It's very odd to see a booth for state-sponsored health care planted under the bleachers at Boston's Fenway Park. Health insurance has a kiosk at the baseball game? The people manning the booth stand there hawking the program, directly across from the balloon guy and directly behind one of the dozens of beer stands where young men wait in line, six-deep, for 20-ounce beers.
All of which means the state people know what they are doing. They know who they are missing in the program. They are missing young men, perhaps up to 130 thousand of them--most of whom are Red Sox fans.
Just to review, last year Massachusetts became the first state to take a truly serious stab at universal health care insurance, using an approach you will begin to hear more of as the presidential election nears: individual mandate. The approach means you must buy private health insurance. You can get it through your employer or buy it yourself, but you have to buy--or be penalized on state taxes. The state will help you pay if you cant afford it. And the state has worked with a handful of insurance companies to offer several low cost policies that are much cheaper (family plan with drug coverage, $662 per month) than what the rest of us could buy on the open market, where the average price is $11,000.
Here's what's great about the plan.
1) They are really trying to be universal. More on this in a second.
2) If you can pay, you can't be turned down.
3) They have reached 170 thousand people who had no insurance last year. And that's just so far.
4) They have jump started the national debate over how to get this intractable problem, the plight of the uninsured, solved. This isn't Clinton care; it's a huge experiment to see whether the private market can work when everyone's forced to be in it.
Here's what's not great, all of which the state admits it's working on.
1) Thousands of employers complain they can't afford to do (offer insurance) what the law orders them to do.
2) Tens of thousands of the working poor--or part timers--can't afford the cheapest plan offered through work.
3) Tens of thousands of middle income folks cant afford $662 dollars a month, especially when that policy has a huge deductible too.
4) They haven't persuaded all those young men, men who don't need or want insurance, that this is a good enough deal. And they badly need these guys paying into the system.
It's early in this game, and the legislature will certainly adjust the law as the budget allows, but even the staunchest defenders say it will take a very long time before universal care lives up to the name.
What this is though, is a great start--not to mention a big time election issue.
And you have to hand it to Massachusetts. It was hilarious to watch that stream of raving Red Sox fans juggling cheese dogs, tankers of beer-- and flyers for health insurance. I am not commenting on the total lack of irony there: I was just jealous.