Why Coakley Really Lost: Massachusetts' Health Care 'Reform'

Even though Massachusetts law requires everyone to buy health insurance and makes sure there are so-called affordable plans for all, some small percentage of state residents remain uninsured. Many more are unhappy with the requirement to buy insurance. Another starburst to Democrats: If they push through national health care reform similar to the plan in Massachusetts, they stand to lose the independent support that is key to national victory.

Also, there are several predictable problems with Massachusetts health care reform that are sure to be repeated on a national scale if the Democratic Congress and President Obama succeed in pushing through their version. The Massachusetts plan has become unaffordable for the state and is just about bankrupt. The state has had to trim hospital reimbursements to remain in business. It has also eliminated coverage for the 30,000 legal immigrants in the state (that's LEGAL, not illegal.)

One cannot expand coverage for so many more people, most of them indigent, without raising taxes on everybody else. It's impossible, though congressional Democrats and the president tell us it is not. Their claim is simply untrue.

Hospitals are fighting Massachusetts' cuts in reimbursement rates. Boston Medical sued the state back in July, as recounted by The New York Times:

"According to the suit, Massachusetts is now reimbursing Boston Medical only 64 cents for every dollar it spends treating the poor. About 10 percent of the hospital's patients are uninsured -- down from about 20 percent before the law's passage in 2006. But many more are on Medicaid or Commonwealth Care, the state-subsidized insurance program for low-income residents."

There are other, more commonly noted reasons why Martha Coakley lost: She is not as charismatic as her GOP rival. She or her advisers made the inept strategic decision not to campaign heavily over the holidays. Her opponent did and gained a lot of ground as a result. Once she started campaigning heavily, she had to go on the attack, which made her look angry and nasty instead of helpful and compassionate.

But if Democrats ignore the message Massachusetts voters have sent them on health care reform and push it through anyway, they do so at their own peril. That the Kennedy Senate seat is in Republican hands should signal a new era to Democrats in Washington. The message of Tuesday's election is this: Camelot is over, and Sen. Kennedy was behind the times in making universal health care his signature issue.