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Unfortunately, the Massachusetts experience signifies that a "coverage first" approach did not achieve the objectives of eliminating healthcare problems such as risk selection and free riding. The approach contributed to increased utilization, skyrocketed costs, and budgetary stress that resulted in poor quality care. PPACA struggled to influence and transform Massachusetts healthcare service industry with a coverage first strategy. In turn, Massachusetts continues to struggle with reducing free riding and cost shifting. .
The role of Connector, Massachusetts version of PPACA, is also an important part of the reform. "Exchanges offer the potential to increase the quality of competition in insurance markets, a change that is desperately needed" (Point/Counterpoint 183). The Connector was created for individuals to shop for any private insurance policy. The contributions came from a defined employer and state subsidies. Taking out the employer, empowering individuals, and enhancing competition were the driving factors of the Massachusetts Connector. .
The connector became short lived and turned into social planning. This so called "connector" denied choice, listed all the employees in the same insurance coverage rather than giving them freedom of choice, as well as kept the employers in the health insurance decision-making process. The Massachusetts state connector and the state Medicaid plan have little differences. "It is an organ of the government that sets coverage and uses its power to negotiate subsidized reimbursements." (Point/Counterpoint 183) The PPACA reform, especially in Massachusetts is far from its initial true vision and continues to struggle in enhancing genuine competition. .
Next is a reform topic from The Boston Globe focusing on a Medical reform crusader Dr. Donald Berwick. "Donald Berwick says our nation's world-class hospitals and doctors are delivering healthcare that is unsafe and unreliable.
