I find it hard to believe but according to both the Globe and the Herald today, October 31, the federal waiver that underlies (or is it underlays?) RomneyCare is in serious trouble. Supposedly the Obama administration seriously wants to cut back on the federal money with which the state of Massachusetts pays for much of the incremental insurance that everyone from Mitt Romney to Deval Patrick to President Obama himself wets their pants over on a daily basis.
This recent post explains the waiver in wonk talk. But the nickle version is as follows:
- (Which has always been almost everyone of us here in Massachusetts. Healthcare insurance was invented here in 1850. We love it.)
- If you're familiar with the proven business concept of eliminating the middleman, RomneyCare works just the opposite.
- Massachusetts used to pay mostly public charity hospitals to take care of the needy using mostly a tax on those of us that used the Massachusetts-based non-profit healthcare insurers.
- A large group of religous charity hospitals in Massachusetts also helped the needy the old fashioned way
- (You probably think I mean via charitable giving. There was some of that but the basic method of the religous approach to helping the needy was to pay workers poorly, ironically making them 'needy.')
- So the state went hat in hand to Bill Clinton and a Medicaid waiver was granted in 1997 to use some Medicaid money to help the charity hospitals to help the needy.
- The 'outside the box' thinking behind RomneyCare in 2006 -- the second time the waiver came up for renewal -- was to take that Federal money and
- give it to politically connected insurance companies instead
- they, in turn, would give it to politically connected teaching hospitals to take care of the needy.
- But no one told the needy. They keep going to the public charity hospitals.
- (The needy can't go to the religous charity hospitals any more because they were put out of business by this so-called reform. That puts more stress on the remaining public charity hospitals.)
Last week, the proponents of single payer healthcare insurance for Massachusetts, a group called Mass-Care, spelled all this out in great detail in a 100-page document.
Or you can work your way back through my blog posts, reading every other post (in the posts not about the failure of RomneyCare, I tend to write about the failure of Medicare).
-- Dennis Byron