The public, including its “opinion makers”, is beginning to understand that the MA Health law rearranges deck chairs on the Titanic while throwing many uninsured and underinsured overboard to the sharks. A public backlash is sure to come. (to get a sense of the coming storm, see this one line excerpt from the below Daily News editorial):
“To risk oversimplifying a most complicated area of public policy: That’s what you get when you let the health insurance industry write the reforms.”
Cost Control and Health Care Reform
Waltham MA Daily News Tribune, Editorial, 2/10/08
The cost of health care continues its inexorable rise, bringing with it a host of problems: more people uninsured or underinsured, more spending diverted from other purposes, employers’ profit margins shrunk, state and municipal budgets stressed. Presidential candidates from both parties have looked to Massachusetts’ health reform law for answers, but they won’t find effective cost controls here…
Think of it this way: An industry has a product to sell, in this case health insurance. It’s a profitable business because most people feel they must have the product, but not everybody. Some people, mostly young and healthy, feel they can get away without the product. Others simply can’t afford it. Since the product keeps getting more expensive, the number of people who aren’t buying it grows.
But there’s one way the industry can get everyone to buy its product: Have a law passed requiring it…
An additional dimension of the law that the editorial doesn’t touch on is the state residents who’ll be paying double and getting nothing.
There’s likely to be over 200,000+ of these individuals who can’t afford the mandated insurance and aren’t eligible for state subsidies nor for a “waiver” (state permission to remain uninsured – how perverse is that?). Under this law they are facing tax penalties of up to $920.00 annually, all for the pleasure of remaining uninsured.
There’s a much more effective way to do health system reform and it’s up to us to make it happen, step by step by step. These reforms certainly should not include taking steps that are largely headed in the opposite direction, as is the new MA mandated private health insurance law. Although it is a VERY good thing that many are newly insured under the law – is it sustainable? Many in this group are already facing higher premiums and higher co-pays and may not retain their coverage. It is very uncertain if the state can sustain the bloated financing mechanism (The Connector) that was created with such fanfare. Let’s learn from this tragic misuse of power and put our state on a successful course to sustainable health system reform and quality affordable healthcare for all.
Yes, that's all true. Here's another glaring atrocity that everyone should know and understand –
They also need to know that if your employer offers you insurance (of their choosing, of course) and you can't afford it, you must sign a paper which goes on record with the state. This disqualifies you from any public plan for 6 months, even if the public plan is more affordable or better than what the employer offers. While still having no insurance, the employee is subjet to all tax penalties. This is written clearly in the law.
This is called “crowd out” protection and is a deal struck with insurers and the other “stakeholders” in order to ensure a continued flow of business.
DEFINITION: Crowd out – The substitution of publicly supported health insurance for private (profit-driven) insurance. Much of the Chapter 58 mandate is written so as to avoid “crowd out”, thereby protecting commercial insurance companies from losing business and profits. *For instance, if you have expensive insurance through your employer but it is less expensive through the Connecter you can't have Connector insurance because that would “crowd out” Blue Cross Blue Shield, Tufts or one of the other companies.
DEFINITION: Stakeholder – Function: noun Pronunciation: 'stAk-“hOl-d&r : a person entrusted with the stakes of bettors; must deliver the stakes to the winner
the scam here is to get mandated purchase of “insurance” part of law. Then shortly after that the insurance companies start cutting back paying for medical expenses.
Government refuses to regulate, media refuses to cover scamming insurance companies.
Codex alimentarius is going after homeopathic treatments and the same time. Oh, and medical records privacy? There is enough reason in that topic to avoid the medical establishment at just about any cost. Two middle fingers straight up on this subject.
p>When it does crash nobody but the most wealthy will have access to medical treatment.
The state of massachusetts has made being uninsured a crime!I have been calling and writting the state house and media to get the truth out about the outrageous treatment citizens have been recieving from their state reps and senators and the governor office.I was hung up on by the governor’s office.I am a 57 year old homemaker and my husband is retired.I don’t have insurance and cannot afford their plans.I feel our state has lost all sense of deceny by way they are not getting the truth out.To force citizens to buy into bogus insurance plans with $4000.00 dedutables or pay a penalty is beyond cruel.I am not wealthy but I am not a criminal either.Thank You AnEm for your post we need more people like you who care about the citizens of massachusetts.
is that the government is forcing people to buy a product from a for-profit industry. And what if Hillary gets her way, do you pay a double penalty if you don’t go along with the federal mandate?
if the mandate does not require for-profit insurance as with the anti-“crowd out” provision noted above, it would be a different story. If the law is written so that everyone has the option of choosing a less expensive public plan if they can’t afford their employer’s plan, then it would be a completely different story than what you’ve got. Still, singer payer/nonprofit health insurance is the only realistic choice…any system built primarily on for-profit health insurance is just too expensive.
…is the lack of preventative care (cheaper) being covered in favor of catastrophic care (Big $ for HMO’s)or Medicine through chemical (the Drug Companies Bigger $$) and mechanical (endless machines to be hooked up to by specialists that cost biggest $$$). Vitamins, exercise, massage, diet etc are ignored for the most part in HMO coverage. Interesting that only Huckabee talks about the preventative path as the way to control costs (not surprising with his own health transformation) and while Obama opposes mandatory Health care I don’t hear him talking about taking the Drug companies, HMO’s and the Medical industrial complex to task. And to be fair neither does Hillary. Edwards was the only one willing to take on that fight.
p>And yes the mandatory part is not Okay given I don’t really have a choice to have health care funded the way I practice it given the outrageous cost and impact on Business and municipal budgets (Otherwise know as Profitability and Taxes).
Does anybody have actual studies that prove it? Sure, preventative leads to higher quality of life in the short term, and longer lives in the, well, long term.
p>But, if preventative care prevents the heart attack that would have killed me at 52, does that mean that I continue consuming health care at high rates well after retirement? If so — if I’m consuming both more health care total and consuming it after I’m no longer generating GDP with labor — haven’t we actually increased the total cost of health care?
p>I’m not arguing against preventative care on the basis of quality of life — I’m merely stating that it’s not obvious to me that preventative care results in the consumption of less care, and/or less care after reaching retirement.
… that preventive care is cheaper. But only if you have to pay for the consequences of no preventive care. Medicare ensures that insurers never have to deal with the fallout, thats why the cost/benefit scenario for them is to forgo preventive care. Note that this doesn’t just mean what most would consider preventive care. Many actual treatments that are cost-beneficial over the life of the patient are also passed over for the same reason.
…. I pay for the preventive care out of pocket and then pay health insurance on top of that. I would rather have the option of covering what I do and then catastrophic and be able to limit the($$$) AMA Drugs and Machines version of Health care being all that gets covered.
Lasthorseman writes: “Oh, and medical records privacy? There is enough reason in that topic to avoid the medical establishment at just about any cost.”
p>You can run but you can’t hide with the mandate in effect.
p>“Interagency agreements” and “Matching Information”
What the Law Says – DATA GATHERING
p>The law stipulates that many State and Federal agencies will have access to the personal and financial information of all citizens and be used as needed. The law says that no specific medical data will be included.
p>All information and communication is done by an newly developed, internet-based computer system and updated and cross-matched monthly.
p>For those who question this, it is written into law.
p>Beginning in January of 2008, INSURANCE Companies will be required to submit monthly reports on the first day of each month of the previous month’s membership, identifying those individuals for whom they provided “creditable coverage”. The Bureau will maintain a database of all health plan membership to confirm who in the Commonwealth has health insurance coverage and during what time frames.
p>MEDICAL PROVIDERS, likewise, must submit monthly reports with similar and other unspecified details, or face substantial penalties and possible prosecution.
p>There are penalties for nonpayment or late payment by a employer, medical provider or individual who does not provide information within the state’s time frame –
QUOTE FROM THE LAW: “including assessment of interest on the unpaid liability at a rate not to exceed an annual rate of 18% and late fees or penalties at a rate not to exceed 5% per month and will be deposited into the Commonwealth Care Trust Fund” for use to subsidize non-paying individuals.
p>What this means
p>Some of these agencies that will collect and share personal information via the internet are:
p>-Commonwealth Health Insurance Connector Authority (Connector Board)
-State Division of Unemployment Assistance
-State Division of Health Care Finance and Policy
-State Division of Insurance
-State Department of Revenue
-State Office of Medicaid
-State Dept. of Public Health
-State Division of Unemployment Assistance
-State Dept. of Health and Human Services
-Department of Public Health’s Bureau of Vital Statistics
-Department of Veteran’s Services
-Department of Industrial Accidents
-Internal Revenue Service
-Social Security Administration
-Bureau of Special Investigations
-Department of Transitional Assistance
-Alien Verification Information System
-Health insurance carriers
-Third party (outside hired) contractors
p>Insurers, healthcare providers and employers must also report all client interaction via the internet.
p>Hospitals and health care providers are required to collect and report racial, ethnic and language data to the State.
p>The State has contracted for all individual information and billing functions will be held and processed in a huge computerized data base that is administered by an international company called Maximus. The State will pay $72 million dollars for this service. A new company called Vecna will cost the state even more money.
p>Not even considered is the security of the computer-based tax preparation firms who will process many thousands of these returns or the providers (doctors, clinics, hospitals, etc.) who are required to report by this system or the potentially thousands of private bookkeeping and accounting firms who will have this personal information.
p>We all know just how “secure ” the internet isn’t, don’t we?!
p>This doesn’t even take into account the human factor, as when in September 2007 the State sent personal information – including the social security numbers of 450,000 citizens – to 23 nationwide commercial marketers. These disks were sent by regular US Postal mail! The data breach victims were not notified until eight weeks after this “computer programming error”. The State’s advised remedy for this is for the affected victims to contact the credit rating bureaus and check their banking and credit card statements.
p>Thanks for the security of our private information, folks!
I will set up a fund to cover uninsured tax penalties.
Look up Infragard. Don’t taze me bro has become don’t shoot me Mr CEO.
I want universal health care–single payer healthcare, government paid for healthcare, whatever healthcare, but it has to be real, real cheap, it must cover everything from a headache, to a runny nose, to I don’t feel like going to work today, to terminal cancer, to stomach stapling because I can’t keep from stuffing my face.
Then there are the alcohol, illicit drug and smoking issues. The onus is on the government to take care of every medical need and the moment I desire and there must be absent any financial consequence to me.
p>All healthcare providers must mainatin a sub par standard of living viz a vis their educational requirements. Salaries will be held stagnant.(we don’t want to break the bank) R&D for pharmaceuticals will cease (again, healthcare must cost nothing to the consumer) R&D for “machines” to maintain life during crises will also be put on the back burner (again, we’ll spend the money on vitamins)
p>It’s a shame that healthcare workers can’t ask in remuneration what the market will bear. “How much is your life worth?” Roger Clemens and A-Rod are worth tens of millions per annum. How about heart and neuro surgeons?
p>Would some please edify me on exactly where you plan on making cuts? It has been my professional experience that when folks have their own ass on that table they want ALL medical intervention possible. Expense is not an issue. S0—–who is going to be denied service.
p>FYI. Many healthcare providers are now limiting or refusing to see any further medicare patients. Why? Reimbursement is essentially zero.
It’s great. Dental is completely covered by MassHealth. But, no dentists take it. Damn you invisible hand!
I’ve worked as a nurse for 15 years and in the healthcare field for almost 30 years in a wide variety of settings and have never experienced what you attest to, mcrd. I do know the problem gary raises r/t dentists not taking MassHealth and that is a serious issue for sure. I believe this would be addressed through the implementation of an improved American Medicare-for-all national health program. After all, we are already spending >$2.1 TRILLION annually as of 2006 in the healthcare sector.
p>For readers who are intersted in a serious and detailed discussion on how a national health program that uses streamlined financing (often called “single payer”) to provide quality affordable care for all would be financed and how it would function, try this excellent piece:
p>I’d start by banning/severely limiting ads for specific prescription drugs. I’d also allow regulated re-importing of drugs from Canada.
p>I’d also raise taxes on smokes and booze — there’s substantial evidence that consumption of these items decreases as price goes up, especially excessive consumption amongst younger groups. Reduce the consumption, you just might be reducing the number of people who miss work due to anything from hangover/head cold to heart/lung disease. So, you get more tax revenue up front to help pay for care, and you get more revenue on the back end [more total hours of work availability per lifetime per person] in the form of income tax.
p>I’d open up federal universities, and I’d certainly seek to increase the supply of doctors and nurses. Since we’re going to have more people seeking health care, we’d better increase the supply of health care providers.
p>I’m interested in electronic medical records, but I don’t know enough about the system to have any sense for cost/benefit/privacy issues.
We should definitely put the money being spent on armies of drug researchers and Life Science companies into better access to more general (lower paid) providers, and arm the providers with the secure records and information they need to either provide treatment or refer to specialists. Too many people go deaf from untreated ear infections, or sterile from undiagnosed STD’s for us to be spending $1B on figuring out how to make future people better.
p>Retiree on social security taking $13,229 in benefits pays $1,122 in Medicare Premiums, or $93.50 per month.
p>Younger, non-retiree earning up to $30,630 pays pays $105 per month,05 per month, and that’s too much? As link shows, if you earn less, you pay less. Regardless, the Connector insurance for the lower wage earner looks generous compared to Medicare.
p>I’m missing the outrage. Can you elaborate on who the missing 200,000+ are and why said plight exists?
There are 3 sets of plans, Gold, Silver and Bronze, my guess is that we’re talking Bronze, which has an enormous amount of money defined as a deductible. You are basically paying a monthly premium for the opportunity to pay an enormous deductible.
This is the spec sheet (Fallon) for the least expensive plan (i.e. highest copays…) I don’t know how this compares to Medicare, but for a young otherwise uninsured individual, it looks pretty decent, no?
p>Deductibles and copays notwithstanding. The original post laments that 200,000 people can’t afford the coverage. I still wonder where this figure comes from.
How many of us have health insurance at work they ask for your children’s birthdates and SS number than the company gives you a flat rate family plan. In our newly designed state plan there is no family plans, each person pays depending upon their age, which is never a factor under any family plan I have had which would be Tuffs and Fallon. So what we did was give this “private industry” which has shown an increase in profits the ability to charge more for the same service they provide for less.
p>In fact based on the increased in those being covered the PRICE should have gone down not up but the Fat Cats on Beacon Hill look the other way.
p>I think we should mandate those in the Senate and House to pay for their own insurance threw these plans and we would see a big change quickly.
p>One more bill we need to pass is make the House and Senate a full time job where they must pass in a time sheet weekly in order to get paid……..now you want to see a lot of crying.
p>We need to address GREED within the system but Patrick who claims to be for the people looks the other way. But as we can see it has not taken long for the people to see Patrick is not for us and the democratic primary was a big time “in your face” Governor.
Your medical records WILL be used against you!