State by State Healthcare Report Card
Written By: Shelby Blakely, Published: 6/16/2010
Shelby Blakely, Executive Director, New Patriot Journal
The states of Tennessee, Hawaii, Oregon, Massachusetts, California, Kentucky, Maine and Wisconsin have tried universal healthcare systems with varying degrees of success. Many more states have tried or are currently operating schemes designed to address the needs of children only. In ALL cases, the programs have cost more than predicted. Some programs have delivered less care and the quality has declined. In a couple of notable cases, the programs have been terminated.
Tennessee – TennCare
The state of Tennessee first tried TennCare in 1994 as a single payer system that was designed to use the anticipated savings from Medicaid to provide coverage to children and the uninsured. The costs and enrolled numbers swelled to the point that Tennessee’s governor made a very unpopular proposal to institute a state income tax to bridge the shortfall. The program nearly bankrupted the state and reduced quality.
A reduced form of the program is now in place along with the companion TennCover. The state had to slash the roles and coverage to avoid a complete economic collapse of the state government.
Hawaii – Keiki Care
Hawaii tried the similar Keiki Care program for children in 2007. The intent was to cover children of parents who did not receive coverage through their employers. The cost was low enough that employed parents realized that they could drop employer provided coverage and put their children on Keiki Care and save a substantial sum. Hawaii’s governor, Laura Lingle, terminated the program after a mere 7 months.
Proponents of a nationalized healthcare system argue for mandating everyone must partake in a socialized system, so that the costs will be shared equally. But Hawaii’s example has shown that the costs will skyrocket when healthcare is “free” as people are more inclined to use the system for even the smallest of incidents. As people look to cost shift to the state and to “get their money’s worth” with more frequent usage of the system, the taxpayers will see the costs increase exponentially and the wait times will drag out considerably.
Oregon – Oregon Health Plan
In an effort to prevent an overload of Oregon’s state healthcare program, the state has limited the number of people eligible for coverage to 24,000. The acceptance is granted through a lottery system. One must wait to obtain benefits through the system that the taxpayers fund. The Oregon Health Plan was designed in the 1980’s to reduce the uninsured from 18% of the state population. The current recession has had the opposite effect of increasing the number of uninsured as the state seeks to limit the number of enrollees.
Massachusetts – Commonwealth Care of Massachusetts
The program that has generated the greatest amount of study is the Commonwealth Care of Massachusetts. This program has been hailed as the model for the nation to follow, but the experience of the state is the better barometer of how well a national plan will work and the impact that it will have on families. For those making as little as $30,000 per year and facing a health issue, the costs of premiums and deductibles rises to as much as one third of one’s income. The state’s spending on this program has doubled from the projected $630 million in 2007 to an estimated over $1.3 billion in 2009.
Insurers report that the cost of premiums must rise by 10% per year in Massachusetts in order to cover the cost of the increased usage of the medical care system and the additional uninsured that are enrolled in the program. This is after the admission that the state program is constructed to allow the poorest to be exempt from the program resulting in nearly 20% of Massachusetts poorest still lacking insurance coverage.
California – Medi-Cal
California is experiencing the unenviable position of having to extend coverage to illegal immigrants that compose a significant percentage of the state’s population. As this group pays nothing into the system and constitutes the group with the highest usage of the medical care system, they are draining California’s resources at an unprecedented rate. Medi-Cal, the state program for the poor, is mired in over $1 billion in debt this year and no end in sight. Attempts at reform in California’s legislature have failed.
Kentucky – Kentucky Kare
An older, but no less applicable study is that of Kentucky. In 1994 the state implemented a reform program that by 1997 had driven 45 insurers out of the state’s market and had the unintended consequences of higher rates, less coverage, increased pricing of services and a shortage of doctors as they left the state for a less restrictive market. Kentucky Kare led to a series of gaffes including leaks of patient records.
Maine – DirigoChoice
Despite repeated attempts to reform the healthcare system in Maine, the state seems to degrade the system with each reform. DirigoChoice, the current incarnation of state insurance, is derisively referred to not as a healthcare experiment but as a deathcare experiment. Like Oregon, DirigoChoice has a wait list for enrollment and has, like Hawaii, had the unintended result of encouraging people to drop their private care to enroll in the state program.
Wisconsin – BadgerCare and BadgerCare Plus
Wisconsin’s BadgerCare and BadgerCare Plus enrollment were suspended in October of 2009 due to reaching the limit of allowable enrollment. Without additional funding, these programs would quickly spiral into debt. The majority of states have programs to assist their poor and uninsured. These programs, in conjunction with the federal programs provide a safety net that negates the need of ObamaCare.
Although these programs vary in their designs, they collectively contain all of the components of the proposed national programs. With history as our guide, we can see the predictable results of the ObamaCare programs without implementation. We are facing increased cost, lower quality, extensive waits, rationing of care, denial of service, economic collapse due to strained government budgets, massive tax hikes, practitioner shortages, decrease in life expectancy, increase in mortality rates, lower productivity, stifling in innovation, and most importantly, an unprecedented loss of liberty.
There are other implications that we have not explored in our national discussion of the potential effects of socialized medicine. As government grows and assumes more power, it accelerates the restrictions on our choices in every facet of our lives. To control the outlays and costs, at some point we can expect that government will begin to curtail our activities as too dangerous and contributory to higher healthcare expenditures.
Will we begin to see our leisure pursuits limited as too dangerous? Will hunting, skiing, scuba diving, martial arts study, sky diving, football, archery, racing, boxing, canoeing and kayaking be deemed too risky and therefore expensive? Will we find ourselves restricted from attending movies and sporting events that excite us too much or from eating foods that are too rich or fattening due to a heart condition? How far will the politicians and bureaucrats take doing “what is best for us” despite our desire to lead our own adult lives?