Deval versus Grover

Turns out Deval Patrick knew Grover Norquist back in the day--they were both Harvard men, and apparently they hit the cafeteria together on at least one occasion.

That's the starting point for an op-ed Patrick has in today's Providence Journal entitled, "Deval Patrick: My ex-classmate threatens Mass. health." Politics is always more interesting when there's a personal component, and that's definitely the case here.

In case you don't want to register at, here's the full text:

AFTER YEARS of weak leadership on health-care reform, the Massachusetts governor and legislature are closer than ever to a bipartisan deal that might make things better for people without health insurance. It is not a panacea, but it looks to be a real step forward.

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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