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Health care in Massachusetts: a warning for America

The Bay State's mandatory insurance law is raising costs, limiting access, and lowering care.

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In his recent speech to Congress, President Obama could have promoted healthcare reforms that tapped the power of a truly free market to lower costs and improve access. Instead, he chose to offer a national version of the failing "Massachusetts plan" based on mandatory health insurance. This is a recipe for disaster.

Three years ago, Massachusetts adopted a plan requiring all residents to purchase health insurance, with state subsidies for lower-income residents. But rather than creating a utopia of high-quality affordable healthcare, the result has been the exact opposite – skyrocketing costs, worsened access, and lower quality care.

Under any system of mandatory insurance, the government must necessarily define what constitutes acceptable insurance. In Massachusetts, this has created a giant magnet for special interest groups seeking to have their own pet benefits included in the required package. Massachusetts residents are thus forced to purchase benefits they may neither need nor want, such as in vitro fertilization, chiropractor services, and autism treatment – raising insurance costs for everyone to reward a few with sufficient political "pull."

Although similar problems exist in other states, Massachusetts' system of mandatory insurance delivers the entire state population to the special interests. Since 2006, providers have successfully lobbied to include 16 new benefits in the mandatory package (including lay midwives, orthotics, and drug-abuse treatment), and the state legislature is considering 70 more.

The Massachusetts plan thus violates the individual's right to spend his own money according to his best judgment for his own benefit. Instead, individuals are forced to choose from a limited set of insurance plans on terms set by lobbyists and bureaucrats, rather than those based on a rational assessment of individual needs.

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