Massachusetts instituted state-wide universal healthcare coverage three years ago.  Now it in financial trouble, and Governor Deval is trying to fix it. How?

They’re trying to manage the huge costs of the subsidized middle-class insurance program that is gradually swallowing the state budget. The program provides low- or no-cost coverage to about 165,000 residents, or three-fifths of the newly insured, and is budgeted at $880 million for 2010, a 7.3% single-year increase that is likely to be optimistic. The state’s overall costs on health programs have increased by 42% (!) since 2006.

Like gamblers doubling down on their losses, Democrats have already hiked the fines for people who don’t obtain insurance under the “individual mandate,” already increased business penalties, taxed insurers and hospitals, raised premiums, and pumped up the state tobacco levy. That’s still not enough money.

So earlier this year, Mr. Patrick appointed a state commission to figure out how to control costs and preserve “this grand experiment.” One objective is to change the incentives for preventative care and treatments for chronic disease, but everyone says that. It sometimes results in better health but always more spending. So-called “pay for performance” financing models, on the other hand, would do away with fee for service — but they also tend to reward process, not the better results implied.

What are the alternatives? If health planners won’t accept the prices set by the marketplace — thus putting themselves out of work — the only other choice is limiting care via politics, much as Canada and most of Europe do today. The Patrick panel is considering one option to “exclude coverage of services of low priority/low value.” Another would “limit coverage to services that produce the highest value when considering both clinical effectiveness and cost.” (Guess who would determine what is high or low value? Not patients or doctors.) Yet another is “a limitation on the total amount of money available for health care services,” i.e., an overall spending cap.

Nancy Pelosi wants to spread this pile of manure over the rest of the country:

March 26 (Bloomberg) — House Speaker Nancy Pelosi said the House this year will consider health-care legislation including an option for a government-run program that would compete with insurers.

“This is a big agenda, and I believe it should have a public option in it for it to be really substantial,” Pelosi told reporters at her weekly news conference in the U.S. Capitol.

It’s for the economy, stupid:

“This is not only about the health of individuals in our country, which will be justification enough,” said Pelosi, a California Democrat. “It’s about the competitiveness of our businesses to make them globally competitive because they are competing with companies and countries where the federal government — their governments — pay for health care. They don’t have to bear those health care costs.”

What good guys those Democrats are.  Always looking out for business.

Real world results?  Who cares?  It’s the thought that counts.

He who pays the piper must also cover his health insurance and retirement benefits.
(Proverb of Obama’s Economic Recovery Team)

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