Health Care Massachusetts Health Care Reform

Universal Health Care Education Fund, 33 Harrison Ave, 5th Floor, Boston, MA 02111-2040



To the Editor:

Re "The Massachusetts Model" (editorial, June 16):

As a Massachusetts primary care physician, I dearly wish that your optimism for our state's health care plan were well placed. My fear, however, is that any plan that does not eliminate the colossal waste of multiple competing private health insurers is doomed to failure.



Costs can never be contained while supporting bloated private bureaucracies and for-profit medicine. Most physicians now support single-payer, national health insurance ("Medicare for all").



Alan Meyers, Boston, June 16, 2008

The writer is associate professor of pediatrics at Boston University School of Medicine and a founding member, Physicians for a National Health Program.



To the Editor:

You hail Massachusetts’ health reform as a promising model for the nation. But within the last year both the State Senate president and the executive director of the agency implementing the new law have publicly recognized that it will collapse if health care costs continue to rise by double digits, which they have.



No effective cost-control legislation is in sight. In Massachusetts we see history repeating itself: a large expansion of Medicaid in the mid-1990s added more than 300,000 residents to the rolls, cutting the uninsured population almost by half. A few short years of rising costs, however, were enough to erase those gains and place the state back to where it started.



Similar fates have befallen many "universal" state reforms hailed as models for the nation. Without eliminating the waste inherent in commercial health care systems and making comprehensive coverage a right, no country has ever been able to achieve universal health care.



We need a single-payer health care system that will be there for our children, not another unsustainable experiment with obvious math problems that won't be there just a few years from now.



Benjamin Day, Executive Director
Mass-Care: The Massachusetts Campaign for Single Payer Health Care
Boston, June 17, 2008



To the Editor:

Your editorial lauds the Massachusetts health care reforms as "off to a good start" and "heartening." The editorial addresses the reforms' higher than projected costs thus:

"The shortfall occurred mostly because the state underestimated the number of uninsured residents and how fast low-income people would sign up for subsidized coverage. It is a warning to other states to keep projections realistic."

I'm sorry, but if states can low-ball the cost of reforms to get them enacted, and still get praised by the paper of record, that's exactly what they'll do. Some "warning."



Michael F. Cannon, Director of Health Policy Studies
Cato Institute, Washington, June 18, 2008



http://www.nytimes.com/2008/06/19/opinion/l19health.html



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Anxiety Over Health Insurance Shapes Life Choices
By VICTORIA E. KNIGHT, The Wall Street Journal 6/10/08


Anxious over being caught uninsured or paying sky-high premiums, some people -- especially those with health problems -- are going to great lengths to get or keep job-based health coverage.



Wedding dates are being moved up to quickly get both husband and wife on a company plan. On the flip side, married couples are holding off on getting divorced so they will both stay on their existing plan. In some cases, those who are self-employed are going so far as to hire employees to qualify for group insurance.



Concern over coverage also is affecting a host of other major life decisions, insurance-industry watchers and financial advisers say, including the age of retirement and the state where people choose to live.



"People are turning themselves inside out to get health insurance," says Karen Politz, a research professor at Georgetown University's Health Policy Institute in Washington.



Under federal law, insurers are required to charge all participants the same for premiums in employer-sponsored group plans regardless of health status. In state-regulated individual markets, by contrast, people with health problems may end up paying high premiums, face exclusions for past or existing medical conditions or be denied coverage.



Financial advisers say health-coverage worries are rampant among clients. For those with medical conditions, conversations increasingly center on how to get or stay on a group policy or segue into the individual market in a way that prevents insurers from denying coverage or excluding pre-existing conditions.



In certain circumstances, two federal laws -- Cobra and Hipaa -- provide such protections, but the rules can be complicated. Insurers may not be limited in what they can charge participants, although some states may set limits. If you are young and healthy, you will likely find a less-expensive policy in the individual market.



"Access to coverage is a huge issue," says Leon Rousso, a certified financial planner in Ventura, Calif. "You may have the financial means to pay for premiums but not be able to get coverage, leaving you exposed to potentially catastrophic losses if you become ill."



Obtaining insurance through an employer is often the easiest way to get comprehensive coverage for those who don't qualify for Medicare or federal or state programs for the very poor.



Employers tend to subsidize premiums, making it more affordable for those in poor health who benefit from being part of a larger risk pool. The coverage tends to be more comprehensive and cost-effective in group policies.




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