10 things your insured patients need to know about health care reform


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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