In late '06, Massachusetts (MA) started to implement universal coverage for people in MA. In '06, about 7% or so of residents in MA were uncovered. The plan would do the following:
1. Salary < 100% of Federal Poverty Level (FPL) gets totally free healthcare and dental.
2. 100% < Salary < 150% of FPL gets totally free healthcare
3. 150% < Salary < 300% of FPL gets subsidized healthcare based on a sliding scale.
4. FPL > 300%, which is $66K for a family of 4, then I'm not sure if people are still subsidized at this level, but they *MUST* have insurance or pay a fine.
Moreover, companies with more than 10 employees must enroll employees and subsidize the costs of their insurance. The employers subsidize the cost by paying a defined contribution, and if the employee opts for a cheap plan, they get credited the difference between the employer's defined contribution, and the cost of their chosen inexpensive plan as additional income.
Since '06, the uninsured has fallen drastically to ~2.5%. The bulk of these uninsured are paying a fine, since they don't want insurance. Also, 99.6% and 99.8% of elders and children are covered in MA!
From a budget point of view, both the Republican candidate for governor, who was CEO of a health care insurance company, and the Democratic candidate (who has successfully ran) both agree that the health care plan does not significantly contribute to the budget deficit in MA. Moreover, credit ratings agency Moody's increased the debt-rating of MA debt.
According to data from America's Health Insurance Plans, (http://swampland.blogs.time.com/2010/12/19/health-care-apocalypse-not/) the largest health insurer trade group, premiums for the previously uninsured (who were employees at small companies or uninsured by medicare/medicaid) have fallen by 40 percent since the reforms were put in place. Nationally, those premiums have risen by 14 percent.
However, the COST INCREASE of health care services are still rising quite quickly. I'm not sure how fast it's rising in the USA, but in MA it's risen by around 9% since 2006 each year.
The MA health care authorities - for a lack of a better phrase - may adopt, or have adopted, a few cost-containing measurements, such as:
1. increase co-pay
2. increased tobacco taxes
3. they won't pay for chiropractors or in-vitro fertilization
4. a payment model based on episodic sickness which is something as opposed to fee-for-service. another words, the patient is sick with illness A. He sees a PCP and a specialist as well as others. The healthcare providers are given a set rate for this one individual and his episode of sickness.
5. a payment model where people have an account. This is rationed-healthcare, which is something as opposed to fee-for-service.
This model is remarkable, and it will be a model for the Obama Administration. Here are some of my questions:
1. We have talked about the absolute COSTS of healthcare in the past, but we haven't talked about the GROWTH RATE of costs. What do you propose is the driver of the GROWTH RATE of costs (not the absolute costs themselves)?
2. What are your thoughts about Massachusetts care?
1. Salary < 100% of Federal Poverty Level (FPL) gets totally free healthcare and dental.
2. 100% < Salary < 150% of FPL gets totally free healthcare
3. 150% < Salary < 300% of FPL gets subsidized healthcare based on a sliding scale.
4. FPL > 300%, which is $66K for a family of 4, then I'm not sure if people are still subsidized at this level, but they *MUST* have insurance or pay a fine.
Moreover, companies with more than 10 employees must enroll employees and subsidize the costs of their insurance. The employers subsidize the cost by paying a defined contribution, and if the employee opts for a cheap plan, they get credited the difference between the employer's defined contribution, and the cost of their chosen inexpensive plan as additional income.
Since '06, the uninsured has fallen drastically to ~2.5%. The bulk of these uninsured are paying a fine, since they don't want insurance. Also, 99.6% and 99.8% of elders and children are covered in MA!
From a budget point of view, both the Republican candidate for governor, who was CEO of a health care insurance company, and the Democratic candidate (who has successfully ran) both agree that the health care plan does not significantly contribute to the budget deficit in MA. Moreover, credit ratings agency Moody's increased the debt-rating of MA debt.
According to data from America's Health Insurance Plans, (http://swampland.blogs.time.com/2010/12/19/health-care-apocalypse-not/) the largest health insurer trade group, premiums for the previously uninsured (who were employees at small companies or uninsured by medicare/medicaid) have fallen by 40 percent since the reforms were put in place. Nationally, those premiums have risen by 14 percent.
However, the COST INCREASE of health care services are still rising quite quickly. I'm not sure how fast it's rising in the USA, but in MA it's risen by around 9% since 2006 each year.
The MA health care authorities - for a lack of a better phrase - may adopt, or have adopted, a few cost-containing measurements, such as:
1. increase co-pay
2. increased tobacco taxes
3. they won't pay for chiropractors or in-vitro fertilization
4. a payment model based on episodic sickness which is something as opposed to fee-for-service. another words, the patient is sick with illness A. He sees a PCP and a specialist as well as others. The healthcare providers are given a set rate for this one individual and his episode of sickness.
5. a payment model where people have an account. This is rationed-healthcare, which is something as opposed to fee-for-service.
This model is remarkable, and it will be a model for the Obama Administration. Here are some of my questions:
1. We have talked about the absolute COSTS of healthcare in the past, but we haven't talked about the GROWTH RATE of costs. What do you propose is the driver of the GROWTH RATE of costs (not the absolute costs themselves)?
2. What are your thoughts about Massachusetts care?
