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In Perry’s America, life would be a Ponzi scheme

Posted Sept. 26, 2011, at 7:03 p.m.

Texas Gov. Rick Perry has been making headlines by bashing the health care plan that GOP rival Mitt Romney signed into law when he was governor of Massachusetts.

You know the one. Romneycare, precursor to Obamacare. It has an individual insurance mandate, a statewide insurance exchange, subsidies and other elements that have conservatives like Perry frothing at the mouth.

Not one to shy away from a wild generalization (think Social Security as a “Ponzi scheme”), Perry wowed a crowd in Iowa by blasting the Massachusetts health care system as “the model for socialized medicine.”

Meanwhile, deep in the heart of Texas, patients without medical coverage crowd the waiting areas of clinics and emergency rooms.

Twenty-six percent of the population is uninsured, the highest percentage of any state.

About a third of Texas’ children go without an annual physical and dental checkup.

The percentage of deaths before age 75 that could probably have been prevented with timely health care is among the highest in the nation.

“Texas just hasn’t proven it can run a health care system,” Dr. C. Bruce Malone III, an orthopedic surgeon who is president of the Texas Medical Association, told Noam N. Levey, a Los Angeles Times reporter who spent some time checking out health care in the Lone Star State.

That’s a withering assessment from the leader of a historically conservative group. Another comes from Dr. Jane Rider, a past president of the Texas Pediatric Society.

“I always thought they would wake up and see, if nothing else, they need a healthy, educated work force,” she told Levey. “Instead, it seems like we’re leading the way into a downward spiral.”

It’s a measure of how inside-out America’s health care debate has become that we have Perry throwing flames and Romney working desperately to put them out.

Near-universal access to medical care has made Massachusetts one of the nation’s healthiest states. Close to 95 percent of its children receive immunizations. Almost 90 percent of pregnant women receive early prenatal care, and the state’s infant mortality rate is lowest in the nation. Massachusetts has the nation’s most plentiful supply of primary care doctors in comparison to its population, while Texas ranks near the bottom of the states for physician availability.

The knock, of course, is that health care in Massachusetts is undeniably expensive. That was true before Romney signed his reform law in 2006, and it remains so today.

While the rate of growth in spending on health care nationwide decreased slightly from 2008 to 2009, it increased by a startling 10 percent in Massachusetts, where care in hospitals costs 56 percent above the national average.

Health care Massachusetts-style will always be under attack until the state finds a way to control what Alan Sager, a professor of health policy at Boston University’s School of Public Health, calls “an elaborate and expensive pattern of care” by the state’s hospitals and physician groups.

But critics omit some crucial information about “Romneycare.” Contrary to predictions, the number of employers opting to insure their workers has risen since the reforms took effect. The government spends less on uncompensated care. And insurance premiums for people on the individual market have fallen by 40 percent since the creation of the state exchange.

The Republican primary season should prompt a lively discussion about what kind of country we want to live in.

Should access to affordable health care be a universal right or a privilege granted to the lucky and the employed? Should the government induce people to purchase health insurance on the front end, or should society just “let them die” if they get caught without a means to pay for care — a solution cheered by some in the audience at a debate of Republican presidential candidates.

But of the two states under the primary spotlight, there’s little debate about where you’d be better off should you get sick.

Massachusetts, no contest.

Barbara Shelly is a columnist for the Kansas City Star.

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