– If they are able to get insurance premiums to the level that we’ve been promised, i.e., $200 per month for a decent policy, they get full salary. Heck, give ’em double salary if they can do this.
– If they add no value, i.e., premiums through the connector are no different than they were before the Connector, they get zero salary.
Do we have a deal here?
Please share widely!
I scanned the salaries in the Globe, and they didn’t seem particularly high for that field. I am betting that most of them took a pay cut in order to be part of a challenging novel project.
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I am not sure what you think these folks are worth–$50K, $70K? You get what you pay for.
They are certainly worth their salt if they can do what was promised. However, they seem to be unable to do what was promised.
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It’s not clear to me that they have added any value at all to the process – do you feel otherwise? If they’ve not, they should not have their jobs.
There must be a way to fix this, even it it means revamping certain elements of the Chapter 58 reform plan.
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For a whole new layer of health insurance executives and managers on the state payroll to make so much more than the Governor’s salary ($140k) is ABSURD. That the Connector was even created and then right off the bat gobbled up $25Mil from the state budget is also ABSURD. $175,000 for a 4 day work week when you’re not adding value but instead adding layers of bureaucracy and waste is just plain wrong. Yes, I have a problem with this reform plan and I will explain why.
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The new Connector contraption represents the creation of yet one more wasteful and harmful layer of bureaucracy in the state’s health care system. In large measure the Connector’s reason for existing is to treat health insurance as a commodity to be sold at a profit and to enforce the mandate that you purchase it or else suffer financial punishment. This is instead of treating health coverage as an essential public good such as public health services or fire services – imagine if you had to purchase your own water and food safety insurance or fire department insurance?!
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I have worked in health care for almost 30 years, 15 of them as a Master’s prepared Registered Nurse in a variety of settings where I witness the harmful effects on patients and families of our system’s fragmentation and bureacracy. And these same harmful effects impact entire healthcare organizations and facilities, especially ones that are smaller or that provide care in low income communities. The finanacial burdens of the current fragementation and bureacracy in the system are just immense.
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It is not impossible to create a reform plan shaped by the goal of guaranteeing coverage for all instead of creating a legal mandate to purchase a product. Responsible stewardship of our state budget and our health care dollars, and the related goal of cost control must be higher priorities in crafting reform if it is to actually work and be sustained over time. Guaranteeing coverage is the humane AND economically sensible approach used by other wealthy countries. They do so at a MUCH lower cost with much better quality and choice. This is the sensible direction in which our state must lead the nation, not in the opposite direction. Here a some constructive suggestions toward this end:
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Why didn’t state leaders (leges et al) simply use the the already existing Medicaid Department to expand subsidized coverage for the poor and near poor? And then create additional expansions in affordable coverage by setting up a model where anyone could purchase the Medicaid Health Insurance plan, maybe on a sliding scale? We could increase choice of coverage and of doctor, hospital, etc and also achieve HUGE cost savings with this approach. Doctors and other providers remain privately employeed but the provision of insurance coverage is streamlined thus reducing fragmentation and wasteful bureacracy.
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Another choice of affordable coverage could allow folks – small businesses, individuals – to participate in the state’s Group Insurance Commission (the GIC provides coverage for all state employees including leges). If it’s good enough for legislators, Division of Medicaid and Connector contraption employees, and all the other kinds of state workers why isn’t GIC a coverage option for others in the state too?
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As more facts are becoming known about the current reform plan many people are joining the chorus to say we must do better. Much better. Do the above ideas have merit as steps toward that goal?
…health insurance for an etire state is unprecedented, no? I don’t think its fair to expect the transition to be easy or cheap. A low six figure salary for a professional who will be endeavoring to help re-write the rules in favor of all citizens of the Commonwealth having access to healthcare is a bargain if the goods are delivered. I’m frankly surprised they are not getting paid more. It isn’t really fair to criticize the first estimate (which the connector wisely and rightly did not vote on) and throw the all things considered not really that expensive baby out with the bathwater. Clearly they can’t have carte blanche for ever, but I’m willing to give them at least a year, if not a little more. If this stuff was easy it would have been done already.
It’s been done by virtually every other industrialized country in the world – and, in all cases, has resulted in:
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– costs that are in the $250 or so range per person per month, NO deductibles (this is for ALL residents – cost is probably much less even than $250 if we take out the elderly)
– coverage for EVERYONE
– medical outcomes that are as good, or better, than we have now
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In all cases, this was achieved by cutting layers of insurance agents from the system – not by adding more layers.
…state in 50 can’t play by completely different rules. To make this work we have to stay withing the existing framework until the rest of the country catches up.
Why can’t Massachusetts have different rules? In fact, if we can slash healthcare costs, it will lower the cost of doing business here, making it a more attractive place for industry to locate.
….but MA exists in a national framework that is set up to operate a certain way. I don’t think the effect of telling every insurance Co. that they have to operate differently in MA than everywhere else in the country will have the positive effect that you imagine. Systemic change has a tendency not to work when only one set in the system wants to change. In that scenario change by degree works better.
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anthony, it has been done already in every other industrialized nation. The clincher is that those countries recognize the shared obligation to guarantee health coverage, they view health security as an element of being a civilized society. Health insurance in those places is MUCH LESS EXPENSIVE and people are healthier because health care is treated largely as a social good and NOT as a commodity in a profit-driven marketplace as our government (under excessive influence of corporate special interests including insurance co’s, HMO’s, hospital chains, etc) has perpetuated for years in the U.S. and most recently, and tragically IMHO, in Massachusetts.
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Most people would rather not drag out being the victim of the biggest rip-off going for another year or more; being at the mercy of private companies for health insurance coverage is not good for our wallets or for our health. Insurance will never be affordable if we allow the status quo to continue.
…..to say that it has been done in every other industrialized country is not on point for what is happening now in MA. If you were to say it has happened in every other state, that would be another story. MA is a vanguard within the context of these United States and as encouraging as the European model may be, we can’t leverage off that becuase the US does not have a socialized economy. Don’t get me wrong, I want this to change, but within the context that we are actually in it is going to take some time, and frankly I don’t think picking apart the salaries of professionals who are working for less than they would in the open market is gonna speed up the process.
and “picking apart the salaries” and what they exemplify may serve to expose the serious flaws of the current reform approach and to open up a productive discussion on how to do fundamental reform a better way that will actually achieve the results we all need.
…going in the opposite direction, and how does picking apart salaries of those entrusted with this duty further the cause? It seems like more patented that’s too much to pay a civil servant grumbling. Where is the harm? What will reducing the salaries accomplish?
…if you think we are going in the wrong direction in general, that is a fine position and I’m sure you can make a colorable argument to that extent. But by quibbling over whether 120,000.00 or 80,000.00 or 50,000.00 is the appropriate amount to pay the individual you feel is not moving in the correct direction is not going to make your case. It is off point and only spins wheels.