Massachusetts Healthcare bill - insuring profits, not healthcare ??

What's up with the new Massachusetts bill that has passed the legislature. Sounds like we are insuring the profitability of insurance companies more than providing healthcare. Or am I just to suspicious?

Let's fine people that $1,000 if they don't give their money to the insurance companies - did I get this right?

Please join in our national and by state discussion about access to healthcare:
http://hctalk.com/viewtopic.php?p=135#135

rather the ones with an income of over 300% above poverty...

because that's $54,000/year, not even enough to be considered middle class any more. Million dollar hospital bills are not that uncommon even for routine surgeries that have a complicated recovery.

Even people who are comfortably in the 6 figures and comfortably middle class can be wiped out my medical bills very quickly should they lose insurance.

Only the super rich with incomes over ten million can afford to get sick without insurance.

That's why we need single payer and we need it now. We can't wait any longer. Our present system is killing us.

6 figures is only the top ten percent. Most people earn well below that and would fall into the subsidized insurance category. With everybody insured, those making above the median, who probably have health insurance already anyway, would see their premiums go down. Everybody wins.

Don't like it? Look at what my ex-governor proposed. Scrapping Medicare and Medicaid for base coverage. You think that's going to fly?

I'll take the Mass plan, thank you very much. At least it has a chance to pass and I can go to the doctor for the first time in 15 years. Take that back, second, I did manage to scrape some money together last year, but couldn't afford an MRI to see if I need surgery, which I can't afford anyway so why bother with the MRI. What good would a "base plan" do me?

Middle class income is what allows one household help, even if one chooses not to hire it. Middle class income is what allows one to save and invest.
Middle class income allows one to send the kids to college without having them too exhausted from a patchwork of jobs to study and without going deeply into debt.

That median income just barely allows people to live decently. There aren't many extras.

The middle class has shrunk, you see. People who call themselves middle class are generally kidding themselves. They're working class.

Poverty has been defined downward, too. It's what we used to call destitution.

This bill fails to make these distinctions and that's why it won't work.

I use holistic/alternative medicine for healing, and I have found in the past that insurance companies aren't, by and large, interested in wellness-they would rather cut you up with surgery or dope you up with prescription drugs. I'd hate to think that I have to waste money on an insurance premium that won't cover the type of medical services that I know work for me.

It also substantially standardizes benefits and sells them all through the state run "connector", so there should be much more competition. At the same time, it eliminates health underwriting. All this means that you should be able to actually shop plans.

Single payer might make the most sense -- but I'm not convinced (even Medicare is not single payer). This certainly goes farther than anything previously tried -- and I wish it luck.

Massachusetts Health Reform Bill: A False Promise of Universal Coverage
by Steffie Woolhandler, M.D., M.P.H. and David U. Himmelstein, M.D.

<snip>

First, the politicians assumed that only about 500,000 people in Massachusetts are uninsured. The Census Bureau says that 748,000 are uninsured. Why the difference? The 500,000 figure comes from a phone survey conducted in English and Spanish. Anyone without a phone or who speaks another language is counted as insured. The 748,000 figure comes from a door-to-door survey carried out in many languages (including Portuguese and Haitian Creole, common languages in Massachusetts). In sum, the reform plan wishes away 248,000 uninsured people who don’t have phones or don’t speak English or Spanish. It provides no funding or means to get them coverage.

Second, the linchpin of the plan is the false assumption that uninsured people will be able to find affordable health plans. A typical group policy in Massachusetts costs about $4500 annually for an individual and more than $11,000 for family coverage. A wealthy uninsured person could afford that – but few of the uninsured are wealthy. A 25 year old fitness instructor can find a cheaper plan. But few of the uninsured are young and healthy. According to Census Bureau figures, only 12.4% of the 748,000 uninsured in Massachusetts are both young enough to qualify for low-premium plans (under age 35) and affluent enough (incomes greater than 499% of poverty) to readily afford them. Yet even this 12.4% figure may be too high if insurers are allowed to charge higher premiums for persons with health problems; only half of uninsured persons in those age and income categories report that they are in “excellent health”.

The legislation promises that the uninsured will be offered comprehensive, affordable private health plans. But that’s like promising chocolate chip cookies with no fat, sugar or calories. The only way to get cheaper plans is to strip down the coverage – boost copayments, deductibles, uncovered services etc. Hence, the requirement that most of the uninsured purchase coverage will either require them to pay money they don’t have, or buy nearly worthless stripped down policies that represent coverage in name only.

Third, the legislation will do nothing to contain the skyrocketing costs of care in Massachusetts – already the highest in the world. Indeed, it gives new infusions of cash to hospitals and private insurers. Predictably, rising costs will force more and more employers to drop coverage, while state coffers will be drained by the continuing cost increases in Medicaid. Moreover, when the next recession hits, tax revenues will fall just as a flood of newly unemployed people join the Medicaid program or apply for the insurance subsidies promised in the reform legislation. The program is simply not sustainable over the long – or even medium – term.

More:

http://www.commondreams.org/views06/0406-35.htm

Too much knee-jerk dismissal of both this plan and Kitzhaber's first step plan for my stomach. The current system is broke, and you're not going to fix it in one fell swoop. This is going to take years of hard work, with many steps, many discussions, many proposals, and many rewritings of those proposals before and after they go into action.

This is about starting to make a change. To simply dismiss the first attempts to move to create change is to say, "let's just sit with the statuse quo." That doesn't work for me. And it doesn't sound like DU should sound, IMO.

into knee jerk.

The more I've read about this, the more I can see that it's bad public policy in the sense that it will make matters worse than the status quo. I'm just glad it's happening in Massachusetts, not Oregon. Romney would be wise to veto this and get overridden- or simply not sign it.

Then the blame for this boondoggle will fall on the legislature.

But Harvard Med School does have turf to defend here, and I wouldn't go there for the best information on the matter. The bottom line is the constant dismissal of proposals, which leads to shutting down the conversations that must happen. We're defeating ourselves, in the long run, by behaving this way. The powers that be don't even need to bother dividing us. We do it all by ourselves.

seems to get at the issue of insuring people who currently have no insurance by subsidizing (depending on income) health care insurance. It doesn't seem to get to reducing health care costs - am I wrong on this?

I'm asking about the minimal insurance covered by this law for people who qualify to pay for it. Because it makes social and fiscal sense to require people to have some kind of insurance, even if it just covers major stuff only.

As a libertarian Dem, I think the best way to get health care for everyone who wants it is offer some kind of single payer plan for major medical (the life-saving surgeries that bankrupt people) and let doctors and clinics offer cash-only services for checkups and routine stuff. Trust me the cash-only payments cost about $20-100, about the same as the co-payment for many insurance plans. They already have the cash-only clinics in rural America. And mini-clinics are popping up in corporate whorehouses like Wal-Mart. And naturopathic hippies won't be penalized for choosing herbs instead of drugs.

Helping your fellow humans is profitable - socially as well as fiscally. Socially responsible free enterprise has a solution that can work right now. A European-style single-payer plan will take forever to implement and will be denounced as "socialism".

I don't know much about the Mass. plan, but Mass. legislators tend to be liberal so how bad could it be? Just regulating and standardizing the paperwork alone will make insurance more affordable by lowering administrative overhead for everyone involved.