This is an idea only an economist could love … or Mike Widmer: Start charging people for using free health care rather than signing up for insurance.
The rules, which are scheduled to take effect Oct. 1, are part of the state’s effort to push nearly everyone in Massachusetts to get health insurance. To fund subsidized coverage for low-income people, the state is drawing on money previously used to pay for free care at hospitals and health centers, so the state needs to reduce payments for free care in the long run.
Last month the state said it planned to stop reimbursing hospitals and health centers for care provided to patients who are eligible for insurance through the state Medicaid program, the state-subsidized Commonwealth Care, or affordable coverage through their work. The new rules would require all but the lowest-income patients seeking free care to make small copayments for hospital visits and patients earning slightly more to pay deductibles of $35 a month. These fees are comparable to what people would pay for Commonwealth Care insurance, although the free-care system does not provide the same comprehensive coverage.
All kneel before the ALMIGHTY ECONOMIC INCENTIVE! May we, by our rational action, be worthy of thy grace.
Sounds like a bad idea for a number of reasons:
1. people’s health will suffer, since they’ll be discouraged from getting necessary care;
2. as Mrs. Meehan points out, hospitals will be unlikely to collect anyway;
3. we’ve got huge delays and lost paperwork in getting people signed up for subsidized care under the new law — should they just go without care while the state gets its act together?
I understand the state wants to get people covered and off of the emergency-room-care, free-care merry-go-round — that’s really expensive. But there’s no good reason to rush into that, especially not at such a human cost.
The way this is supposed to work is even worse than you think. Patients using the Health Safety Net program who are 150%-200% of poverty (about $15,000-$20,000) will have a deductible of $35 month when they use a hospital. That’s bad.
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But the deductibles accumulate, month by month. If you start off in January, and don’t use the hospital until October, that’s 10 months so you owe $350. You pay even if you don’t use the hospital. The most it can grow is to $420, after a year, then it resets back down to $35. That’s very bad.
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– Patients are expected to keep track of when they’ve paid and how much they still owe. I don’t think so.
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– The incentive is to not sign up, since the $35 starts accumulating. But if you don’t enroll, you can’t get primary care at health center, even though it’s free. Result: sicker patients.
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– As you get to the end of your year (everybody will have a different start month), the incentive is to stay away from the hospital at all costs. If you hold out long enough, your deductible will reset and you just owe $35.
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Lots of detailed testimony against the proposal here: http://blog.hcfama.o…
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Are you sure? That doesn’t sound right. For example, using your description, GUY goes into hospital for 5 day stay on December 25. Owes $420. But, if same guy goes into hospital for 5 day stay on Jan 1, then he only owes $35.
that’s pretty durn cheap for a week in the hospital, unless that was just the bill for aspirin.
Lament the poor sick guy earning $28K per year who can’t afford a $35 monthly deductible. (Wonder if he can afford a cell phone?)
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Instead, let’s opt for “medicare for all” that is the brainchild of
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Under the moonbat plan, there’d be a 3.3% payroll tax so the same poor sick guy who’d be paying $35 dollars deductible per month or $420 per year, instead would get free health care. Of course he’d be paying over $900 per year of extra tax.
with Massachusetts’s first attempt in the nation at some kind of health coverage for EVERYBODY?? I thought “progressives” cared for the well being of all the people?
Clearly, the “younger crowd” doesn’t like it because they believe that they never get sick anyway so why should they be required to have any insurance at all? Or if they do get pneumonia or break their arm in a motorcycle accident that the emergency room is always available at State expense or ‘bill me “and the chase is on for payment to a hospital that will probably see their bill turn into another “bad debt” with the cost being passed on to those who pay for insurance.
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To the younger crowd, this is some kind of big business “cabal” to rip them off by forcing them to have insurance.
To me, and the older crowd , I’m sure, the new coverage for all program is a Godsend.
After losing my job at 62, COBRA for me and my wife was $677 a MONTH!!! Young people (who are convinced that they are immortal) don’t realize that a heart attack or other serious medical problem can absolutely devastate someone’s life savings.That aside, as a recent retiree, I now have a small social security benefit which requires me to pay $35 a month for insurance…wow thank God! compared to $677!which I had no possibility to afford. Thank you former governor Romney and Sal Dimasi for this incredible blessing!
The new health insurance program may have lots of problems and many detractors. In any case , it’s a hell of a lot better than what we had just a few years ago which was NOTHING.
and I don’t consider a government law that requires me to enter a financial contract with a private company to be progressive. Heck, the government won’t even let me commit suicide to avoid the contract; that’s illegal too!
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And before you cite auto insurance, I choose to live in the Boston metro so I don’t need to own an auto. My wife feels the same way — we both work full time, and own zero automobiles. Auto insurance is optional because owning an automobile in MA is optional.
Preliminarily, I reject the use of “progressive” as applied to me. I consider myself a pragmatist.
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Let me parse this
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I thought “progressives” cared for the well being of all the people?
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Actually, that is very pragmatic. Public health began, in large part with the extensive use of sewage service in western Europe, and in NYC because of Typhoid Mary. I am not joking. Illnesses in some people can extend to others. Wealthy people might believe that they can isolate themselves from the health problems of the lower classes, but the fact is that they can’t.
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To the younger crowd…
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There is something of an inter-generational contract. We, in our working years will pay to educate you, in the younger generation, so that you might be able to earn a liveable wage when you are older. But we expect you to support us in our older years. From what I read long ago, within an extended Chinese family, that was the case. We do not have extended families in the US, but we do have similar societal structures. We will support the younger generation in our middle years in the expectation that when the younger generation matures, they will support us in our older years.
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The extent of support is negotiable, but it is very real. Otherwise, I would not have any interest in providing any form of support for other peoples’ kids.
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After losing my job at 62, COBRA for me and my wife was $677 a MONTH!!!
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You are fortunate. I am 57, and my last MA BCBS bill was at an annual rate of in excess of US$8000. That was higher than my German mother-in-law’s bill here in Germany. And she, at 77 years old, is a breast cancer survivor (she’s private-pay, so she has to have private insurance). BCBS refused to pay for virtually anything for me; her policy pays for everything, including eye-glasses (two pair per year). There is something totally out of wack with the American health care financing system.
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I wrote that I was a pragmatist. The MA health care “solution” is cute, but what is going to be done if a resident of MA is unable to afford the nearly US$3K/month that is to be charged. You can’t evict them from the state. So, as far as I can see, you will go back to the beginning. Low income people who cannot afford the premium will still go to the emergency room. As far as I can tell, this “solution” is merely window dressing.