially to approach the goal of universal coverage. This premise of “shared responsibility” for the costs of the reform was in many ways disingenuous. Although employers, individuals, state and federal government have shared the burden of increased costs roughly equally, this overlooks the fact that governments pass on their spending to taxpayers, and employers pass on their costs to employees. The actual burden of health reform was regressive, with increased spending after health reform falling disproportionately on lower-middle income residents.

The reform failed to “bend the cost curve” in Massachusetts because it contained no significant cost-control provisions. Health care costs in Massachusetts are higher than in any other state in the nation, and reform has been found to accelerate the rising costs of employer-sponsored health care. There is general agreement that the Massachusetts reform is itself not sustainable without effective cost control.

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We believe that the data in this report should give pause to those concerned with national health care reform. Although not without its successes, the Massachusetts reform has not addressed the fundamental deficiencies in the health care system – treating symptoms rather than causes – and even its modest successes are unsustainable for the state and Massachusetts residents.

Yes, that's a rousing success, isn't it?