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Massachusetts Gets Universal Health Coverage
Massachusetts looks set to pass legislation to guarantee universal health coverage—the first state to do so—and that should count as good news, even if the policy itself might have a few kinks in it. At first glance, the new law will require everyone to carry health insurance or face higher income taxes, provides subsidies for low-income workers (those making under $9,500 a year get free coverage), and levies a very small fine on businesses that don't provide health insurance.
As with most things, the devil's in the details. Matthew Holt has an incisive comment here—how this plan fares will depend on how the state regulates its insurers. If insurance companies are allowed to offer cheap policies to the healthy and unaffordable policies to the unhealthy, then the market will implode; those people forced to buy very expensive policies under the new mandate will simply end up underinsured, with all the risks that entails. Or perhaps insurance companies will be very heavily regulated (Massachusetts already requires community rating, which is good); we'll see. Leif Wellington Haase also notes that funding issues, which have torpedoed many a state universal health care plan, could become an issue.
Ezra Klein says he would've preferred legislation that severed the tie between employers and the insured. That might be ideal, although now we'll see once and for all whether individual mandates, which are often touted as a moderate alternative to single-payer or single-insurer systems, can actually work, and how well. There's something unsettling about watching states "experiment" with various approaches to universal coverage—there are, after all, actual lives at stake here—but seeing as how the U.S. health care system is going to need a radical overhaul once someone who actually cares comes to office, it will be good to have evidence on which systems work and which don't from as many states as possible.
Posted by Bradford Plumer on 04/06/06 at 11:08 AM | E-mail | Print | Digg this | de.licio.us
Comments
Krugman and Wells have well documented how the gov. pays directly or indirectly for more than half of the nation's health care, but the actual delivery both of insurance and of care is tackled by a "crazy quilt of private insurers, for-profit hospitals, and other players who add cost without adding value."
According to these two: "A Canadian-style single-payer system in which the gov. provides insurance, would almost surely be both cheaper and more effective than what we now have. And we could be even better off if we learned from "integrated" systems, like the Veterans Administration, that directly provide some health care as well as medical insurance.
I have to agree with them, and disagree with Mr. Haase about his concerns with single-payer coverage: That new technologies are less likely to be incorporated, that private insurers won't get on-board, and that costs will escalate.
Certainly new technologies would be introduced and embraced--unless stymied by a corrupt, disgruntled bureaucracy..., private insurers are exactly what we need to do away with, and costs would be cut, where currently they're escalating bigtime...
Pertinent here is how, "The military is now venturing into joining the problems the rest of our health care system is experiencing," or so says David Blumenthal, director of the Institute for Health policy at Massachusetts General Hospital in Boston. "You're in for a long struggle."
Like private employers, the Pentagon is facing an aging "population," skyrocketing prescription bills and a technological explosion that has spawned an offspring of pricey new tests and treatments.
Sen. Tom Coburn (R-Okla.) says the problem is not the military but the entire health system, "It's broken for our military; it's broken for everyone else."
My point here is that we should do away with a separate Veterans Admin., and instead have all "participate" in a Nationalized Health program.
As for the Massachusetts universal health coverage plan, well I can't help but think it would exacerbate the problem of soaring prices by catering to the current "status quo," where, on the one hand, much money is wasted through an "inefficient" system, while, on the other hand, insurance companies make out like bandits...
Posted by: Michael L. Wagner on 04/06/06 at 2:24 PM
As a resident of Mass I can tell you this is a scam! This is an Insurance company bill. It is designed to create windfall profits for the industry. The bill victimizes low income residents who can't afford healthcare by taxing them if they don't pay insurance companies for coverage. A universal, single payer, nation wide plan is the only way to solve our healthcare coast problems. Mark my words: In two years this "plan" will implode. As usual the people get screwed!
Posted by: Bruce Pieroni on 04/11/06 at 5:22 AM
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I like the idea in theory, but I'm not sure about the details of this particular plan. And it doesn't loko like there's anything to stop companies from simply hiring contractors instead of employees, thus negating the plan. Or maybe I missed something.
Posted by: Josh Boelter on 04/06/06 at 12:23 PM