Rumors of MA health care’s demise, etc.

I'm hearing a fair amount of grumbling that recent cuts in the state's health care coverage point to the law's “failure”. I've even promoted some of it, since it's valuable to honestly discuss its shortcomings.

But please — “failure”? This kind of commentary is awfully premature.

Yes, health care is expensive; covering people with subsidies and free coverage is expensive; costs are still going up. No, the 2006 Massachusetts law did not deal with costs; it was not intended to do so. It was an access law.

We are in a historic budget crisis. The state is cutting a lot of things — not just health care. Is Massachusetts K-12 education a failure because we have to cut $79 million this year? Is respite care a failure because it's getting cut by $9.6 million? Come on. That's crazy. (Almost as crazy as thinking of health care as a “luxury”.)

The law has some notable successes. First of all, 97% of Massachusetts residents have coverage, shielding them from financial catastrophe — though, as we've seen, certainly not from debt and crippling expense. From 2006 to 2008, say researchers, “access to care improved markedly.”

Believe it or not, the executive branch, legislature, and AG continue to work on the cost issue with some seriousness. In 2008 cost control legislation was passed, and there continues to be legislative ferment in cost control. The executive branch is indeed working on both the current financing, and in realigning incentives for quality of care, not quantity (“payment reform”).  The Attorney General has a relatively new health care division, which deals with consumer issues and fraud.

So, good-faith criticisms should be acknowledged and taken to heart.  Some markers of access and affordability have begun to backslide somewhat. That is indeed a great concern, and that's why health care reform is an ongoing project. It was not, was never, could never have been, the “make everything perfect for all time” law. The law was a way, a framework, for trying to make things better. It's not done.

This post was originally published with Soapblox and contains additional formatting and metadata.
View archived version of this post
.



Discuss

3 Comments . Comments are closed.
  1. BMG? Or the Herald?

    Wow, Charley!  I did a double take.  Your post today sounds like the Herald's editorial yesterday:

    Best of a bad situation

    By Boston Herald Editorial Staff Thursday, June 25, 2009 Editorials

    The folks who administer the state's health care reform law took steps this week to keep it solvent, and some advocates would have us believe that their actions threaten the core mission of the 2006 reform law itself.

    They would be wrong.

    The changes approved by the state's Connector Authority are rather a nod to fiscal reality - and to the fact that, in an unprecedented fiscal crisis, no government agency can be held completely harmless.

    It's not as if the authority, in the process of trying to save $115 million and preserve coverage for the greatest number of individuals, is going to be simply tossing sick people overboard.

    Under the new regulations, an individual who is deemed eligible for free or subsidized health insurance but who fails to pick a plan within 45 days will no longer be enrolled automatically. That will affect about 18,000 individuals who will be without insurance for at least part of the year, leading to savings in the neighborhood of $59 million. Those individuals would remain eligible for Commonwealth Care.

    So in other words if you want to keep your subsidized insurance . . . just pick a plan.

    The board will also limit dental coverage for 92,000 individuals. And surely the insurers who won bids for the agency's business won't be pleased with the decision to achieve savings by slowing their payments.

    Meanwhile, there is a separate but related debate raging over whether to continue offering subsidized insurance to some special-status immigrants who are not eligible for federal matching dollars - and who are on track to lose coverage under the state budget now on Gov. Deval Patrick's desk.

    But even with all these adjustments the authority estimates that 193,000 individuals - up from 177,000 today - will be covered in fiscal 2010.

    This is no picnic. But the sky isn't falling, either.

  2. I agree

    that the Massachusetts mandate for health insurance has it's flaws, but I do feel a sense of comfort knowing that should I lose the benefits I now have, there is an option to obtain coverage.

    Although I'm not certain, I believe if you have such illnesses as diabetes, history of heart attack, or perhaps even high blood pressure or heart disease, you can pretty much forget about trying to get insurance in the marketplace.

    At least with the Massachusetts mandate, you will be able to get insurance if you lose a job that offers benefits and have to take one that doesn't.  To me, that is the greatest gift the State of Massachusetts could give us.

    My hope for U.S. Healthcare reform is that we will have something similar to what Massachusetts offers. It would be great to have a public option too.  Having the government run a healthcare option would set an example of what health insurance should be (I would hope, Oh God, did I say that!).

    I think the days of for profit hospitals and insurance companies should be over. They should not be traded on the stock market, and their main goal should not be profits. It should be providing health services to the people of the country, and staying solvent, that's it.

    How to pay for it....the hardest question of all. Not on the backs of the middle class, that's for sure. Hopefully, without a need for profit, the premiums alone could cover the costs.  Isn't that the way it was suppose to work.

    • Pre-existing conditions

      I believe (but am not 100% sure) that MA law prevented insurance companies from declining coverage based on "pre-existing conditions" long before the current health care law went into effect.  Just FYI.

« Blue Mass Group Front Page

Wed 23 May 4:48 AM