I am a Massachusetts resident. Today is the second anniversary of the passage of universal health care coverage. Two years ago, then-Governor Mitt Romney signed a bill into law to make it mandatory for all state residents to sign up for health insurance. Three times the number of people expected have signed upm and some local news stories have been published about people who would not have been able to afford health coverage if it weren't for this law.

As I searched the blogosphere this evening, I found that bloggers were remarkably silent on this anniversary. I suspect it has attracted minimal national notice because it's specific to a single state. Perhaps it is not getting covered much by those who have noticed because for the most part it appears to be working adequately. There are problems, so it isn't a glowing success for those who advocate for univeral health care. On the other hand, the problems have destabilized neither the economy nor the health care system, which some opponents of universal health care consider to be the immediate consequence of legislating such coverage. As with most public policy issues, some things are going well and some things are going poorly.

Local coverage within Massachusetts did highlight a few of the issues. One of the problems is trying to figure out how to pay for this. The Examiner.com writes that there is concern over whether or not the state can affort this. Another problem is that demand for medical care has significantly increased without an increase in supply. There is now a shortage of doctors because so many more people are insured and receiving medical care. That is a double-edged sword, as it is also proof of one of the successes of the law - it is allowing people to get health care who previously lacked access to the system. There are some suggestions for how to address these problems, including adding another $1 tax to cigarettes to pay for the coverage, or implementing a loan forgiveness program for student loans for primary care physicians who are willing to work in areas where there is a doctor shortage. Each of these solutions would likely have some positive impact and other undesired impacts, but it is good to see people thinking through the possible solutions. Finally, Marc Klimer of State Policy Blog wrote "So, at the end of the day, all we really did was force everyone in the commonwealth to purchase a health insurance policy and impose a new tax on the business community. We did practically zero to reduce costs. In fact, it is possible that we actually created new costs.".

Despite these few New England voices, I was surprised by the relative quiet. After all, I would think that other states would be interested in how Massachusetts is doing with this policy. I assumed I would either read glowing reviews or hear from people who find far more problems with the system. Hopefully this doesn't come as a shock, but there is an election coming up after all, and skyrocketing health care costs, the high number of uninsured, and the competing health care plans of the various candidates are all hot issues. It is worth understanding what works and what does not work in a state that has tried it. There are no easy answers to how to handle our national health care problems, but the only way to encourage the best possible legislation is for us to scrutinize the impact on cost, quality, and availability of care and allow what we learn to inform our advocacy and voting.