Blue Mass Group

Reality-based commentary on politics.

The Governator outdoes Chapter 58

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Here’s John M. on the latest proposal from the golden state:

– All businesses with 10 or more employees that do not provide coverage would have to pay a 4% payroll tax to the State (the MA law requires a $295 annual contribution – the House approved version would have required a 5-7% payroll tax on non-covering firms).

– Insurers would no longer be able to write or deny coverage based on an individual’s medical condition (MA outlawed such practices back in 1996).

– All individuals would be required to purchase coverage, with significant subsidies to help lower income individuals pay for coverage. (Close to the MA version.)

– Hospitals would be assessed 4% of revenues and physicians would be assessed 2% of revenue, and Medi-Cal providers would be given rate increases (the MA law gives significant MassHealth rate increases to hospitals and physicians, with no new assessment on others).

– Everyone would be eligible for subsidies and assessments, including undocumented immigrants (in MA, only legal immigrants are eligible for new subsidized coverage).

In a word, wow.

With a hugely popular Republican backing a payroll tax for employers who duck their obligations, will it happen?  (The CA legislature is heavily Democratic.)

More importantly, if we start calling our health care bill “MassCare,” has anyone noticed the easy anagram that perhaps more accurately describes it?

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  2. Compared to the US’s weird hodgepodge of islands of greed, single-payer healthcare costs far less, and works better, in every single industrialized nation where it’s been tried.

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    Why are we putting lipstick on this pig?  Why pay more for less?  Why not do this right?  Do Americans believe that we are somehow inferior to folks in other countries – that they can do it, but we can’t?

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    Wachet auf, ruft uns die Stimme!

    1. If Mitt Romney had decided to pull a Schwarzenegger, move to the center, sign RGGI, Cape Wind, and push honest-to-Betsy health care policy … maybe he’d have Arnold’s approval ratings instead of being early ’08 roadkill. Arnold got more popular the old-fashioned way: He became a much, much better governor.

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    2. Does this give Patrick and Sal some momentum to revisit (in a few years) the free lunch that big uninsuring employers got in MA?

          • Good one. 

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            Regardless, like the Romney Health Mandate compromise or not, you can’t deny that Mass led the way on this type of ‘universal’ coverage. 

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            Key difference is greater reliance on payroll tax–we’ll see how that turns out.  NPR:  Calif is “MA on steroids”.

            • Looks to me that Willard merely showed up in a nice suit, smiled and signed, and took off before the actual implementation details were worked out.

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              In the end, I expect that Willard will claim responsibility for the basic humanitarian concept, while Deval and the legislature will take the hit for the (likely) dysfunctional implementation.

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              Clever guy, that Willard.

    • charley says “honest-to-Betsy health care policy”??!! – Not by a long shot.  see the below that was part of an action alert from a health justice activist in calif.

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      Comparing Arnold Schwarzenegger’s plan to SB 840 (now that’s honest to betsy healhthcare policy).

      Key points are listed below.  You will have to pick a topic or two as most newspapers have a 200 word limit.

      Cost

        * SB 840 would save Californians 12 billion dollars in 2007, Arnold’s plan would cost an extra 12 billion dollars.  * SB 840 savings would occur by removing the middle man insurance industry from health care and bargaining vigorously with the drug companies.  My 12B figure is from the Lewin analysis of Kuehl’s legislation.  That report can be found at http://singlepayerno…  * Arnold’s plan will use state funds to subsidize the insurance industry.  We do not want welfare for the insurance industry which has always tried to avoid the sick and insure only the healthy.  The insurance industry should be removed from healthcare.

      Bureaucracy

        * Arnold maintains the current bureaucratic nightmare of over 6000 health insurance plans and 69 government programs.   * SB 840 is a bureaucracy buster as it reduces the bureaucracy from 6000 to 1.  Most politicians want to cut  bureaucracy.  But not Arnold.  SB 840 is the biggest bureaucracy buster in history.

      Comprehensiveness

        * SB 840 is extremely comprehensive and includes full coverage for mental health, dental, vision, and prescription drugs.   * Arnold’s program does not require employers to offer any minimum benefit.

      Deductibles and Copays.

        * Arnold’s minimum required coverage has $7500 out of pocket costs for individuals and $10,000 out of pocket costs for families.   * SB 840 has no out of pocket costs or deductibles.  We think it is bad health policy to set up barriers to care.

      Racial, gender, and class inequalities

        * SB 840 delivers great health care to everyone.   * Arnold’s plan maintains the current system in which different classes of people receive different classes of care.

      Labor

        * Arnold’s plan does nothing to remove the contentiousness at the bargaining table.  All labor negotiations today revolve around health care.  * SB 840 removes health care from the bargaining table. 

      Business

        * SB 840 levels the playing for all business.  Costs are known.   * Arnold’s plan maintains an uneven playing field.  And Arnold’s plan sets a new low bar for what business should pay.  Businesses that currently provide health care spend slightly over 10% of payroll on health care.  Wal-Mart spends 7%.  Arnold calls for a minimum of a 4% payroll fee on some employers.  This is a plan that Wal-Mart would love and should be called the Wal-Mart plan.  Arnold’s projected income from the 4% fee amounts to one billion dollars in a state that is projected to spend $200 billion on health care in 2007.

      Who pays

        * Studies on SB 840 project an employer payroll tax of 8.1% of payroll after the first $7000 per employee and a employee payroll tax of 3.8% after the first $7000 of income.  These figures reflect the current relationship between employers and employees.    * Arnold’s plan lowers the bar on employers to 4% with no capped rate for employees.  * Arnold’s plan is in line with the three decades long shift of wealth from working families to the rich.

      Choice of health care provider.

        * Arnold’s plan allows insurance companies to limit choice.  * SB 840 allows full choice of provider.

      Cost controls

        * SB 840 uses an annual budget to pay for health care.  * Arnold’s plan allows insurance companies to raise rates.  Insurance companies have no incentive to control costs in California.  They actually have an incentive to have Californians spend more money on health care.  * Arnold proposes limiting the insurance industry’s overhead and profits to 15 cents of every premium dollar. Ask yourself, would insurance companies want 15% of 200 billion dollars or $300 billion dollars?  The more money that Arnold directs to the insurance industry, the better for them.

      On the hidden tax

        * Arnold talks of a hidden tax on current insurance premiums to cover the uninsured.  Don’t hold your breath for a rebate check from your insurance company.    * SB 840 takes on the real hidden tax on health care which is the existence of the middle man insurance industry.  Medicare has about a 3% percent administrative costs versus the proposed 15% administrative and profit cost of private insurance.  I will take the government efficiencies any day over the insurance industry’s, especially when the insurance costs 5 times as much.

      Insurance Industry

        * SB 840 uses government to remove this bureaucratic, wasteful middleman.  * Arnold’s plan uses government to enforce citizen funded subsidies for the insurance industry.  You could label Arnold’s plan “Leave no insurance company behind”.

      SB 840 is health care for Californians.  Schwarzenegger’s plan is welfare for his needy friends in the insurance industry.

      If you like how Wal-Mart’s CEO Lee Scott treats his workforce, you will love how Arnold treats the health care of Californians.

      Thank you.

      Don Bechler
      Chair – California Universal Health Care Organizing Project
      415-695-7891

  4. But California’s The Golden State, Florida is The Sunshine State.

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    By the way, if the bill passes California’s uninsured will undoubtably shout “Eureka!” rather than “In God we Trust.”

  5. Employers shouldn’t be punished for failing to provide health care to their workers, you and I both know its the small businesses that are going to get killed by the new health care laws, not the WalMarts of the world, but small time businesses, we already tax small business way too much and put that on par with minimum wage increases and this new healthcare bill and we are surprised that we see more and more of them close in our state.

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    Employers do have a responsibility to their workers, but just as we have unions since not all bosses can be generous we also have a government that has the ability and the responsibility to pay for healthcare. Universal healthcare is great for business and I cant believe more small business owners and CEOs are still card carrying members of the GOP since the healthcare our current system forces them to pay for is far worse than any tax.

    • Spot on.  Walmart and the bigger employers can adapt.  Walmart even endorses minimum wage, mainly because it doesn’t pay minimum wage.  It’s smaller competitors, however, do.

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      I’m unaware of public statements Walmart has made with regards to the Mass Health Mandate, but I wouldn’t be surprised if Walmart actually endorsed it.

  6. many years ago passed a reform package called Dirigo Health that seeks to put Maine on the path toward “universal coverage” but no one paid much attention… and Calif. has a powerful groundswell movement building for universal single payer health reform called One Care Now that successfully passed legislation last year that the governator then vetoed.  So let’s give credit where credit’s due on these developments.  Don’t settle for less than we all need and deserve in respect to sensible and sustainable HC reform.  It’s not “Don’t let the perfect be the enemy of the good” (as j mcd at hcfa and richard moore at the MA lege like to say) it’s more like  “Don’t let the mediocre that serve corporate interests prevail over the health and economic needs of the people”.

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    Calif., Maine, MA Chap 58, and other tinkering at the edges of the status quo are state-based reforms that merely rearrange the chairs on the titanic in order to placate a few advocacy groups, make some elected officials feel a bit better, and protect the insurance-medical-industrial complex and their riches.  The crisis in HC costs and poor access and quality will persist until we enact something akin to a national health program that utilizes streamlined financing (aka single payer) to provde truly universal coverage.  HealthCare-Now is the national organizing project for buidling and for winning this social movement.

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    Of all forms of inequality, injustice in health care is the most shocking and inhumane”  – Martin Luther King, Jr.

    • Is that its really not a hot button grassroots issue, most students get coverage through their school or parents, most people get coverage through work, the usually mobilized elderly already essentially enjoy the benefits of state sponsored healthcare, and the poorer among us do as well. Essentially the only beneficiaries of universal health care would be those who lack insurance but don’t qualify for state aid, and they are too busy working to protest!

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      Now one big beneficiary would be GM, and the day that GM (inevitably at this point) declares bankruptcy and lays off the largest privately employed workforce in the country is the day our lawmakers will begin considering this measure as hundreds of terrified CEOs will lobby and demand universal coverage.

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      Sadly people enjoy the status quo until it stops working for them, even if its flawed to begin with.

      • in fact it is one of THE BIGGEST rip offs going in this country.  so mightn’t that be the way to mobilize and consolidate the different demographics of people over this issue?  i mean, no one wants to knowingly sit by while they and their family are getting so royally ripped off by the U.S. HC system and its corporate marauders, do they?

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        HC spending is sucking the economic life out of many other domestic issues that really could make good use of some of those funds.  yet it seems like the ceo folks at GM etc still cling to their corporate tribe mentality and cannot bring themselves to accept (much less to advocate for) the need for a national HC program.  could it be that they sit on each others’ boards to the extent that it plays a factor?…

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