It's been said that the rest of the country should look at Massachusetts to witness the success of universal health care.
Perhaps they shouldn't look too closely.
Massachusetts has had universal health care since 2006, thanks to former Republican Gov. Mitt Romney, the late U.S. Sen. Ted Kennedy and the Legislature. At one level, it looks like a smashing success — according to state officials, nearly 98 percent of the state's residents have coverage of some kind.
But, it is costing far more than anyone predicted it would. Since 2006, total health care spending in the state has jumped 28 percent. Insurance premiums have been increasing 8 to 10 percent a year, nearly double the national average.
And while government has always underpaid for Medicaid and Medicare services, letting private insurance premiums make up the difference, it has recently cut reimbursements to hospitals even more. So, some cracks are showing.
Six Massachusetts health-care facilities, including the Merrimack Valley Hospital in Haverhill, are threatening to sue the state to force it to pay them more.
What they have in common is that two-thirds or more of their patients are covered by Medicare, Medicaid or other government-funded insurance, like the one provided through the Commonwealth Care. And, as Merrimack Valley CEO Michael Collins puts it, "There is a recognition that Medicare and Medicaid do not pay their fair share of costs."
He said his hospital's shortfalls from those patients were $2.2 million in fiscal year 2007, $1.1 million in 2008 and $1 million in 2009.
How has the hospital coped? Collins said since he became CEO 21รขÑ2 years ago, he has presided over two staff reductions.
And that exposes another crack. At the Statehouse this past week, there was a contentious hearing on proposed bills that would put state government in charge of setting nurse staffing levels.
The Senate bill was filed by Sen. Marc Pacheco, D-Taunton, famous for the so-called Pacheco Law, which inflates the cost of every public construction project in the state. Clearly, he is not a model of fiscal restraint. Now, he is out to inflate the cost of health care even beyond its already unaffordable levels.
This week, a rally was held in Newburyport by proponents of the bill, apparently to bolster state Newburyport Rep. Michael Costello's support for the bill.
Hospital leaders are fighting it, of course. Among them is Delia O'Connor, CEO of Anna Jaques Hospital in Newburyport. She argued that if the bill passes, the hospital will have to lay off workers in order to hire staff needed to fill the mandatory minimal nurse staffing levels. She also argued that Anna Jaques already has a staffing plan in place that has flexibility to handle patient needs and the hospital's need to be financially efficient.
Massachusetts already has a big problem with the cost of health care. Lawmakers like state Rep. Harriett Stanley, D-West Newbury, are taking leadership roles in crafting what's been called the "second act" of health-care reform — putting mechanisms in place to control the costs.
Before lawmakers start sticking hospitals with additional burdens like the nurse staffing bill, they ought to get the financial problems of universal health care in order. They should focus their energies where it is most needed — controlling runaway costs.
