Saturday, May 19, 2007

Again, Universal Healthcare Not So Universal

People who can't afford their plans at work aren't eligible for the state plans.

The more and more I hear about this, the more and more I don't think this health care plan is going to work. While better than what we had, in its current form it seems more like corporate welfare than any honest attempt to solve the health care problem. It does nothing to solve rising costs, while leaving behind hundreds of thousands in our "universal" insurance.

It's time to start creating the plans to switch to single payer. It would save this state tens of millions of dollars.


AnnEM, RN said...

Ryan, you are so right about single payer reform being the best solution; it would SAVE us well over a BILLION dollars in year in our state alone!! I hope you're active with, the coalition to create a single payer financed, universal coverage health system that places people before profits.

For you and others that might want data on such reforms, the BU Health Reform Program has a wealth of info. Here's their link

Below is an excerpt from one of their many great reports "Health Care for All in Massachusetts Requires Cost Control, 3 March 2006, 74 pages". See item #6 in particular...


Massachusetts health care and current reform plans are complex, so this report is long. Yet it’s only about 1 page for each $1 billion spent on health care here.

1. Health care for all in Massachusetts is like the weather. Everyone talks about it but few want either to pay more to achieve it, or to act seriously to cut costs.

2. Since passage of the state’s failed 1988 employer mandate, health care costs have risen by 38% as a share of the economy. Despite spending more—and probably because of rising costs—the share of residents uninsured rose 78%.

3. Even without reform, health costs this year will soar almost $4 billion—almost four times what the House bill adds to cover uninsured people.

4. Though costs are soaring, spending even more seems the shortest political path to insuring us all. But the added sums can’t buy solid insurance policies.

5. Flimsy paper coverage may result. A numbers game of counting nominally- insured people may be replacing real financial protection. That’s no solution. Many people are already under-insured and can’t get needed care.

6. An even flimsier individual mandate attracts support because it doesn’t yet face political opposition. But it is regressive, abandons responsibility to cut costs, and is a bad deal for patients, caregivers and taxpayers. Its administrative cost could exceed that of group plans by $250 million per $1 billion in added premiums.

7. The House payroll tax is fairer and job-friendlier than flat premiums. But its mandates and subsidies pour water on the sinking ship of private insurance. Private health insurance protects waste in health care, harming patients.

8. Rising public subsidies will be hard to fund. Health care costs here rose by 199% from 1988 to 2005, but the state’s own revenues rose only 131%.

9. Hospitals seek higher Medicaid rates despite costs 44% above the U.S. average.

10. Although half of health spending is wasted on unneeded care, paperwork, high prices, and theft, cost control is not yet popular, for at least 10 reasons.

11. Today, the bill that could work can’t pass, but the bill that can pass can't work. Still, the House bill does more good than harm and is worth supporting.

12. Succeed or fail, efforts to expand access will boost interest in cutting waste.

13. Doctors, not patients, are the key to cutting waste. They control 87% of health spending. It’s vital to negotiate a clinical, legal, political, financial, and ethical deal that lets us trust doctors to care for us all well without spending more.

14. Today, high costs hinder coverage expansion. But having the world’s highest health spending makes health care the easiest problem to solve here—if we squeeze out waste and use the savings to finance comprehensive care for all.

15. Only when patients, caregivers, payers, politicians, and voters demand that current spending finance full care for all will this state design, test, and adopt practical ways to cut cost—and reconcile private interests with the public interest.

Anonymous said...

Universal coverage is going nowhere. Hospital Administrator "gets it".

Ryan Adams said...

There were more holes in that argument than a funky bloc of Swiss Cheese. First, it ignores the fact that maybe one of the reasons some people are more satisfied by their services is the fact that a small pool of people actually partake in them. Of course, there isn't going to be a insanely long wait if 50 million americans don't have insurance and another 100 million have lousy insurance.

Furthermore, it just simply ignores the fact that we don't insure everyone and lots of people are underinsured. He said that the Mass Health plan looks like the way to go, but I've shed some light on the many holes in THAT plan - not the least of which is the fact that it isn't particularly good insurance.

The most offensive aspect of it is the fact that in every measurement he put out there, Germany outranked America. Maybe we don't want the Canadian system, but the German system looked like a good idea to me.

Oh, and gee whiz, I wonder if the CEO of a major Boston Hospital would be in favor of shaking up the status quo in terms of how we fund health care? I just wonder why he wouldn't be in favor of that.. such a difficult concept. I bet it's sort of similar to the Exxon execs that just don't believe in global warming.

Anonymous said...

Patient responsibility needs to be factored in somewhere. This is purely anecdotal but I know a guy who was overweight and smoked. He went in for a high blood pressure screening where he works and they rushed him to the hospital. He has great insurance, had a triple by-pass that cost him next to nothing and now is back to work. Guess what he started smoking again. The "health care system" should not pay for his next operation.

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