(UPDATE: Ryan and David have pointed to this commentary from Connector chief Jon Kingsdale:
The seven different health plans offer different levels of cost-sharing and premiums. Among them, individuals may choose an annual deductible ranging from $1,000 to $2,000-$2,000 to $4,000 for a family-or a basic health plan without any annual deductible. All plans with a deductible cover preventive visits -some cover all physician visits-without the policyholder having first to satisfy any deductible. [my emphasis]
Well, that’s excellent news. And Kingsdale repeatedly notes that these plans can be purchased with pre-tax dollars, bringing down their effective cost. It’s a better deal than I thought, though it’ll still be tough for a lot of folks to comply. Cost-cutting is still the big fight.)
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So, as reported in yesterday’s Globe, the new health care plans to be made available to the uninsured are going to carry deductibles of $2,000 for an individual, $4,000 for a family. That is really not especially good news. I’ve had high-deductible insurance, and it feels a lot like having no insurance at all. The Globe’s Alice Dembner has a very fine article today citing research that shows that high deductibles force people to go without care, and squeeze folks that do get care.
Wait, isn’t the whole point that people can go to a doctor when they’re sick? And that shows the basic conceptual problem with Chapter 58: It prioritizes insuring everyone — at whatever cost to individuals — with much less emphasis on actually increasing access to health care, much less encouraging health.
So, what can be done? Perhaps the plans offered can be made to include a basket of preventative services: yearly checkups, cholesterol testing, smoking cessation, and so forth. After all, the insurance companies don’t want you to hit the deductible either, so maybe they can spend a little to discourage that.
But this seems like nibbling around the edges. Health care costs are a massive problem in the US: They threaten municipal budgets; they threaten our federal budget; they threaten our business health; they threaten our military strength; and of course, they threaten our very bodies and minds. And the people on the receiving end of all that spending have enormous political clout. It’s going to take a huge investment of political capital to pick apart that coalition that’s so invested in the status quo. The Patrick administration has shown admirable involvement in even getting the plans’ costs as low as they are; but there’s a lot of daunting work ahead.
I don’t have time to give a full responce to this diary, so I ask that you read my blog about it. It’s actually a short one for once LOL.
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Especially pay attention to my update because, if true, there really isn’t too much of a reason to worry about the high deductibles.
I find it strange that one is required to have the health insurance by July 1, and here it is March 5 and things are still up in the air.
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I have managed withoug health insurance for eighteen years now. I am self-employed. I had coverage at one time for several years through a professional group, but it cost me about $3400 a year and I never satisfied the deductible. So in effect I was throwing money down the drain to contribute in some way to a stupid system that I derived no benefit from. Apparently I’m going to have to have some sort of coverage in the near future. I may get a pair of glasses from it every year, but except for that it will probably be money down the drain. In the long run I may give some thought to moving to Rhode Island or New Hampshire.
…but your mortgagor probably required you to keep property insurance. And, you might not have had an automobile accident, but you were probably required to maintain auto insurance to satisfy the financial responsibility requirements in order to drive.
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What is it about conservatives that they do not understand “spreading the risk” until it is they to whom the risk is supposed to be spread, after which they have contributed nothing?
Take the T.
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Don’t want to buy property insurance? Rent.
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Don’t want to buy health insurance?
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Um … leave Massachusetts.
It’s like the movie, Groundhog day
I travel for work, so living in Rhode Island wouldn’t be all that different in terms of driving mileage and time for me.
…if you are a renter, and if you start a fire in your apartment that damages the contents of other peoples’ apartments, you are liable for the damages.
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If you have never heard of renters insurance, you had best high-tail it up to your insurance agent and inform yourself.
The point is that it isn’t required. Furthermore, you could rent a single family house with some surrounding land.
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The argument isn’t about what’s wise, it’s about what is required.
Yeah. If you don’t want to buy health insurance, leave the state. I don’t want to have to pay to subsidize you when the your health shit hits the proverbial fan.
These include the private plans that most of the newly insured 100,000 are covered by with sliding scale state subsidies (from us) to the private insurers. And the $25 Mil in last year’s state budget that is being spent on the Connector to drive business into the private insurance sectors coffers, including large amounts to market the newer plans that are being debated now.
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How much $$ is earmarked for the Connector Contraption in Patrick’s proposed budget while DMR and other disability funds are cut?
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Must steps toward universal health reform require creating–and paying for–another costly and cumbersome layer of bureacracy? The answer must be “yes” if building on/propping up the private insurance industry is essential to getting “reform” through the legislature…sigh
I have been involved in the HC financing business for over 30 years and I know bad legislation when I see it. The MA reform legislation is some of the worst that I have ever seen. Let me tell you a little story that you should pass on to your MA political types. I am a Vietnam Veteran and the MA legislation reminds me of a anti-personnel mine that the Viet Cong would set for american infantrymen – it was called a Bouncing Betty. When you stepped on this mine it wouldn’t initially go off until you took you foot off of it and then it would bounce up to waist high and explode. The MA health care reform legislation is the MA politicians political version of the Bouncing Betty mine. When the politicians that support this half-assed legislation realize that it is unworkable, it will bounce up and blow their political ambition to bits.
Here’s an idea: Let’s be brave and talk about the elephant in the parlor – the wasteful, profit-driven, private health insurance industry – and what to do about it, shall we?
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Anyting less is just tinkering, even major tinkering, and serves to perpetute the tragic failures of the US and MA healthcare system.
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A colleague that John McDonough and I were with at a recent DC meeting says it very well below, followed by succinct commentary from a primary care doc:
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Profit For Some Or Care For All
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By Diane Archer, TomPaine.com, Feb. 27, 2007
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The health insurance industry is full of surprises, but history and
experience show that insurers will never surprise us with a good,
affordable health care system for America. No cocktail of
regulations, subsidies and tax credits will provide health security
to the uninsured, underinsured and anxiously insured; virtually all
Americans.
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Unlike private insurance, Medicare works for older and disabled
Americans because it pools risk and does not punish people
financially because they need costly health care services. It works
because it has predictable benefits and offers reliable coverage. And
it works because coverage is automatic, unlike Medicaid and SCHIP,
ensuring all eligible persons coverage and protecting them against
the risk of losing coverage for failing to sign up or recertify.
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Of course, every health policy expert out there knows that a publicly
administered system would guarantee all Americans good, affordable
health care at far less cost than we can ever achieve through private
insurers, and they’ll say so at the dinner table. It’s time they went
public….
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link to full article: http://www.tompaine….
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Dr. McCanne’s Comment: Request to the policy community: Please come out of the
closet. We need you!
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Get involved in making positive change by signing on at http://www.MassCare….. Thanks.
via the WBUR health blog:
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So things may not be as bad as they appear.
Notably, Kingsdale’s statement that plans under consideration by The Connector would not charge deductible fees for preventive services omitted whether they would charge a CO-PAY fee. If a $125 doctor visit for preventive care has a 50% co-pay, that’s going to be a problem for lots of people. Once again, we don’t have good information (or we have very selectively released information). Anyhow, the “preventive services” statement doesn’t address the example Alice Dembner cites, a person who had a colonoscopy for $1,250 and her deductible was $2,000. This was a diagnostic, not a preventive service, and she’s accumulating medical debt which, according to the Demos/Access Project study (http://www.accesspro…), she is likely to put on a credit card.
It’s copay,
Sounds like they are heading towards similar coverage schemes as they have been doing now. If you look at the benefits chart (pdf file) on the second page you’ll notice two columns, one for low premium and the other for low copay. They might take a similar approach on coverage. At this point we have nothing concrete to go with, so it’s a little frustrating. I know it’s still a work in progress. But I like the way it’s going.
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I’ve been away for awhile so these might have been posted already, but a few new postings on Connector web page. The excel file gives you the numbers and breakdowns by age. But the columns are missing ages 40-55. (or am I read it wrong?)
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New Health Insurance Plan will be Available for Under $200 (word)
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Young Adult’s Plan and Minimum Creditable Coverage (excel).
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–note, how’s the removing Microsoft from the state house going?
I mean, isn’t putting profit for health care executives and shareholders the meaning of patriotism?
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Who cares if the country is so riddled with debt that we can’t defend ourselves?
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Leaving my snark aside…this is the main problem with the philosophy the Republican Party has brought to the table. At some stage, selfishness has a price we all pay.