If you have any doubt that the wheels have come off Commonwealth Care, the Massachusetts health reform that former Gov. Romney signed in April 2006, read the latest from the Alliance of Massachusetts Safety Net Hospitals, who are upset that the state proposes to “cut millions of dollars from annual payments to Massachusetts hospitals that provide care for the majority of low-income and uninsured residents,” as reported by the Boston Globe.

Whoa, Nellie! Wasn’t the whole point of this exercise in “universal” health care to eliminate the uninsured, by a complicated mechanism of Connector, compulsion, and contributions from taxpayers that would shovel the uninsured into government-regulated health plans?

In that case, safety-net hospitals are surely redundant, aren’t they? Not according to the safety-net hospitals, of course. It’s not just inertia. Rather, “safety-net hospitals contend that few residents in their low-income communities have signed up for the state’s free or subsidized health plans.”

This news corroborates previous evidence of continuing uninsurance in Massachusetts. The Massachusetts reforms have not changed the fundamental incentives facing the participants in health care: the patients have little incentive to enroll, and the providers have no incentive to wean themselves from government dependency (as anticipated a year ago).

I have little doubt that the safety-net hospitals will get their payments back up to what they demand; that they will continue to lobby for whatever is required to maintain and increase the supply of uninsured patients they see; and that Massachusetts is now burdened with yet another government health care bureaucracy that does little except add cost and confusion to the mix.