… by a quite skeptical observer, Matthew Holt of The Health Care Blog. Kingsdale does pretty well defending the plan, noting that 120,000 previously uninsured people are now getting quite good care, and talking about the new plans negotiated by the Connector. He’s rather less convincing defending the paltry (and uncollected) $295 uninsuring-employer fee … but he wasn’t responsible for that particular bit of legislative sausage anyway.
Here’s an intriguing tidbit — Kingsdale looking down the road at the debate to come:
I think that the cost issue is going to come bubbling up in a way that’s never happened before, as a result of this reform. The problem we have now in this country is we have two separate dialogs that go on. It’s sort of like the authorization and the appropriations process. On the one hand, the dialog at cocktail parties or in the press or public meetings about: “My doctor’s great,” “This hospital screwed up,” “Isn’t it great they can now replace my hips with artificial hips, and I can walk again?” And then you have this conversation about affordability and cost, and how outrageously expensive it is. And those two conversations go on separately. We’re actually going to bring them together … And I think that’s going to have a tremendous impact on competition in the market.
I can actually imagine that happening.
Give it a read, and then ask your MA-05 candidates exactly how much and which parts of the MA plan they plan to export nationwide.
John Kingsdale is truly naive and out-to-lunch if he thinks that the Massachusetts model of health care reform will spur the long-term containment of run-away health care costs in the health care system.
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The HMOs, PPOs, and other private managed care insurance organizations have spent the last twenty years wringing out maximum costs savings and trying to hold down medical inflation through the imposition of high deductibles, co-payments, using internists as gate-keepers to specialized care, capitation of payments for medical services rendered, and required use of generic drugs. Nevertheless, last year, premiums for employer-based health insurance rose, 7.7%, on avarage; small employers saw their premiums increase 8.8 percent, and firms with less than 24 employees experienced a 10.5% increase in their premiums.The annual premium that a health insurer charges an employer for a health plan covering a family of four averaged $11,500 in 2006. Finally, workers contributed nearly $3,000, or 10 percent more than they did in 2005. The annual premiums for family coverage significantly eclipsed the gross earnings for a full-time, minimum-wage worker($10,712.)
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Indeed, I would argue that the high-deductible, high premium, and exorbitant co-insurance components of most of the private health insurance plans approved by Mr. Kingsdale and Connector discourage low-income insurance plan enrollees from seeking the type of regularly scheduled primary and preventive health care (such as annual physicals or mammograms) required to hold down health care costs in the system. The health insurance plans approved by the Connector penalize thoughtful health insurance plan subscribers whou make judicious, selective, and preventative use of their primary care docs by requiring these enrollees to spend $2,000-$4,000 and, in some cases, significant co-insurance monies before their health insurance benefits kick-in. A state health care reform initiative that discourages the utilization of inexpensive primary and preventative health care services should be resisted actively by Massachusetts citizens by demanding that Mr. Kingsdale and his political colleagues in the Legislature scuttle this hopeless endeavor and go back to the health insurance reform drawing board.