Peter Suderman sums up the conservative argument for why Romneycare has failed:
So insurance coverage has increased, but largely thanks to tax-funded subsidization. Yet that’s created problems too: As more people got coverage, the system has struggled to keep up with increased demand for services. Uncompensated care, frequently cited as the justification for ObamaCare’s mandate, has remained expensive as emergency rooms have been flooded. And we’re not even getting into the cost overruns.
All this basically boils down to the claim that increasing coverage results in higher demand for providers and necessitates more stringent cost controls. This is a very valid reality, one that is leading Massachusetts lawmakers, providers, and insurers to continue tweaking the health care system.
But nobody in the Bay State is proposing repealing the expansion in coverage, as conservatives are suggesting. Rather, the legislature is now exploring different delivery system reforms and means of addressing provider shortages to accommodate all of the additional patients. Tossing residents off their insurance coverage may free up providers, but it won’t do much to lower the growth in health care costs or diminish the amount spent on uncompensated or emergency room care. If anything, it would only deepen those problem.
So rather than overstating the problems in Massachusetts — the state has spent nearly $300 million less on uncompensated care since 2006, for instance — and pretending that there is some perfect conservative alternative that would magically heal the system, the state is now looking for ways to realistically address the challenges of reform. Conservatives would be more useful if they proposed actual solutions to these problems.