Massachusetts Set to Offer Universal Health Insurance

[QuikClot]

Massachusetts Set to Offer Universal Health Insurance
Published: April 4, 2006


BOSTON, April 4 — Massachusetts is poised to become the first state to provide nearly universal health care coverage after the state legislature overwhelmingly passed a bill today that Gov. Mitt Romney says he will sign.

The bill does what health experts say no other state has yet been able to do: provide a mechanism for all of its citizens to obtain health insurance. It accomplishes that in a way that experts say combines several different methods and proposals from across the political spectrum, apportioning the cost among businesses, individuals and the government.

"This is probably about as close as you can get to universal," said Paul Ginsburg, an economist who is president of the nonpartisan Center for Studying Health System Change in Washington. "It's definitely going to be inspiring to other states about how there was this compromise. They found a way to get to a major expansion of coverage that people could agree on. For a conservative Republican, this is individual responsibility. For a Democrat, this is government helping those that need help."

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[dilated]

It's a very misleading article title. Massachusetts is not going to "offer" universal health care, it's going to REQUIRE everyone to get insurance, presumably mostly private, with tax penalties if you don't.

I'm kind of split on it personally. Certainly it's preferable to government run mandatory health care, but on the other hand we supposedly live in a free country and I don't really need Uncle Sam making sure I eat my wheaties or he'll tax me more.

 

[QuikClot]

If Uncle Sam is going to require people to build according to fire codes, wear seatbelts, and smoke outside, I don't think requiring people who can pay for it to get health insurance is any great loss of liberty.

It should be pointed out that there is a large expansion in free healthcare under the plan, and well as an expansion of employer incentives to provide healthcare. It's by design a mixed bag -- avoiding the single-payer boogeyman.

 

[Smilemaker100]

Massachusetts Set to Offer Universal Health Insurance
Published: April 4, 2006


BOSTON, April 4 — Massachusetts is poised to become the first state to provide nearly universal health care coverage after the state legislature overwhelmingly passed a bill today that Gov. Mitt Romney says he will sign.

The bill does what health experts say no other state has yet been able to do: provide a mechanism for all of its citizens to obtain health insurance. It accomplishes that in a way that experts say combines several different methods and proposals from across the political spectrum, apportioning the cost among businesses, individuals and the government.

"This is probably about as close as you can get to universal," said Paul Ginsburg, an economist who is president of the nonpartisan Center for Studying Health System Change in Washington. "It's definitely going to be inspiring to other states about how there was this compromise. They found a way to get to a major expansion of coverage that people could agree on. For a conservative Republican, this is individual responsibility. For a Democrat, this is government helping those that need help."

Where was this article published ?

I'd like to hear the updates about this subject in particular as it concerns me personally. I am very much interested in moving to the state of Massachussetts (unless I get married to a Canadian here and settle in the Great North. ) One of the main reasons why I have feared moving to the US permanently is precisely because of the medical system/medical insurance.

 

[McDoctor]

It's a very misleading article title. Massachusetts is not going to "offer" universal health care, it's going to REQUIRE everyone to get insurance, presumably mostly private, with tax penalties if you don't.

I'm kind of split on it personally. Certainly it's preferable to government run mandatory health care, but on the other hand we supposedly live in a free country and I don't really need Uncle Sam making sure I eat my wheaties or he'll tax me more.

If you drive an automobile, then you are required to have minimum coverage so you don't stiff someone with a bill if you cause an accident. I don't see why the same principle shouldn't apply to healthcare. Look at how many ER's do not recover the cost of taking care of an uninsured patient.

 

[dilated]

If Uncle Sam is going to require people to build according to fire codes, wear seatbelts, and smoke outside, I don't think requiring people who can pay for it to get health insurance is any great loss of liberty.

Well, smoking outside and fire codes are both public safety issues where individual regulations are there to prevent you from hurting others. I personally think seatbelt laws are a ridiculous infringement on people's rights. The government really has no business micromanaging my life to make sure I'm making the "healthiest, safest" choices. Should there be legislation to make sure I'm not consuming an excessive number of calories a day, because I might get fat and consume more health care money? The continual erosion of personal liberty in this country is depressing.

 

[QuikClot]

Where was this article published ?

I'd like to hear the updates about this subject in particular as it concerns me personally. I am very much interested in moving to the state of Massachussetts (unless I get married to a Canadian here and settle in the Great North. ) One of the main reasons why I have feared moving to the US permanently is precisely because of the medical system/medical insurance.

Front page of the NYT, sorry.

 

[Smilemaker100]

Front page of the NYT, sorry.

Merci, beaucoup ma cher.

 

[QuikClot]

Well, smoking outside and fire codes are both public safety issues where individual regulations are there to prevent you from hurting others.

Let me introduce you to my little friend, drug-resistant TB. Individual health is a facet of public health . . . esp. when the public bears the cost of a catastrophic event.

If course, if you are ethically opposed to all government regulation, you won't like universal health care. Or public schools. Or public fire departments, the CDC, a standing army . . .

But the liberatarian/public welfare debate is not really about healthcare issues, and furthermore it's been done to death on these forums.

 

[dilated]

If course, if you are ethnically opposed to all government regulation, you won't like universal health care. Or public schools. Or public fire departments, the CDC, a standing army . . .

I never said I was opposed to all government regulation. I specifically said that I was opposed to the government interfering in decisions people make that affect only themselves because the politicians think their judgment should apply to all people.

I think I see the reason the Republicans supported it though. A $300/employee employer penalty for not offering insurance? Big deal. Is there any way it costs the employer anything even close to that to insure an employee for a year? It seems to me like they'll just shift the burden of the mandatory insurance onto the employees.

 

[TypeA]

Where was this article published ?

I'd like to hear the updates about this subject in particular as it concerns me personally. I am very much interested in moving to the state of Massachussetts (unless I get married to a Canadian here and settle in the Great North. ) One of the main reasons why I have feared moving to the US permanently is precisely because of the medical system/medical insurance.

It is on msnbc.msn.com.

Specifically, here.

 

[hardy]

I never said I was opposed to all government regulation. I specifically said that I was opposed to the government interfering in decisions people make that affect only themselves because the politicians think their judgment should apply to all people.

How does somebody going to the ER for a cold and not paying their bills only affect themselves? Unnecessary ER visits reduce the quality of care for others and unpaid bills increase the cost for others.

The same is true for the seatbelt/helmet requirement for cars/motorcycles. If you would just die without harming anybody I could care less. But most often people who do not wear helmets/seatbelts just become vegetables on a ventilator and produce enormous costs before they expire. And most of the cost is not paid by their insurance but my the government, which means more taxes for me.

 

[Sol Rosenberg]

INHERENT BIAS ALERT: I am fundamentally Libertarian; however, I'm also a reasonable person, like most Libertarians (the guy who said that Libertarians don't believe in a standing army is ignorant -- just read the "issues and positions" section on www.lp.org) That being said, here is what I think about this new Mass. law......

Admittedly, I've only read what has been published by the mainstream media about this new Mass. law, but I don't think it is going to make a big difference in the problem with the uninsured and health care. The reason I think this is because, it seems that the law "leaves out" the middle class.

From what I read, the law will provide state-subsidized health insurance to "the lowest earning residents." Nothing is mentioned about the middle class. It may be more economical for older, middle class citizens to just pay the tax penalties rather than pay for the health insurance that they cannot afford. What I read was that the penalties are "half the cost of the lowest priced-insurance plan each year." Seems like, if money is tight, it is better to pay the penalty than the full cost of health insurance. Furthermore, how is providing state-subsidized health insurance to the "lowest earning residents" significantly different then MedicAid?

So, at first glance, I don't think this new law is going to have that big an effect, other than creating a new bureaucracy to oversee the programs created by it. Whether that means that the costs borne by the state to run such a program exceed those borne by the state from the currently uninsured (most of whom will probably remain uninsured) remains to be seen. In that sense (if the costs borne by the state are reduced even slightly) the program might be a success. I'm skeptical.

J

 

[Sol Rosenberg]

Sorry, the article I was quoting from was posted on Yahoo News. It's titled "Mass. Lawmakers Approve Ambitious Healthcare Plan," by Belinda Yu.

 

[xSTALLiONx]

Well, smoking outside and fire codes are both public safety issues where individual regulations are there to prevent you from hurting others. I personally think seatbelt laws are a ridiculous infringement on people's rights. The government really has no business micromanaging my life to make sure I'm making the "healthiest, safest" choices. Should there be legislation to make sure I'm not consuming an excessive number of calories a day, because I might get fat and consume more health care money? The continual erosion of personal liberty in this country is depressing.

I feel that if a seat belt would NOT be required.. Those people should waive their rights to sue for any physical or mental damages..(a Black Box could record that)... You could only claim the damage done to the car..

Otherwise, you not wearing a seat belt.. affects your claims.. which affects my insurance company.. which affects my premiums..

 

[hardy]

Otherwise, you not wearing a seat belt.. affects your claims.. which affects my insurance company.. which affects my premiums..

Somebody will still have to pay their medical bills, which are higher for people not wearing seatbelts. IF they have insurance that might cover part of it, but the government still has significant outlays for long-term care.

 

[bananafish27]

I agree to this comment. The middle class, economically speaking, are the ones who tend to be unable to afford adequate health care for their children. The severest indigent population is supported by many national and state-funded programs that provide them with subsidized services. I have in many cases read that the most difficulty in accessing health care comes from those too poor to purchase private healthcare but not poor enough to qualify for subsidy.

Too, I think that many people abuse the health system in regard to their concept of E.R. It becomes freely available urgent care that is often treated like a walk-in clinic, with the hospital left standing to absorb the costs. I guess the one response that immediately comes to mind: What would you do? If you had a child who was suffering and in need of medical attention and you happen to fall in a nebulous void in terms of where the state stands on your health costs, you're going to do everything you can to ensure the health of your kid - even if it means abusing the system like that. I'd sure as hell rather abuse the system than let my child go sick (assuming I am unable to afford insurance).

INHERENT BIAS ALERT: I am fundamentally Libertarian; however, I'm also a reasonable person, like most Libertarians (the guy who said that Libertarians don't believe in a standing army is ignorant -- just read the "issues and positions" section on www.lp.org) That being said, here is what I think about this new Mass. law......

Admittedly, I've only read what has been published by the mainstream media about this new Mass. law, but I don't think it is going to make a big difference in the problem with the uninsured and health care. The reason I think this is because, it seems that the law "leaves out" the middle class.

From what I read, the law will provide state-subsidized health insurance to "the lowest earning residents." Nothing is mentioned about the middle class. It may be more economical for older, middle class citizens to just pay the tax penalties rather than pay for the health insurance that they cannot afford. What I read was that the penalties are "half the cost of the lowest priced-insurance plan each year." Seems like, if money is tight, it is better to pay the penalty than the full cost of health insurance. Furthermore, how is providing state-subsidized health insurance to the "lowest earning residents" significantly different then MedicAid?

So, at first glance, I don't think this new law is going to have that big an effect, other than creating a new bureaucracy to oversee the programs created by it. Whether that means that the costs borne by the state to run such a program exceed those borne by the state from the currently uninsured (most of whom will probably remain uninsured) remains to be seen. In that sense (if the costs borne by the state are reduced even slightly) the program might be a success. I'm skeptical.

J

 

[JakeHarley]

I like the balance that this plan is trying to create.

The full article (from NYT) comments that under the plan, the state will subsidize the purchase of private insurance by the working poor and their children. While they predict that the plan will cost no new state funds within 3 years, it really leaves the door open for private insurers to set whatever premiums they choose, which could quickly make this plan untenable.

Will the state require private issurers to justify premium increases or maintain a transparent process for deciding premiums?

It will be interesting to watch what happens with this.

 

[gostudy]

I never said I was opposed to all government regulation. I specifically said that I was opposed to the government interfering in decisions people make that affect only themselves because the politicians think their judgment should apply to all people.

I think I see the reason the Republicans supported it though. A $300/employee employer penalty for not offering insurance? Big deal. Is there any way it costs the employer anything even close to that to insure an employee for a year? It seems to me like they'll just shift the burden of the mandatory insurance onto the employees.

So you're against the gvt telling us our kids have to go to school.

 

[scpod]

I feel that if a seat belt would NOT be required.. Those people should waive their rights to sue for any physical or mental damages..(a Black Box could record that)... You could only claim the damage done to the car..

Otherwise, you not wearing a seat belt.. affects your claims.. which affects my insurance company.. which affects my premiums..

It's not just a problem of "rights." Try working in an ER. I've seen a hundred MVC's where one person wearing seatbelts was badly bruised, but walked out of the ER hours later. But...another person not wearing seatbelts was thrown through the windshield and had to undergo months of rehab-- if they survived. With 65% of ER charges not being paid, that puts a strain on the pocketbooks of every taxpaper in the US. That "right" not to wear a setbelt infringes on the "rights" of every taxpayer who has to fund the treatment.

 

[DrBowtie]

It's not just a problem of "rights." Try working in an ER. I've seen a hundred MVC's where one person wearing seatbelts was badly bruised, but walked out of the ER hours later. But...another person not wearing seatbelts was thrown through the windshield and had to undergo months of rehab-- if they survived. With 65% of ER charges not being paid, that puts a strain on the pocketbooks of every taxpaper in the US. That "right" not to wear a setbelt infringes on the "rights" of every taxpayer who has to fund the treatment.

The same can be said about multiple things yet seatbelts are the only thing required by law.

 

[dilated]

So you're against the gvt telling us our kids have to go to school.

Unless you are being intentionally obtuse, I cannot even begin to fathom how you would get this conclusion out of "the government should not interfere in things that affect only me" as a child is obviously ....... another person? And one who is recognized by the law as being mostly incapable of making their own decisions, at that.

It's not just a problem of "rights." Try working in an ER. I've seen a hundred MVC's where one person wearing seatbelts was badly bruised, but walked out of the ER hours later. But...another person not wearing seatbelts was thrown through the windshield and had to undergo months of rehab-- if they survived. With 65% of ER charges not being paid, that puts a strain on the pocketbooks of every taxpaper in the US. That "right" not to wear a setbelt infringes on the "rights" of every taxpayer who has to fund the treatment.

I have a sneaking suspicion obesity causes about ten times more in health care costs than people who weren't wearing their seatbelts. So I presume you are in favor of the government taxing people for being fat without extenuating medical reasons - after all, they have no "right" to be fat and their fatness is impinging on my "rights" as a taxpayer to a far greater degree than those damn seatbelt rebels.

 

[chef_NU]

It's not just a problem of "rights." Try working in an ER. I've seen a hundred MVC's where one person wearing seatbelts was badly bruised, but walked out of the ER hours later. But...another person not wearing seatbelts was thrown through the windshield and had to undergo months of rehab-- if they survived. With 65% of ER charges not being paid, that puts a strain on the pocketbooks of every taxpaper in the US. That "right" not to wear a setbelt infringes on the "rights" of every taxpayer who has to fund the treatment.

Is there a federal compulsion law for all ERs to admit patients regardless of their ability to pay? I thought that was only in certain states. Also, what if the person who comes into your ER is not a citizen? Do you still have to treat them? If I ran a hospital like this and the government slapped a dumba$$ regulation like this on me, I would treat these patients with the minimal quality of care possible. And there's no way in hell I would hire any MDs to treat them. It'd be the cheapest I could get away with (maybe an NP). Screw that, the ER techs can handle those cases. ;o

EDIT: Yes theres that EMTALA law or whatever which is completely ridiculous to me. I think you only need to accept anyone who walks in your door if you also accept medicare/medicaid. Makes me want to avoid places that accept medicare/medicaid like the plague especially if I ever am considering a job as an ER or staff specialist at a hospital.

 

[chef_NU]

So you're against the gvt telling us our kids have to go to school.

I am. It's up to parents to do the forcing. I just don't get it that the government lets single-parent, drug addict, HIV+, HepC+, HS dropout, criminals have kids but it won't let parents make decisions about education. I mean, lets start with the basics of parenting before we tell parents they have to send their kid to a public school they know will be worthless. Or just leave everyone alone and let them screw up their lives as they wish.

 

[humuhumu]

I think this is an interesting experiment, and an unusual example of bipartisan support for health care reform. Whether it achieves the desired outcome remains to be seen.

 

[McDoctor]

Finally, the vocie of reason...

Is there a federal compulsion law for all ERs to admit patients regardless of their ability to pay? I thought that was only in certain states. Also, what if the person who comes into your ER is not a citizen? Do you still have to treat them? If I ran a hospital like this and the government slapped a dumba$$ regulation like this on me, I would treat these patients with the minimal quality of care possible. And there's no way in hell I would hire any MDs to treat them. It'd be the cheapest I could get away with (maybe an NP). Screw that, the ER techs can handle those cases. ;o

EDIT: Yes theres that EMTALA law or whatever which is completely ridiculous to me. I think you only need to accept anyone who walks in your door if you also accept medicare/medicaid. Makes me want to avoid places that accept medicare/medicaid like the plague especially if I ever am considering a job as an ER or staff specialist at a hospital.

Every time one of these old ladies on Medicare come to the ED clutching their blouse and whining about "chest pain" I just want to puke.

Chef NU, tell us more about you're utopian healthcare ideals...