If he wins, as now looks likely, this kind of nuance is all going to be lost, but it’s worth paying some specific attention to what Scott Brown has to say about health care. Specifically, the candidate says he doesn’t think Massachusetts voters need a federal universal health care plan since Massachusetts already has a universal health care plan:
“We have insurance here in Massachusetts. We have some of the best doctors, nurses and hospitals in the country; that’s why people come here,” he said in the final debate. “Not only is this bill going to be bad for the state, my job is to be the senator from Massachusetts. I’m not going to be subsidizing for the next three, five years, pick a number, subsidizing what other states have failed to do.”
A Brown advisor made this even more explicit. The national plan is very similar to the Massachusetts plan. And Brown thinks the Massachusetts plan is good. It’s just that Brown thinks the Massachusetts plan will, on net, transfer funds out of Massachusetts and toward other states:
“In Massachusetts, 98 percent of residents are covered by insurance through our own state reforms. The plan is not perfect, and we need to get costs down, but we have already achieved near-universal coverage. There is nothing for us in a national plan except higher taxes and more spending to finance coverage expansions in other states. It’s a raw deal for Massachusetts,” he said.
As Jon Cohn argues it’s not really true that there’s “nothing” else for Massachusetts in the plan. In particular, the long-run sustainability of the Bay State’s efforts will be greatly enhanced by federal reform. At the same time, Brown isn’t wrong that progressive social policy interventions, by redistributing money away from richer-than-average people to poorer-than-average people tend to take money away from rich states (like Massachusetts) and give it to poor states.
But assuming you’re interested in the issue of whether or not the proposed federal health plan will work well on the whole, Brown’s point of view strongly suggests that it will. Massachusetts did something similar a few years back and it’s worked so well that even Republicans like Scott Brown happily embrace it. Canadian Conservatives love Medicare, British Tories love the NHS, and Massachusetts Republicans love Commonwealth Care. There’s a pattern here.