JUAN GONZALEZ: Well, the Massachusetts plan has been held up in recent years as a model. What are the main problems that you see with how the plan has operated there?
DR. DAVID HIMMELSTEIN: Well, I see them day to day. I’m a primary care doctor here in Massachusetts, and my patients still can’t afford the care they need. They’ve given some people insurance, but they’ve actually given them insurance, in most cases, that has such holes in deductibles, co-payments, that people still can’t afford care. And there are still hundreds of thousands uninsured.
And meanwhile, the thing is costing much more than they said it would….in order to keep the insurance industry in business, they’re actually having to slash care and leave it unaffordable to people who have coverage.
AMY GOODMAN: Len Nichols, are you for preserving private health insurance industry?
LEN NICHOLS: Well, like I said, Ms. Goodman, I’m for getting everybody covered and for enabling that coverage to let us buy high quality care that we can sustain over time.
I think the way to think about what’s being talked about down here is, I think Massachusetts is something of an example, but you want to be careful about how to interpret the implications of it. The first big problem is that Massachusetts tried to cover people without being able to do anything serious about cost growth containment over time, so that, as a nation, we know we have to do both.
But I would also say that while David’s right—there has been an underestimate of how much it would cost in Massachusetts—that was because of, I would say, a technical error over the estimation of the number of people who were uninsured. There were two different surveys that were done. The government, a combination of then-Governor Romney and the legislature, chose to go with the survey that was basically saying there were half as many uninsured as a different survey suggested. The national experts thought the latter was the better. That had the right number of uninsured. The legislature budgeted for the lower number of uninsured, and that’s why they’ve hit a budget constraint.
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AMY GOODMAN: Dr. Himmelstein?
DR. DAVID HIMMELSTEIN: Well, first of all, we don’t have everyone covered. In fact, there are lots of uninsured people left in Massachusetts despite this massive spending, and more and more every day. We’ve lost 85,000 jobs in our state in just the last year, and the coverage hasn’t expanded to take those 85,000 people in. So, that’s a myth.
And we told them off—right off the bat it was going to cost more than they said. They refused to believe us. And we’re telling the Obama people that the plan they’re talking about costs much more than what they are saying. The cost containment they’re claiming in their plan, the Congressional Budget Office has told them won’t work. They’re saying computers are going to save massive amounts of money. There’s no evidence for that at all. The Congressional Budget Office says there’s no evidence for that at all.
The efficiencies Mr. Nichols is talking about, we could get those efficiencies, but only if we get the insurance companies out of the system. We do $400 billion each year in useless paperwork in healthcare, and there’s no way of getting rid of that unless you get rid of the private health insurance companies.