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September 28, 2005

Patrick backs ACT

This is welcome news:

Democratic gubernatorial candidate Deval Patrick will deliver a speech today endorsing a plan [The Health Access and Affordability Act, written by Health Care for All] to establish universal health coverage [sic] in Massachusetts that is funded by hiking cigarette taxes 50 cents a pack and by creating a new payroll tax for employers that do not offer worker health plans.

Well, the bill is not a universal health care bill. The Globe really needs to get its facts straight.

But the bill is a major step forward, and Patrick's support is good to hear. Perhaps this will give the bill some traction and visibility, at least among his grassroots supporters. And it's also a way for him to distinguish himself from the Dem pack, for the time being.

Reilly counters:

Reilly's campaign committee issued a statement yesterday saying the attorney general will address the state's healthcare issues in the future, adding: ''No candidate can match Tom Reilly's experience and record of accomplishment in healthcare."

Great. Prove it by supporting the bill.

(Hat tip to the Healthy Blog.)

Posted by Charley on the MTA at 02:14 PM in Health Care, Massachusetts | Permalink


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Good to see Patrick drive ahead on the issues and not just sit around and get ready to run TV ads.

I love that non-statement from Reilly. Basically an "Uhhhh...yeah...healthcare, we got some poeple on that. We'll get back to you." How lame and uninspiring. I expect more...oh wait a second...it's Reilly.

Posted by: anon | Sep 28, 2005 2:54:04 PM

I think that the confusion arises, because the proposals on Patrick's web site do call for a universal state financed catastrophic coverage. I think that the ACT coalition supports a form of reinsurance to keep premiums down for those with insurance, but it doesn't do much for people who are bare and find that they have cancer.

The weakness of Patrick, from my perspective, is that he talks a lot about hope in Clintonesque ways without providing much in the way of policy details. Of course, electorally, this is probably a strength. And everyone knows that what comes out of a legislature is never exactly what you wanted at the start.

Posted by: Abby | Sep 28, 2005 3:11:50 PM

I appreciate his strong desire for universal healty care, but his approach seems overcomplicated and still too dependent on employers to provide health care. Health care, like fire and police, should be guaranteed by the state regardless of employment status. The state could achieve this with a much simpler single-payer plan, like that offered in S.755 "An Act to Establish the Massachusetts Health Care Trust". This smells like a Clinton idea: a complicated and ultimately insufficient proposal instead of a single, more robust solution.

Posted by: Greg | Sep 28, 2005 5:54:33 PM

Great blog!
Off topic:
FYI: I caught you guys on google news when I went hunting for info from the Globe story on Health Care for All. Pretty nifty that you guys get listed on Gooogle news...
On topic:

Those of us who are policy wonks can get into the nitty gritty of any proposal and get lost.

What I find most impressive about this is that at least Mr. Patrick is willing to put issues, real issues, on the table and say this stuff matters. No real health care plan will happen unless people put aggressive ideas and plans out there and say "we need to talk about this stuff." Mr. Patrick is at least willing to push aggresively on the issue, not just give it lip service.

Are we going to blame someone for talking about the issue? Shouldn't we reward them for bringing it up, for actually trying to accomplish something? What about those who remain silent and just play pure electoral politics? To me it seems like he is asking for the debate, and that he will modify plans based on those who chime in. Isn't this what we really want from our elected officials? Isn't that the core responsiblity of their jobs?

Posted by: Julie V. | Sep 28, 2005 6:38:28 PM


I think that it would be extraordinarily difficult to do single payer in a state given the existence of Medicare and Medicaid. It would require a whole bunch of waivers which might not be forthcoming from the current administration.

I'd love to see it done at the Federal level.

Posted by: Abby | Sep 28, 2005 6:39:23 PM

Abby makes a good point, and one which I was about to make before she beat me to it. I am troubled, some times, by Patrick's some what obvious reaction to proposals such as these.

Is this a signal of how he would react to things as a Chief Executive of the state? I don't think so, because I think the position necessitates more pragmatic decision making process.

The politics of hope needs to be more about "this is good, now can it be done" and less about "this is great, let's go."

Posted by: Ben | Sep 28, 2005 8:19:47 PM

Greg, I agree with you about single-payer; that would be great, especially at the federal level. If you count votes, either in MA or in DC, you will see that it's not happening soon. I wish things were different. But in the meantime people who don't have insurance are getting sick.

And so we do what we can. The the ACT legislation will most definitely matter to the 400,000+ people who will be covered. No, it's not complete, and no one who supports real health care reform will tell you that it is. I think Patrick is being as clear as anyone in saying this is the short-term strategy (i.e. the next 12 months), with universal coverage as the long-term goal. (How long is "long-term" I don't know. That might also be a useful discussion.)

It has seemed to me that all of those "micro-initiatives" under Clinton actually added up to a fairly impressive record of accomplishment, in the aggregate. And I wouldn't describe the ACT legislation as "micro"; it's a pretty significant step forward.

In any event, check out our interview with John McDonough of Health Care for All, in which he addresses some of your concerns. Thanks for commenting.

Posted by: Charley on the MTA | Sep 28, 2005 9:38:45 PM

And Julie, you are absolutely right -- this is all about framing the terms of the debate. Patrick is taking a bolder stand than any other Gov. candidate, including Romney (who's probably not a candidate, after all). I've asked for specifics from Patrick, especially when we interviewed him. He's given us an answer on health care. I appreciate that very much, and really want to hear some meat n' potatoes from Reilly and Galvin now.

Posted by: Charley on the MTA | Sep 28, 2005 9:42:26 PM

Charley ... I think you make a good point about the need for answers from all candidates, but is it necessarily advisable to be coming out with stances now? I'm not sold either way, it's just a thought. The attention being devoted to the Gubenatorial at this stage in the game is very low compared to what it will be come spring and summer.

I go back and forth on both strategies. There is an argument for coming out first, taking a stand, and forcing other candidates to respond to you, there is also an argument to be made for taking a stand when the audience to see it/hear it is so minimal.

I know this is more about strategy and less about the health care bill, but its worth considering the dynamics of a campaign.

Posted by: Ben | Sep 28, 2005 10:25:00 PM

Ben, maybe this is a continuation of his grassroots strategy, to attract folks concerned about health care to his campaign. And many health care activists are in full swing these two weekends. So he becomes part of their news as well.

I don't know -- what do you think? Is that too blatantly self-serving? :)

Actually, in his interviews, he had talked about nailing down some specifics on policy over the summer. So maybe this is just one of the results of that. In light of that, the timing doesn't seem surprising.

Posted by: Charley on the MTA | Sep 28, 2005 11:29:34 PM


Patrick has been talking in this vein since I first met him in the spring. I am not surprised by his stance. He said from early on that doing something significant to solve the healthcare crisis would be the top priority of his administration, and he would be willing to spend a lot of political capital to make it happen. I would also see his position as the beginning of his effort to tackle health care -- and not the end.

That he made his announcment right now, when the subject is on people's minds, seems like smart politics to me.

Posted by: Frederick Clarkson | Sep 29, 2005 1:21:53 AM

Charley and Frederick,

Both very good points. Personallly, some times I look too much at the crass politics of an issue (how, where, when, and who) and miss the why - - in this case because he believes in the issue and cares.

That being said, I don't think we can ignore the other questions. I think whoever is the nominee from the Democratic party will aggressively attack the health care crisis in the state. The problem is, there are limitations to what can be done (I know, again this is drifting from why to how) within the federal framework. I'd be interested to see if anyone here knows about other states that have tried to implement systems similair to ACT. I want to say Hawaii has single payer, if anyone knows anything about this I'd greatly appreciate the input.

Anyways, politics aside, I think we all can agree the more the healthcare topic is discussed the better. Once it is a major issue for all, it will require an actual solution.

Posted by: Ben | Sep 29, 2005 11:17:52 AM


Hawaii does not have single payer. They have an employer mandate that requires that anyone working more than 20 hours per week be covered by their employer.

They can do that, because a specific exemption was written into ERISA for Hawaii only.

The ACT proposal doesn't do that. It simply says that for payrolls above 50K, a tax of between 5-7% will be assessed to fund expansion of MassHealth and the Insurance Partnership which helps low income people buy their employer's private insurance. To the extent that a company already provides healthcare they get a credit against the tax, but there's no employer mandate in this legislation.

Posted by: Abby | Sep 29, 2005 4:18:57 PM

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