On Health Reform, Victory’s Many Fathers

President Kennedy famously said after the Bay of Pigs disaster that victory has a thousand fathers while defeat is an orphan. There’s no clearer path to that proverb in action than today’s Boston Globe report on a poll showing Massachusetts residents support the state’s historic 2006 health insurance reform by a 2 to 1 margin.

The obvious signs were there for all to see this morning on Twitter. Former Governor Mitt Romney’s longtime spokesman Eric Fehrnstrom took credit early, posting barely after 8 a.m.: “New poll finds MA residents like RomneyCare by 2 to 1 margin.”

A few hours later, Governor Deval Patrick’s chief political adviser and former chief of staff Doug Rubin chimed up for his boss: “Gov. Patrick's efforts to implement health care reform are paying dividends - reform efforts supported 2-to-1 by MA residents.”

The good news is, they’re both right, for now.

Massachusetts wouldn’t be the leader it is on insuring the uninsured without Romney’s insistence on a personal mandate, which requires those without insurance to get it or without Patrick’s efforts to implement it – bringing the ranks of the uninsured to record low levels, just 3 percent. Of course, no one is yet taking credit for the Democratic-led Legislature, which forced Romney into a compromise that required an employee mandate – a component without which this stool would not stand.

While there is plenty in the Globe poll for pols of all stripes to boast about, some warning clouds persist. Those warning signs for reform, more than the chest-thumping, will be what is on the minds of policy-makers on Beacon Hill (and those watching from Capitol Hill) this week.

The top trends to watch:

• Forty-three percent of Bay Staters say the state can’t afford to continue this health care reform. While that 43 percent is not even outside the 5.5 percent margin of error (40 percent say the state can afford it), that plurality will be seen as a clear message that payment reform must quickly follow this insurance reform. Lawmakers were already gearing up for a major payment reform debate this session, probably right after they finish the casino debate this fall. This will only hasten their resolve.

• Seventy-one percent say the health reform is either not having any impact or hurting the cost of health care. While most of those people (47 percent) say it is having no impact, the glass-half-empty pols will see that as cause to act. They know people want lower costs and they believe they’re expected to do something about it.

• And while the Globe didn’t put a number on it, the story notes that most respondents didn’t feel like the reform had much impact on their lives. While almost an afterthought in this story, that fact – if true – is huge for elected officials. How many times were they warned the sky might fall? How many times were they told people will revolt? The truth is, the Massachusetts law has helped insure the uninsured. While it would be nice if people thought about the benefits of that in a global sense (more insured means more people with primary care docs, fewer sick visits, fewer ER visits, lower costs for us all), few do. For now, the mere fact that people don’t feel like this law has hurt them is a huge victory for policy-makers on both sides of the aisle.