So, we’ve wondered how much the new health care bill would affect those uninsured folks earning just too much to get subsidized care — about $30,000 for an individual. Would these folks be required to buy “Yugo health insurance”, or Minimum Creditable Coverage (MCC) in the lingo?
The answer, according the Healthy Blog, is likely to be “no”:
The committee resumed discussion of minimum creditable coverage (MCC), which dominated the meeting. There was acknowledgement that MCC plans will not be affordable for all people over 300% fpl (given that deductibles of at least $1,500 were proposed) and that affordability for individual mandate purposes will be a separate decision.
So, I read this as saying that they’re taking into account the fact that a high deductible is part and parcel of “affordability”. Indeed, being forced to pay for high-deductible insurance might deprive one of the money that you might spend on, say, a doctor’s visit. High-deductible insurance really has little or no preventative benefit, so I tend not to be too enthusiastic about it.
In other words, the Connector seems likely to decide that they will encourage the creation of relatively high-value plans, and require folks who can afford them to get them; while leaving other folks in the doughnut hole. On one hand it’s criminal to make people pay for crap coverage; on the other hand I think that’s a shame that many people are going to be left out of this supposedly “universal” coverage.
Now, WBUR’s indispensible Martha Bebinger did a nice report raising the prospect these folks would be required to buy high-deductible plans to the tune of $250 a month or so, but that’s distinctly not the impression I get from the folks at Health Care for All.
I used to wonder how the various bureaus and counsels in the Soviet Union worked. Think of the responsibility!
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But, these connector folks are smart people. I’m sure they’ll get it just right.
That’s not working out too well for some 46 million uninsured people.
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1: Most Americans (as in the majority) like the system whether they admit it to pollsters or not: low co-pays, tests, choice of physician and the like. The majority fears change particularly if the change puts at risk their current system.
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This reason, IMHO, is the show-stopper. People are afraid to change and lose the system they have, (how long has Ed Kennedy been pushing Universal?) therefore, they won’t.
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The majority usually gets what it wants.
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The other reasons (2-4) are minor by comparison.
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2: The big expense in health-care is the end of life care. Universal can’t do anything about that, except ration it.
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3: Short of a political coup, there’ll still be immigrants, even after Universal, who’ll not have medical insurance coverage, therefore millions of uninsured residents.
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4: Universal coverage has no solution to rising provider salaries. Notice upthread, someone was lamenting the doctors who are going private and not even accepting insurance as payment, only checks and credit cards.
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your rosiness is appreciated.
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but post after post, your claim that all is just peachy with the american healthcare system has been roundly and methodically trashed.
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i’m glad that all is well with your world, but you’re beginning to take on some of the characteristics of the titanics bandleader.
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your point of political apathy is well taken. but that reality doesn’t mitigate the real hardship that tens of millions of americans are going through. nor the urgency to remedy that hardship.
Please link, anywhere, anytime, where I suggested, even remotely that “all is peachy”.
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Many people are uninsured. No question.
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Most people in the U.S., as in the majority, are satisfied with the current system is my point. That’s my only point.
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Answer this, if you have insurance coverage: Will you abandon your current coverage and accept Universal coverage IF 1) it would involve higher taxes to you AND 2) it may mean that some of your health service will be rationed.
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Both 1 and 2 are a risk that no state nor the United States has been willing to take, because IMHO, that the majority of people are too satisfied with the status quo to take the risk of Universal.
to first re-frame your question (which is important, because all of the push-poll questions about the gummit “running” healthcare create results as bogus as the premise);
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would bob and linda minivan like to see their taxes go up, say $5,300 a year? answer: if it means that they get comprehensive, quality, portable coverage that cannot be taken away from them in case bob loses his job, or linda decides to stay home so she can be more involved in the kids growing up, AND the $850 a month family premiums (read; $10,220 per year) become a thing of the past, then YES.
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YES they would abandon their current coverage.
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just this morning on wbur’s onpoint, when asked by tom ashbrook how the u.s. can address the yawning trade gap with china, the first thing out of newly-elected senator from missouri claire mccaskill’s mouth was . .healthcare! and how the burden of out-of-control healthcare costs is dragging down american companies ability to compete.
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how many issues have both advocates of the homeless, and the big 3 automakers makers agreeing that a crisis point is at hand?
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add in between- those who’ve just been laid off, the self-employed, those working for co’s that don’t offer coverage, those whose co-pays keep them from seeking preventative care, around 60% of physicians polled, older fixed-income but not yet ss eligible, those who want to grow their family but can’t afford the healthcare cost, those who want to grow their business but can’t afford the healthcare cost, those who want to change their jobs but can’t because of the risk of loss of coverage, and . . and . . . and . . . and . . . and . . . .
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Heck yeah. Give me a government policy that costs $5K as opposed to $10K insurance, even I’ll vote for it.
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I don’t know where you get your numbers. Convince me that the numbers work: 50 million more people covered yet it costs less and the coverage remains the same?
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Where does the extra money come from to pay for the extra healthcare those new recipients will demand?
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Then, how do you convince the majority of the population to agree to a system where,
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(i) they give up existing coverage;
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(ii) they pay taxes in an amount now approximately equal to the insurance payments you’ve given up and knowing the government will administer Universal Health Program;
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(iii) there is uncertainty whether health care will be rationed as the result of greater population coverage and price controlled medicine.
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My repetive argument is that most people in the U.S. won’t do it. And they won’t do it, until the following problems are solved.
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–End of life health care. That’s where the costs are. Rationing?
–Rising cost of health care providers. UH does nothing to control those cost short of price controls.
–Immigrants. 3-4 million people without coverage.
–Efficiency. How can the voting public be convinced that Big Government is any more efficient that Big Insurance. Said different, the healthcare inflation rate has been in excess of 10% for many years. Why can the Gov do better?
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I see no solution near. Therefore, I’m convinced UH is a pipe dream.
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by (oh, hundreds of millions of) people in spain, japan, canada, ireland, norway, australia, france, greece, new zealand, austria, korea, south africa, slovenia, scotland, germany, and . . . and . . . .and . . . . and . . . .
I like the health system of [country], except for [the bad stuff].
i wish you and the status quo a long and happy union.
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meanwhile, i look forward to working with people who are trying to bring improvements to the welfare, prosperity, and moral standing of our society.
and safely tucked into bed, I’ll try to keep working on gary cuz we know he’s not alone in that line of thinking, thinking that is very adeptly promulgated by the profit-driven insurance industry.
who care about the details of how we are going to get from where we are now to a functioning health care system that provides affordable universal coverge for all
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Enjoy! Feedback welcome.
It isn’t always. Sending 22 year old men to have their prostate examined isn’t likely to be worth the cost. Sending 50 year old men very well might be.
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My point is this: there are certain examinations, procedures, etc. which on average are efficient. Society as a whole benefits. However, people don’t always act on these interests… we don’t get our annual physical, etc.
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Once we know which preventative methods are efficient, it would seem wise for the state to financially encourage these procedures. It would seem wise for insurance companies to encourage these procedures. It would seem wise for anyone stuck with the bill of an avoidable problem later to help pay the lower bill now.
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What is the state’s role in this? How can we make it happen? How much will this help lower the total cost of health care?
we would focus on insurance options that promote preventitive medical care, but this plan does not. A $1500 dollar deductable makes it more likely that people will only seek healthcare if it is critical and will forgo care if it is not dire. I have other concerns about the plan as well. Many Boston doctors are no longer accepting insurance; not medicare, not medicaid, not private insurance. My mother recently was referred to two neurologists, only to find that both only accept cash or credit for services. If this is a trend then what does it help to have a mandate that everyone have health insurance if fewer doctors accept it? It may save the state from having to pay for emergency healthcare services but is that the point of unversal healthcare? Or, is it to have a healthier public?
If we have to force people into buying care, why not have an extensive list of those preventative procedures and tests in each age group which is NOT part of the $1500 deductable? Seems to me it would be pretty easy to do, and allow people preventative care appropriate to their age while allowing for plans that people in that “donut hole” can afford.
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I think health care should be 100% non profit anyway. It’s a conflict of interest for companies to make money off of health care in my opinion. Our whole system is crap.
But I bet the deductible would have to then be $5000 in order to keep the package within reach of these folks.
I am disgusted beyond words that our state has concocted this “nearly universal” plan that is so so so far off the mark of achieving affordable quality health care for all.
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It is so obvious that we don’t yet have the political leadership in this state to take the bull by the horns and say that here in Mass. we’re going to treat health care as a public good rather than as a commodity, and we’re going to have government set some rules requiring good stewardship of how health care resources are spent, e.g. limiting spending on admin. and marketing, and emphasizing health promotion and disease prevention, and here in Mass. we’re not going to allow corporate profiteering and personal fortunes to be made off of people’s illness and suffering, here in Mass. we’re already spending MORE THAN ENOUGH to provide every person in the state with comprehensive quality care–if we required healht care dollars to be spent primary onhelaht care, that is. But maybe, just maybe, sometime after Jan 4 we will have that leadership to bolster the good work of a few leges, namely Steve Tolman, Pat Jehlen and a few assorted others. Time will tell…
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In the meantime we have this “historic bipartisan achievement” health reform law that has created new and additional layers of bureacracy in the system, is soaking up even more state budget dollars on admin and marketing ($25 Mil worth so far), and is failing to address the underlying causes of waste and dysfunction in the system.
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And it’s being touted as a model for other states, for the nation for cripes sake?!! Really, words cannot express how tragic this is to be coming from Massachusetts. Heaven help us that we won’t be saying this about Romney when he runs for prez, getting traction off of this “historic bipartisan achievement”.
Link HCFAMA minutes will be posted.
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They are missing the “affordable” part of the equation, we should be working on the inefficiencies and the factors that drive the prices up. To my knowledge none of that has taken place.