Thursday, April 12, 2007

Weak: Universal Healthcare Not to Be Universal at All?

If this story is true, I'm going to be very, very disappointed.

To remove the threat of a public backlash, the state plans to exempt nearly 20 percent of uninsured adults from the state's new requirement that everyone have health insurance.

The proposal, expected to be approved by a state board today, is based on calculations that even the lowest-cost insurance would not be affordable for an estimated 60,000 people with low and moderate incomes who do not qualify for state subsidies. Forcing them to buy insurance or pay a penalty could jeopardize the rest of the state's initiative, officials said. Instead, the state board appears prepared to settle for near universal coverage, all but 1 percent of the state's population.
Talk about a non-solution to a problem. The problem in insuring these brink cases is affordability. So, instead of the state actually fulfilling their promises to help with affordability, they're instead going to go into the realm of The Quasi. That way, they can still pat themselves on the back and say "we got Massachusetts Universal coverage," except they'll be lying lairs - liars who got quasi-universal coverage, coverage that fails to cover 20% of the people they sought to cover.

No one fool themselves: it's not universal insurance. It's also not acceptable.


Cent21 said...

Why do you think Romney pushed health care reform the last year he was in office?

I don't know the answer here. Romney didn't either, so he left implementation up to his successor, who can take the blame for the rough spots.

Charley on the MTA said...

It's probably true that that's the case. You're right, it's not true universal coverage.

But for those 20% uninsured, it's no worse than the status quo, which is after all what most states have. There are many thousands of people who didn't have care before Chapter 58 that now do. That's just undeniably good.

We gotta figure out a way to insure the rest of those folks. Hopefully that'll be easier when we get more folks into the risk pool; but we still need the political will to 1. increase subsidies for folks of modest incomes (i.e. $$$), and 2. control costs by rewarding quality, not quantity. Those are both tough sledding.

Ryan Adams said...

Honestly, while I'm willing to give this a try, I really think we need true universal coverage - a la the Netherlands. It'd be nice to see some real expiramentation in Massachusetts and for the state to go that route - but that seems like wishful thinking.

It can't possibly be that much more money to get that last 20% though. I know the numbers are crunched - and I know Deval doesn't (and won't) raise the income tax, but there's got to be some kind of funds that could be shifted toward the health care bill. Otherwise, while a good effort, we've failed at what we set out to do.

Charley on the MTA said...

Funny you should mention ... until 2006 the Dutch didn't have a totally universal system, either. They did have the right priorities -- primary care, lots of nurses -- and they spent their money well and wisely. But they're not a "single payer" system, either. They're just better. MA could stand to pay attention to what they do well.

Ryan Adams said...

Well, that's a good point Charley - and perhaps I should be a little more patient - but this does seem to me to be such a small number of people that we could be the change we want in this situation. We could, for example, gaurantee the $150 a month option - and be willing to pay the difference for people in that very small threshold who don't get it.

Anonymous said...

It never should be universal health care. That is the wrong answer. Putting it back into the private sector is the answer.

By the way it was your fat cat Ted Kennedy that started the mess we were in with the passage of the HMO Act in the early 1970's. Now you want to government to make the mess even worse?

Government is never, ever the solution to any problem.

Ryan Adams said...

Really? Government can't be the solution to health care? Almost every other industrialized country would disagree.

America pays far more for its health care system, yet we derive far less from it - with 45 million Americans going without health care and even more than that with lousy plans, we have a failing system.

Anonymous said...

And you think health care won't be even more expensive and more shoddy with government running things? As it is, the government has regulated health care to such an extent that it has reached its porous state.

I'm sorry, unlike you I don't place blind faith in the government to run anything right. Maybe you should study economic theory and realize why socialism has never, and will never work.

To quote Eric Phillips: Of course, the health care crisis that this new government intervention seeks to remedy was caused by government in the first place. Licensing laws limit competition; services that could easily be performed by nurses at lower costs must be performed at higher costs by a government-approved doctor. Many states prohibit you from seeing a doctor licensed in another state, even if he is a specialist that would be better able to treat you. In addition, fees are raised due to costs involved with complying with regulations. As frequently reported on the news, the cost of malpractice insurance has skyrocketed, further increasing costs. This is, in part, because courts generally refuse to accept contractual agreements in which patients waive their right to sue in return for a lower price. Indeed, physicians can be sued for simply turning down treatment of a patient. In addition, instead of allowing some type of charitable system to develop, the government simply forces hospitals to treat patients, regardless of their ability to pay, thereby passing the costs on to other patients and taxpayers (since over 30% of health care transactions involve Medicare or Medicaid). Further, government subsidies keep researchers busy on projects chosen by politicians, who chose programs on the added basis of political expediency (see the late Harry Browne’s Why Government Doesn't Work).

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