Ezra Redux

Despite my gentle attempt to prod him awake, Ezra Klein continues to dream that ObamaCare is a tried and true health care reform.


At length, he makes two points.  First, he insists that Massachusetts and ObamaCare are a unique, common approach to coverage expansion. Since exchanges (FEHBP, Utah) have been tried elsewhere and subsidies are ubiquitous, this must hinge on the ObamaCare mandate.  Fine.  That similarity will end in June (see the arguments in my amicus briefs or just believe the 70 percent of Americans who think it is unconstitutional), leaving nothing special to link ObamaCare and Massachusetts.


The second argument is about bending the cost curve.  Ezra pin his hope on ObamaCare working on the notion that it worked in Massachusetts.  It didn’t.  Here it is probably simplest to just appeal to Mr. Klein’s preferred authority, Jonathan Gruber who points out that “In Massachusetts we completely punted on cost control.”


Or, one could look at health care costs, which rise faster in Massachusetts than in the rest of the U.S., and increasingly so after the reforms.  If you want to understand health care spending, look at health care spending.  Insurance premiums reflect costs, of course, but also the pool of insured, the benefits covered, the copays, the deductibles, the out-of-pocket limits and myriad other factors on top of pure health care spending per person.  Accordingly, they don’t paint a clear picture about the spending issue.  It is better to look at the data directly.


If the mandate is what makes ObamaCare and Massachusetts special, the jig is up.  And even with it, they flunk the test of controlling costs.  Time to wake up Ezra.