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“Good Job Mitt”: Romneycare Is Making Massachusetts Healthier and its certainly working and liked by the citizens
In newly released research, Charles Courtemanche and Daniela Zapata ask perhaps the most important question about the Massachusetts health-care reforms: Did they improve health outcomes in Massachusetts?

The answer, which relies on self-reported health data, suggests they did. The authors document improvements in “physical health, mental health, functional limitations, joint disorders, body mass index, and moderate physical activity.” The gains were greatest for “women, minorities, near-elderly adults, and those with incomes low enough to qualify for the law’s subsidies.”

Some of those results are a bit odd. Although it’s possible to tell yourself a story about how the Massachusetts health reforms affected the body mass indexes of the newly insured, you have to stretch a bit.

But most of them make perfect sense. The reforms led to more people having insurance, which is to say more people having more opportunities to see a doctor and get early and/or regular treatment for ailments. That led to improvements in health. If that hadn’t led to improvements in health, it would be the worth of going to the doctor and getting timely medical care that would be called into question. And if going to the doctor and getting timely medical care isn’t worth doing, the Massachusetts reforms are pretty far down the list of practices and policies we need to rethink.

The researchers end by asking whether the Massachusetts reforms provide a good guide to what will happen under the Affordable Care Act. “The general strategies for obtaining nearly universal coverage in both the Massachusetts and federal laws involved the same three-pronged approach of non-group insurance market reforms, subsidies, and mandates, suggesting that the health effects should be broadly similar,” they write. “However, the federal legislation included additional costcutting measures such as Medicare cuts that could potentially mitigate the gains in health from the coverage expansions. On the other hand, baseline uninsured rates were unusually low in Massachusetts, so the coverage expansions — and corresponding health improvements — from the Affordable Care Act could potentially be greater.”

I’d add one point to their discussion: The national reforms, unlike the Massachusetts reforms, included major investments in comparative-effectiveness research, electronic health records, accountable care organizations and pay-for-quality pilots. If any or all of those initiatives pay off, they could dramatically improve our understanding of which treatments work and force the health-care system to integrate that new knowledge into everyday treatment decisions very quickly.

If that happens, medical care could become substantially more effective than it is now, which should also improve health outcomes. Quality improvements like that could, for the already insured, be the largest payoff from the Affordable Care Act.



"“A Window Into The Future”: Mitt Romney Won’t Enroll In Medicare And Doesn’t Want Anybody Else To Either

Mitt Romney hasn’t explained his announcement yesterday that he won’t be enrolling in Medicare despite turning 65, but as Jonathan Cohn points out, Romney is at least practicing what he preaches. Romney supports Paul Ryan’s plan to turn Medicare into a voucher program, a plan that would effectively end Medicare as we know it, and Romney is putting his money where his mouth is by deciding against enrolling.

Romney’s decision is a window into the future that he promises to deliver. Instead of a Medicare program that directly provides coverage, Romney wants seniors to obtain coverage from private insurers. Depending on their income and personal wealth, a portion of that coverage would be subsidized, but the guaranteed coverage of Medicare would be eliminated.

The fact that Romney was able to forego the Medicare system without penalty or punishment puts the lie to the notion that government health care programs are tyrannical. That’s an important fact to point out, because even though any senior who doesn’t want Medicare coverage could walk away from the system, just like Mitt Romney did, the overwhelming majority of them don’t—and that’s a testament to the effectiveness of Medicare.

But even though Medicare works, Mitt Romney wants to end the program as we know it. He wants Medicare to be transformed into a voucher provider, subsidizing private insurance plans instead of directly covering medical care. For 99 percent of Americans, it would be a radical overhaul, raising costs and making it difficult if not impossible to find insurance. Given his means, Romney would do fine in such a system. That’s basically the system he’s living in now, but it doesn’t take a rocket scientist to realize most people can’t afford what he can afford. And if Medicare were privatized as he proposes, that’s exactly what he would force every American senior to do.

If you’re only concerned about personal benefit, Medicare might not turn out to be the best deal in the world for someone like Mitt Romney, who is fabulously wealthy and doesn’t need the coverage. But even the Mitt Romneys of the world are better off living in a society where senior citizens have the security of health care coverage that Medicare provides. If we were to adopt Mitt Romney’s proposal to turn it into a voucher system, Medicare would no longer provide it’s greatest benefit of all: the peace of mind that comes with knowing that every single senior citizen has the health care coverage they need.



CBO: Health reform to cut deficit by $50 billion more than we thought

I’m getting a lot of e-mails quoting articles like this one, by John Ransom, that say something like, “In a wholly predictable development, it turns out the cost for Obamacare will end up being twice the original price that the Democrats said.”
But let’s back up. The occasion for this dust-up is a set of updated cost estimates for the coverage provisions of the health-care law. The new estimates reflect a couple of factors. The Congressional Budget Office lists them:

- An increase of $168 billion in projected outlays for Medicaid and CHIP;

- A decrease of $97 billion in projected costs for exchange subsidies and related spending;

- A decrease of $20 billion in the cost of tax credits for small employers; and

- An additional $99 billion in net deficit reductions from penalty payments, the excise tax on high-premium insurance plans, and other effects on tax revenues and outlays—with most of those effects reflecting changes in revenues.
You’ll notice something about the above list: It appears to add up to a net reduction in the cost of the health-care law. And, sure enough, here’s CBO: “the insurance coverage provisions of the ACA will have a net cost of just under $1.1 trillion over the 2012–2021 period—about $50 billion less than the agencies’ March 2011 estimate.” You would get the opposite impression reading Ransom.



Flat Earth Society vs. Dr. Kevorkian Fan Club!

With Obamacare projected by the CBO to cost twice the price as originally estimated, rationing of healthcare would be a likely outcome. So if the GOP are the founding members of the Flat Earth Society, would the Democrats then be the founding memners of the Dr. Kevorkian Fan Club?

Read the story at The Political Commentator here: http://bit.ly/xwME7e

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