The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Massachusetts to Determine Health Care Reform? How Fitting.

Posted by Alan on January 18, 2010

After all the policy debates, lobbying, letter writing, political infighting, town hall meetings, cable news show histrionics (let alone nonsense), fear mongering, hyperbole, overpromising, committee hearings, academic musings, back room negotiations, blogging, twittering, spam emails, rallies, and even, on occasion, thoughtful and civilized discussion, the fate of health care reform all comes down to a special Senate election in Massachusetts. No scriptwriter could get away with this plot twist. The audience wouldn’t buy it.

But tomorrow, November 19th, voters in Massachusetts determine whether health care reform will pass. Pretty much. Yes, there are ways Democrats can overcome a win by the Republican candidate, state Senator Scott Brown. They might recruit a moderate Republican in the Senate to join them in passing their legislation. But as there are really only two moderate Republicans left in the Senate (both from Maine) that’s a long shot.

They could ram through legislation before the election results are certified, but that will hand Republicans a huge stick to wield in other 2010 elections. Democrats in the House could simply approve the health care reform bill passed in the Senate, but there’s plenty in the Senate bill to give House members up for election this year heart burn.

On the other hand, even if the Democratic candidate, Attorney General Martha Coakley, manages to win tomorrow, there’s no guarantee health care reform passes. But as I’ve written recently, with 60 Democrats in the Senate passage of a comprehensive health care reform bill is not inevitable, but it’s certainly likely.

So what happens in Massachusetts tomorrow matters. A lot.

Voter turnout will be the key to determining the outcome of the special election. Which is why both parties are pulling out all the stops to get their voters to the polls. One challenge for Democrats is that, although they outnumber Republicans in the state 3-to-1, the majority of voters (51 percent) are unaffiliated with either party. And they are supporting Senator Brown.

A single state having enormous influence on American politics and policies is not unusual. Iowa and New Hampshire have a tremendous impact on who emerges as the party’s presidential nominees. And why shouldn’t Massachusetts have a big say concerning health care reform? As a reader of this blog, Jim Hicks, noted in an email, they’ve been living under their own reform plan for the past few years.

How fitting. Unbelievable, but fitting.


7 Responses to “Massachusetts to Determine Health Care Reform? How Fitting.”

  1. You can tell a lot about a nation by the way they take care of their lower class and the needy. America can be proud to say that we have turned our back on these people and have made it more difficult than ever for our fellow citizens to obtain basic medical services.

  2. Being from Massachusetts I think a lot of people here view this as a vote on Obamacare. Hopefully they will elect Brown and put an end to this 1000+ pages of corporate appeasement that they confused with a health care bill.

  3. Meg McComb said

    Alan, I know you don’t watch Fox News, so……Brit Hume said tonight that if Scott Brown wins tomorrow, it’s the best thing that could happen to the Democratic party. He said, like Clinton did in the ’90s, they might move closer to the center and keep more seats this November. Otherwise, he says Americans will revolt when they find out what Obamacare really looks like.

    • JimK said

      Attached is a link to a list of the Left Wing supporters of Ms. Coakley courtesy of the Washington Examiner.

    • Alan said

      Your right. I try to steer clear of Fox … most of MSNBC, too. But I agree with Mr. Hume. When Clinton overreached on health care reform, Republicans were able to takeover Congress. But there was no January 1994 wake-up call for the Democrats that year. Whoever wins in Massachusetts tonight, Democrats know what they’re facing. No candidate will ever take a week off one month before the election again. No Democrat will take any seat for granted.

      What will be especially interesting, however, is how the White House and Congressional leaders pivot in light of what happened in Massachusetts — again, regardless of who wins. My guess is you’ll hear a lot more “us versus them” language (I’d hate to be a Wall Street banker). But if Martha Coakley wins, do they push hard on a few liberal items while they have the necessary votes or do they start moderating their politics. My guess is it will be the latter.

      Then what will become fun to see is how Republicans respond. Republicans are in danger of being viewed as the Party of No. Right now, that’s OK because Congress is more liberal than the country. But if Democrats pivot toward more moderate policies and Republicans still refuse to vote for anything, it will be interesting to see how they’re viewed by votes.

      In any event, 2010 will be a good year not to be an incumbent.

      • James S. Thornton said

        Alan, I am not sure how you can conclude exactly that Congress is more liberal than the country. What I think (not that this matters much in the greater scheme of things) is that money talks, and that those who stand to profit from health care reform inaction managed to grease enough palms and propagate enough misinformation and play on enough subtextual fears (particularly racism) that they have managed to get what they want: continuation of the status quo.

        If you are open to topics for future blogs, I would love to hear your predictions for what our system is likely to become in the future absent any meaningful reform, which looks increasingly likely.

        If a middle class person like me is being priced out of the individual market, I can’t imagine that the ranks of the uninsured will do anything but swell in coming years.

        Maybe I am wrong about this.

        I wonder if one of the less costly nations where “medical tourism” is legal might be able to create catastrophic policies for Americans like me. The coverage, I suspect, could cover the following:

        * generic drugs here in the US, and possibly a once per year flight to pick up a year’s worth of branded prescriptions if needed

        * initial ER care in the U.S. to stabilize the patient in the event of a heart attack or other acute event

        * the cost of medical evacuation to the nation offering the policy, possibly on specially chartered jumbo jets filled with patients

        * treatment over there

        I suspect that even with the cost of the airflights factored into the policy cost, they could still offer infinitely more affordable premiums than what are being offered here. This, of course, would help bring the much-lionized but rarely practiced “market forces” to bear on our system, possibly forcing some sort of economy.

        Right now, the only hope I can see for true market forces is to open up our country and make it compete with others offering healthcare at a fraction of the cost.

        • Billy B said

          Congress is more liberal than the country. Just like it was more conservative in the last 90s/early 00s.

          Unfortunately, the current health care reform bill would have probably made your premiums go up even faster and you would be priced out even faster.

          Until problems like the “medical arms race” are addressed, that is going to be the case.

          I hope the next go around, we end up with a bill that:

          1. Put the necessary screws on the docs/hospitals/labs to stop the latest and greatest and focus on what’s effective yet reasonably priced.

          2. Guaranteed issue with very high penalties for non-compliance.

          3. Force drug companies to prove new medicines are more effective than cheaper existing ones to have them covered.

          But I doubt our govt could even figure this out.

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