Health Care in Massachusetts

If a tree falls in the woods, but nobody can hear it, does it make a sound? If people pay for health insurance, but they can't use it when they need it, are they really insured? That's the context we must look at Health Care Reform as a country and in Massachusetts, with our own 2006 effort.

The story about Massachusetts's 2006 Health Care Reform shouldn't be the 98% of our population that has health insurance. After all, health insurance is not health care and shouldn't be confused or treated as such. The story has to be how successful we are at truly expanding access to quality health care in this state -- how successful we've been at ensuring those of us who are in need of medical treatment can get good care at a rate they can reasonably afford.

On that end, we aren't nearly as successful -- 1 in 5 people in this state with insurance, as of 2009, didn't get treatment they thought they needed because they couldn't afford it. Outside of the population of kids and seniors, populations of this state that get extra federal help to afford coverage, that number jumps to a full 40% of the population. 

When allowable deductibles in this state are $2000 or $4000 for families, and co-pays can be so high that they'll eat half a paycheck for some people, such a statistic becomes very understandable -- if not excusable. These are people who already pay a hefty price for the plastic card that says they have health insurance, but they can't use it. In many cases, the premiums may be so high that it's the reason why they can't use it. Is it insurance if, when we're sick, we can't cash it in? People used to make Matt-Damon movies about these kind of frauds. 

Massachusetts does considerably better than most states in terms of the percent of the population who's insured, but there's little evidence we do much better in terms of making sure people can get care when they need it. We aren't the healthiest, we don't live longer and we don't have the lowest medical bankruptcy rates. While we may be better off with 2006's effort -- and the country may be better off with this past year's federal Health Care Reform -- we may not be as better off as we think. Health insurance reform that fails to make quality health care affordable to at least 20% of the population is less reform than it is a smokescreen. We have problems that no one seems to want to talk about, and meanwhile we're still patting ourselves on the back as if it's a job well done.