http://ledger.southofboston.com/article ... opin02.txt


COMMENTARY: By doing nothing, state lawmakers made healthy choice

By DAVID A. MITTELL JR.

All in all, and as these things go, it was a pretty good year on Beacon Hill. In contrast to the way things used to work, this year the Legislature passed, and the governor signed, the 2006 state budget before the legal deadline of July 1. That ought to have left the rest of the year to consider longer-term policy questions such as automobile insurance, health care reform, future transportation choices, tuition for illegal immigrants, etc.

However, each of those matters was deferred to next year’s session. On the face of it that’s no tribute to the theoretically full-time Legislature’s work ethic. But a closer look leads to a different conclusion: The Legislature’s rules now require prorogation before Thanksgiving in order to avert the late-night, sometimes drunken ‘‘feeding frenzies’’ that used to occur in the last days of a session. Year after year these sessions produced goodies great and small for special interests great and small.

So while this session’s achievements have been modest, the Legislature followed Hippocrates more closely than Hypocrisy in ‘‘first do no harm.’’ Health-care reform, in particular, has the potential for creating billions of dollars in spending mandates in the name of providing health insurance for the uninsured. Federal mandates will require health legislation by the middle of next year. But bad legislation this year under an artificial end-of-session deadline would not have served the public well.

The financing of health care is a vastly complex subject. In the 1980s and 1990s, under governors Dukakis and Weld, Massachusetts learned the hard way that tinkering with one aspect of it, and labeling the action a ‘‘reform,’’ can have detrimental consequences throughout the convoluted series of systems by which we finance health care.

I would make two observations. First, health insurance gets more good press than it deserves.

The question must be asked: If, as has been proposed, the state were to mandate that citizens buy health insurance - as it currently mandates they buy automobile insurance - what kind of insurance? Bad insurance with limited benefits would amount to a give-away to insurers, without doing much to help those who are now uninsured.

It is health care, not necessarily health-care insurance that right-minded people would like to see provided for every citizen. How to do this, without massive fraud against the taxpayer, has bedeviled policymakers for 40 years since the fee-for-service system was (rightly or wrongly) first judged to be an inadequate economic and social model.

Second, I would note that here in Massachusetts we ought to have the means to reorder the health-care payments system in a way that could be a model for the nation. We have the world-renowned hospitals and universities, and therein the doctors, economists and academics, to think the problem through. That’s all the more reason to be giddy with thanks that our legislators saw fit to get out of town for the year without doing anything hare-brained.

The same note of Thanksgiving could be applied to the three other issues I noted.

Football fans and other television viewers will understand the need for automobile insurance reform if they understand that all those dumb but clever Geico commercials do them no good if they live in Massachusetts. For Geico won’t do business here. But to date there has been no real debate on the issue, except in dueling special-interest TV ads.

On transportation, some legislators are salivating at the prospect of spending the state’s new-found surplus on billions of dollars of new projects in their districts. They are forgetting how recently the state had a deficit of billions; and they are completely forgetting the voters’ long-ago mandate (in 2000, actually) to return the state income tax to its 1989 rate of 5 percent.

Most legislators seem to favor the in-state tuition break, worth about $10,000 a year, to illegal immigrants, whom they simply call ‘‘immigrants.’’ (The insinuation: if you don’t agree, you’re anti-immigrant and downright un-American.) But the majority of voters are opposed to the idea. Overriding Gov. Romney’s promised veto (he also vetoed it last year) would probably require the deniability of a voice vote. This matter, too, was deferred until 2006.

Alvaro Lima, a very astute legal immigrant from Brazil, has done some research for the city of Boston, showing that giving the in-state tuition break to illegals would actually increase tuition collected at state colleges and universities.

I believe the larger issue is the date on which the U.S. population is going to reach one billion if illegal entry isn’t somehow curtailed in the coming decades. Thanksgiving, 2105 - in just 100 years - is a good offhand guess. I’m therefore thankful the Legislature prorogued before taking any action on this measure, along with the rest.