Negative Interest

A creative health care comparison

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The America Needs Mitt blog has a thought-provoking comparison of health care reform under Barack Obama and Mitt Romney:

There’s a lot to parse through here. The highest apparent priority of the Republican Party is currently page length. There’s no mention of the individual mandate, the most politically and legally controversial mechanism of the Affordable Care Act and a centerpiece of the 2006 Massachusetts reform law (which Romney recently defended, correctly, as a conservative idea). Some statements are just misleading (Obama didn’t have the opportunity to veto individuals parts of the legislation because he doesn’t have the line-item veto Romney enjoyed as Governor). Some are confused (“RomneyCare” passed with bi-partisan support because it was passed by the Democratic legislature; going back to the previous example, the bill was passed with enough Democratic support that the legislature has since overrode all eight of Romney’s vetoes). My favorite, however is this one: “U.S. ranked lowest in the world” vs. “MA ranks highest in fifty states.”

The Affordable Care Act, which passed in 2010, is given credit for the United States’s health statistics. The footnote to the claim that the U.S. is ranked lowest in the world links to the World Health Organization’s ranking of world health systems, in which the United States is ranked 37th overall, out of 190 countries. This ranking was released in 2000 – I’m going to have to go back and check how many of the Affordable Care Act’s provisions had kicked in during the last year of Bill Clinton’s presidency. It is also possible that the author is withholding access to more recent data showing that the United States has dropped 153 places.

The claim that Massachusetts ranks highest in health outcomes in the 50 states is footnoted by this subscriber-only Roll Call piece on the Congressional Budget Office’s scoring of the Affordable Care Act; this makes it difficult to verify the claim, but luckily I’ve got some other statistics to look at. America’s Health Rankings ranks Massachusetts second in overall health in its 2010 report behind Vermont; Vermont didn’t pass its single-payer health care reform bill until 2011, but it did reform its health care system in 2006. These results tell me that 1) the Northeast in general has better health outcomes than the rest of the country and 2) the Northeast states who have passed the most sweeping health care reforms bills in the nation have done particularly well. Determining causation and correlation with health outcomes and health insurance systems is tricky; Vermont is 94.3% white, and there are enormous disparities in health outcomes between white Americans and black and Latino Americans. Surely, however, this sort of thing should be encouraging to supporters of health care reform; this should indicate that the experiments undertaken in Vermont and Massachusetts are successful models that other states should benefit from. Apparently Barack Obama and the Democrats in the 111th Congress agreed.

It’s tough for me to fully understand the ideological flexibility required of a die-hard Romney partisan, but I really do appreciate it.


Written by negativeinterest

October 11, 2011 at 5:21 pm

Posted in Uncategorized

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