by Paula Hartman Cohen
My husband and I live in Massachusetts, a state that already has health care reform.
On April 12, 2006, our state legislature enacted a law requiring all residents to have health insurance.
They could buy it themselves, they could buy it from their employer through a group plan or, if their income was below a certain level, they could buy it from the state at a reduced rate. This is the so-called public plan. If people are totally disabled and therefore unemployable, and have no assets to cover the costs, the state pays for it. Very few people fit the last category.
Employers – even small-business owners – are required to provide basic minimum health care plans. If they do not, they are fined (a whopping) $295 per employee, per year.
To date, the vast majority of employers – even small-business owners – have found a way to provide health insurance plans for their employees. Few have paid the fines. In fact, the number of small-business employers in the state that do offer insurance rose from 88% to 92% from 2007 to 2008, according to a recent story in Investors Business Daily.
This program has been in effect almost three years and, as far as we can tell, the world has not come to an end.
My husband enrolled in Medicare the year before the new Massachusetts plan began, but I was still buying my own insurance (at $620 per month). Now, we’re both on Medicare, with a Blue Cross/Blue Shield supplemental drug plan. That means we’re saving about $800 per month on health insurance, compared to what we spent several years ago. Thank you, US taxpayers and government bureaucrats!
Like many, we weren’t sure we liked the idea of mandatory universal health care when it was first presented. We worried about starting over with different providers, seeing the level of our care reduced, paying higher bills, and all the other things people worry about when they’re facing change.
Here’s what has happened to us as a result of mandatory, universal health care:
1. We still go to the same doctors.
2. We’re still on the same medications.
3. We still use the same pharmacy.
4. All other medical facilities we use – imaging labs, hospitals, blood testing labs, physical therapy — have not changed.
5. As far as we can tell, our insurance premiums have not changed or have changed slightly.
6. Our co-pays are lower, but we’re on Medicare.
7. If I had stayed in the same HMO plan I had before Medicare, some of my co-pays would have increased, such as alcohol and drug treatment, and prosthetic limb fittings, not that I used any of those benefits.
8. We both have reduced our prescription drug regimen and increased our weekly exercise, in part, because our insurance now encourages prevention by paying a nice benefit for going to the gym.
9. We feel more comfortable being in crowds at the grocery store, movie theaters, or in close quarters at the barber shop and hair salon, knowing everyone there has access to health care. That means everyone we deal with is less likely to be spreading infectious disease than they were three years ago.
10. We’ll feel even better when this year’s flu season comes around, since school children, teachers, bank tellers, store clerks and others dealing with the public can get the necessary vaccines or treatment to contain this year’s flu, no matter how rich or poor they may be.
And that’s the truth.
Paula Hartman Cohen is a freelance writer and blogs at birdsonawire.
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Mass health care “reform” is a failure. Concise outline of the problems found in Boston Globe http://tinyurl.com/c9qw3g
Need to mention a couple of other things that have come with Massachusetts health care reform: Increased taxes and increased budget deficits. Last I heard, the program was costing roughly double what the initial estimates thought it would.
(Disclaimer: I pay Massachusetts taxes, but do not qualify for any of the Massachusetts Health Care provisions).
This post argues in favor of RomneyCare using Medicare anecdotal details. With respect, it makes little sense.
The author is happy with Medicare bcs with medicare there are winners and losers. She just happens to be on the winning side.
What about drs? If they bill $100 for a service, Medicare likely says the rate should be $70 and then pays 80% or $56 to the dr.
Most likely the dr is out the $44 unless she has some supplemental coverage – which many do not. If she does, then the dr get $14 more and is still out the $30.
Medicare is simply a form of price controls – unfair to drs and hospitals – and ultimately not good for society. There are consequences to price controls – has anybody noticed there are fewer PCPs around? This is in part bcs they are the first line in dealing with Medicare and young drs with large loans to repay do not need the heavy hand of price controls, huge paperwork problems, etc. So they are opting out of being a PCP.
Btw, approx 20% of drs are not taking new Medicare patients. Maybe the author should ask herself, Why?
>>Thank you, US taxpayers and government bureaucrats!
You’re not welcome. It will not be there when it’s my turn. The Ponzi scheme can no longer be hidden. Thanks for nothing.
christophil, thanks for the link. Sometimes I wonder. The Institute of Medicine ought to add the word “prestigious” between “The” and “Institute”. I’ve yet to see a reporter write a column without putting it there.
How wonderful that this person has received one of the greatest gifts anyone can receive — piece of mind. If the federal government would simply extend Medicare to everyone in the country legally, we’d all have this gift. Fund it by pulling out of Iraq and Afghanistan. Let the doctors get their money the same way they’ve been getting it — from pharmaceutical companies!
There’s one part of Massachusetts health care reform that works: I am able to buy health insurance. It costs me over $8300 a year in premiums & deductible alone, but as a self-employed individual with a recent history of cancer, I would not have been able to buy health insurance at any price without this law. Since I am not disabled, I am also not poor enough to qualify for Medicaid so I would have been uninsured and now deeply in debt, or facing bankruptcy, because of medical bills.
The big problem with health care reform in Massachusetts is that they decided to expand coverage first, then deal with cost containment later. “Later” hasn’t arrived and our legislators seem to have completely forgotten that part of their unfinished assignment. This is what concerns me about federal health care reform: they’re apparently following the same playbook, looking to expand coverage first and worry about costs later. We all know that “later” means “never” in government-speak.
To fund Medicare, under current rules and tax rates, for future generations would require 85 trillion dollars in money that is currently promised but not funded.
Ask yourself. If Medicare is 85 trillion dollars unfunded now, for 50 million people, how and the Hell are you going to fund it for 300 million.
If you think the solution to funding Medicare is to pull out of Iraq and Afghanistan, you are correct. But you’re also going to have to pull out of transportation and education and housing and infrastructure and national defense and environment and every other dollar that your government spends. Why?
Because funding Medicare in the future, under current rules would require cutting 97% of all current federal liabilities.
That’s right. 97%.
Are you ready for that?
Happy Hospitalist is correct in stating that there will have to be some changes to health care as we know it now. Medicare will soon “break the bank,” so to speak. Not doing anything about Medicare is not feasible. There are good models for cost containment of care, such as successful studies of 30 day readmission rates at hospitals. Also, Virginia Mason Medical Center and a few other providers have significantly cut costs while improving care using the Toyota Model. John Black’s “The Toyota Way to Healthcare Improvement” amply illustrates this. Care providers who compete for the Baldrige Award always have better financial outcomes while improving patient outcomes. So, it seems that we can cut costs significantly, improve patient care and not operate in the red if we follow these models that have been fully detailed and successfully implemented. So, it seems to me, what needs to change most is the business model of providing health care.
>>Thank you, US taxpayers and government bureaucrats!
Put your “thank you note” in a time capsule. It will be your grandchildren and great-grandchildren who will be paying off this federal debt for decades to come. I am sure they will enjoy the irony of that IOU.
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