Health Care: The Promise and Perils of "Compromise"

The New York Times takes a look at Massachusetts' ground-breaking push towards universal health care, and what it found offers some interesting insight for national health policy.

Three years ago, Massachusetts enacted perhaps the boldest state health care experiment in American history, bringing near-universal coverage to the commonwealth with Paul Revere speed.

To make it happen, Democratic lawmakers and Gov. Mitt Romney, a Republican, made an expedient choice, deferring until another day any serious effort to control the state's runaway health costs.

The day of reckoning has arrived. Threatened first by rapid early enrollment in its new subsidized insurance program and now by a withering economy, the state's pioneering overhaul has entered a second, more challenging phase.

Thanks to new taxes and fees imposed last year, the health plan's jittery finances have stabilized for the moment. But government and industry officials agree that the plan will not be sustainable over the next 5 to 10 years if they do not take significant steps to arrest the growth of health spending.

By all means, read the whole thing. Here are a few points which I think stand out.

First, there are two ways of looking at this. You can see Massachusetts' experience with its "Commonwealth Care" program as evidence that bringing everyone to the table -- including a 'disease care' industry whose ultimate goal is profits rather than a healtheir society -- results in a muddled policy where the number of people with health coverage might expand, but lacking any serious effort to contain costs, the ultimate policy remains unsustainable.