Amid rising health-care costs and growing legions of uninsured, Kansans and Missourians are looking to Massachusetts.
The Bay State’s Legislature on Tuesday passed a groundbreaking bill to provide nearly universal health-care coverage. The bill, which Republican Gov. Mitt Romney says he will sign, requires all Massachusetts residents to obtain health insurance.
People who can afford private insurance will incur financial penalties if they do not buy coverage. Government subsidies to private insurers will enable more of the working poor to buy insurance and will make more children eligible for free coverage. Businesses with more than 10 employees that don’t provide coverage will get hit with fees of up to $295 per employee per year.
The program will cost more than $1 billion a year, though much of that money will come from shifting existing funds. Massachusetts will provide $125 million in new money, mostly to help pay for health insurance for lower-income residents. The rest could come from existing programs and the penalties paid by businesses and individuals who don’t follow the law’s mandates.
The bill, the first of its kind in the nation, is poised to take effect as America grapples with the problems of 45 million uninsured individuals. Health experts say that the lack of health insurance frequently leads to illness and premature death, and that the health-care costs of the uninsured get shifted to those who have insurance.
As a physician, and an individual who had no employer provided health insurance for several years, I am divided on this issue. While I don't think that "bigger government" is ever the solution, clearly the current system is broken, and needs improvement.
As a nation, we probably can't afford a true universal health care system. However, we have the money as a society for indigent care, often provided in our Emergency Departments. Just the other night, the ED physician was complaining to me at 2 AM as to why he was seeing a child with an ear infection. That child would clearly be better served in a pediatrician's office during the daylight hours. After all, that one visit to the ED probably could pay for a years worth of visits to the ED.
I give credit to Massachsetts for grappling with the problem, and trying to urge all to get health insurance. They are continuing with an employer based model, that has served the needs of many, but clearly not all.
However, if an employer chooses not to provide insurance, they pay a $295 fine...annually per employee. In the current marketplace, one month's insurance will cost more than that, so this is not much of a fine at all. There is also talk of eliminating the fine altogether.
Also, if an individual chooses not to get health insurance, they pay extra state taxes. Isn't this going to place an unfair burden on the already cash strapped poorest of the state?
In my opinion, this is too radical a step for the nation's uninsured. Some might see it as a way for a state to collect more taxes under the guise of providing universal healthcare. I would like to see as a first step, a way that families, that are not otherwise eligible, be able to "buy in" to Medicare. Also, employers that have someone working for them need to provide insurance for them, and not redefine them as per diem, or consultants for the sake of not providing benefits.
If Massachsetts real goal was to bring the issue of affordable health care for the uninsured to the national table for debate, they clearly have succeeded. In the meantime, we'll all have to see how this plays out, and it's not clear how many folks will be helped. Don't think for a minute that now everyone in the state will be automatically covered.
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4 comments:
Why does everyone automaticly assume that healthcare should be provided for no money? Or that one individual should pay for anothers healthcare expenses? It's rediculouse at best and socialistic at worst...
The answer to healthcare in the US is amasingly simple; if you want healthcare, payfor it yourself. The free market system would sort this out IF the government could simply staty out of the matter...If they did, you would see a cotage industry of lower priced medical equipment, drugs, and healthcare.
I don't think that you're amazingly simple answer is the answer. The problem created by the uninsured Americans is that the cost of health care is skyrocketing due to hospitals trying to recuperate the costs of providing medical care (typically emergency, the most expensive)to unisured individuals. The program proposed by Mass. is not providing free healthcare for all it is requiring the people who can afford insurance to get it and those who cannot to at least pay a portion of it. The end result is less of a burden on all. The people who did not have insurance previously and were running off to the emergency room for medical care will now schedule an appointment with a doctor at a far more affordable rate. I don't know if this truly is the answer but I at least admire the attempt to fix a system that is clearly broken.
"The problem created by the uninsured Americans is that the cost of health care is skyrocketing due to hospitals trying to recuperate the costs of providing medical care (typically emergency, the most expensive)to unisured individuals."
Actually, my solution would solve that problem by not providing healthcare to uninsured individuals...Only those who pay for insurance/healthcare should by all logic receive those services. Like I mentioned before the free market system would work this out over time...
A pure free market system wouldn't work in health care. What do we do when an uninsured patient arrives in the ED with an emergency condition? Turn them away at the door? I think the idea of an affordable entry system into healthcare is what is needed. $500/month is not affordable for most Americans, and a family plan costs even more.
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