I'm sure Hillary and Obama won't be calling any attention to this, but -- lo and behold -- the Massachusetts universal health care plan (upon which both the Clinton and Obama proposals are modeled) is costing a crapload of money. It's on track to be nearly double the size and several hundred million dollars larger than expected within 3 years. The overruns are apparently because way more people are enrolling than had been forecast; how much of this is due to bad initial forecasts of the number of uninsured, or due to (I haven't seen this mentioned at all) people opting for it rather than continuing with existing private care they were previously paying for. The boosters in the Boston Globe piece seem to suggest that a lot of this was because the program hasn't been pursuing cost reductions. Color me a skeptical that they would have found nearly half a billion in 'cost savings' to be had over the next 3 years.
From what I understand, Commonwealth Care does have a mandate (everyone is required to have a policy -- either privately purchased or the state-subsidized Commonwealth Care), which is what Hillary is pushing as well (Obama's does not have a mandate)...but that the penalty imposed by MA for noncompliance is so small as to not have any real teeth. I don't know what numbers Hillary is tossing around (if she is tossing around numbers at all) as how much she will fine people for noncompliance. The only thing along I've heard mentioned around this is that she has talked about garnishing wages to impose such fines...but I don't know how large the fines are to be.
In any case: if the overrun was this large in a relatively small, wealthy state, I'd be scared to see the numbers involved in a national version of he same program.
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