| Massachusetts health care delivery has become the model for Congress as they seek to enact insurance reform. But is the 2006 Massachusetts law that mandated private insurance with subsidies for the poor a valid model? Will it work? While it is certainly true that more people in MA have health insurance than previously (duh, you make it the law that people have to be insured, you'll see more insured people) the program has failed to live up to it's promise of affordable health care for all. Further, given the current economic situation, many elements of the program for the most vulnerable are being ripped to shreds. Here are some of the highlights: Facing diminished revenues and large numbers of unemployed people seeking coverage, Connector officials this week announced a $115 Million slash in subsidies. According to a front page story in the Boston Globe, “an estimated 18,000 poor residents who qualify for full subsidies, but who forgot to designate a health plan, will no longer be automatically assigned a plan and enrolled and thus could face delays in getting care." Connector officials eliminated dental coverage for more than 90,000 people enrolled in Commonwealth Care, for an estimated savings of $10 Million. Twenty eight thousand legal immigrants also face the loss of their state subsidized medical insurance as a result of being dropped from the budget recently approved by the legislature.
But wait, there's more: “PNHP’s study of the Massachusetts model found that the state’s 2006 reforms, instead of reducing costs, have been more expensive than expected. The budget overruns have forced the state to siphon about $150 million from safety-net providers such as public hospitals and community clinics. (actually, Boston Medical, our largest safety net is suing the state for funnelling money away from the care they provide to the poor to pay for the MA health program--masslib) “Many low-income residents, who used to receive completely free care, now face co-payments, premiums and deductibles under the new system - financial burdens that prevent many of them from receiving necessary medical treatment. Since the state’s reforms passed, premiums under the state insurance program have increased 9.4 percent. The study found that if a middle-income person on the cheapest available state plan got sick, he or she could end up paying $9,872 in premiums, deductibles and co-insurance for the year.”
According to a recent Wall Street Journal article, some MA residents are buying the insurance when really ill, and then dropping it after treatment (which, I would argue is because the premiums are too cost prohibitive). That sounds like one way to get the care you need out of a completely disfunctional system, but what about preventative and follow-up care? The MA test is recent and now Congress is set to take it national without much discussion on whether or not it has succeeded. Does this sound like universal health care success to you? |
