Now the media are reporting that Grover Norquist is joining the
health-care debate in Massachusetts. Norquist -- the so-called prophet
of Republican conservatism and the man who invented the no-new-taxes
pledge so popular among aspirants for political office -- is now
counseling Governor Romney to reject the legislative compromise. Why?
Because he wants us to believe that the $295-per-employee assessment on
businesses is a tax.
My message to Governor Romney: don't listen to Grover. Grover and I
were classmates in college. I remember sitting with him in the dining
hall while he described a vision of government as something bad, mainly
about advancing the interests of the well connected and powerful, not
worthy of the talents of anyone competent or committed. He espoused the
view that we should all be on our own. At college 30 years ago, it was
a theoretical rant. Now, he and others who share that vision are in
charge.
That's the wrong vision for Massachusetts. Over half a million
people in Massachusetts have no health insurance -- in many instances,
even if they have a full-time job. Many more are underinsured, because
of the prohibitively high costs of our current system. At every level,
our system is failing us, and the private market is not getting the job
done on its own.
The debate at the State House stalled over who should pay to make
high-quality insurance more widely available in our state. The truth is
that we already pay to care for those without coverage; we just do so
in the most inefficient and expensive way possible. Many of the
uninsured seek emergency care, rather than primary or preventative
care; emergency care is significantly more expensive and less
effective. And that care is paid for, in the form of higher premiums
and co-pays, by insured individuals and businesses alike.
Let me be clear: It is time for those companies that don't cover their employees to pay their fair share.
Beyond the question of who should pay, there is the issue of how
much we pay already. By some estimates, we spend $1 billion a week on
health care in Massachusetts. Of that staggering sum, $300 million goes
to the cost of administering the system. That's too much. If efforts to
reform the health-care system don't include serious cost-containment
measures, no one is going to be able to afford anything approaching
adequate coverage -- even with state and employer contributions.
There are several ideas that the legislature should consider in
order to make a serious dent in the soaring cost of health care: better
prescription-drug purchasing and price policies; fixing catastrophic
care; uniform codes and forms for reimbursements; more and smarter use
of technology to maintain and manage medical records, and reduce
medical errors; and targeted investment in our grossly underfunded
public-health system, so that we prevent and treat chronic illnesses
before they lead to expensive emergency-room visits.
Some of these ideas are discussed with only passing interest in the
current legislation. They will never get serious consideration if
Norquist with his tired rhetoric influences the debate. Meanwhile, the
rest of us continue to pay more for less.
Health-care reform has the potential to be a win-win situation for
business and consumer interests alike. Massachusetts's employers (even
drug and insurance companies) recognize that a better health-insurance
model would make them more competitive; and citizens recognize that a
system that offers skimpy coverage at an ever-increasing price is no
system at all. But striking the right balance will require genuine
leadership and an honest debate.
Our system is broken; we must fix it. We all have a stake in that.
And when we all have a stake in something, government leadership has a
role to play. But that is not how Norquist sees it. The sad fact is
that Norquist's vision of government is precisely what was on display
in the Gulf Coast after Hurricane Katrina: thousands of vulnerable
people, abandoned on rooftops, who had in fact been abandoned before
that storm.
Health is a public good. Start from that simple truth, Governor
Romney, and you will see why it is so important for Massachusetts that
you show my old classmate Grover Norquist the door.
Deval Patrick is a Democratic candidate for governor of Massachusetts.
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