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Massachusetts Makes Health Insurance Mandatory
Iron Condor writes "Massachusetts is the first state to require its residents to secure health insurance, a plan designed to get as close as practically possible to statewide universal health care. Presidential hopeful and former Massachusetts governor Mitt Romney originally introduced the idea in 2004. Effective July 1, 2007, the law, which uses federal and state tax dollars, is aimed at making health insurance affordable to all residents of the state, including low-income populations. Those who fall below the federal poverty line may be eligible for health care at no cost."
You know, a few years back I was in San Diego and went to Toorcon (excellent conference by the way - please support it) and I got in to this discussion late at night on socialised health care.
For those that don't know, the United Kingdom spends eighty billion pounds a year on healthcare, funded directly through taxes. His central point was: "Don't you feel like you're being ripped off paying for the health care of jobless people when you're busting a gut earning a living?"
I think it's an important question and one that needs answering if the United States is going to replace their broken healthcare system. My answer is simply that even ignoring the people who don't work, it is still a better deal for you if you have socialised health care.
Free market economies work best when prices are elastic; that is, where changes in price affect the demand for the product. This allows price to signal the level of available supply and prevent shortages of goods. The problem with healthcare is that it is not elastic. If I have cancer, a broken leg or some other ailment I have to get it fixed - regardless of the cost.
In a profit making company, this means raising the price indefinitely sees no reduction in demand. This leads to an ever increasing cost that outstrips inflation. The American system compounds this because a lot of white-collar workers get insurance plans from their companies. Companies have deeper pockets than an individual ever could so the prices increase still further!
Socialised health care delivers better value for money because of the enormous purchasing power of the government. The NHS can purchase millions of shots in one go. That allows you to hammer the drug companies on price and share the proceeds with the population. In the American system, it is you against the drug company and you are needy; you are willing to pay anything to fix yourself. In short you're screwed.
There are also other economic benefits. Heathier and less desperate neighbours translates to less crime and increase productivity. It pays to insure that the daughter of a crack-addict prostitute get first class health care and education - if only to increase their chances of escaping the poverty trap and contribute more to the economy.
It also pays because you can remove the inefficent insurance companies. If everybody is covered then there is no need to have a bureaucracy to decide if a person is covered.
Socialised health care is not evil communism, it is a practical solution to the health care of your nation. I don't see anybody complaining about the socialised road, garabage collection, fire, police and military. When you trust the security of your nation to the government, why do you not trust your healthcare to them too?
I'd I've seen the benefits first hand. When a friend of mine, at the age of 20 developed Lukemia, put his Computer Science course on hold, checked in to the local hospital and began his treatment straight away. He was cured and back in education the following year. I fear that had he born in the United States, he would not have been able to continue with his studies, in fact, he probably would have been bankrupt. Socialised healthcare not only save his life, but his future.
Simon
...what's the point in having insurance for all, if insurance companies will just deny all the claims due to conditions obscured in legalese?
I have looked at the Mass health insurance plan. I may be misunderstanding something, but their idea seems to be to get rid of uninsured by declaring it illegal. The closest equivalent I can think of is to stop New Orleans floods by declaring it illegal for levees to break.
They haven't gone a single step forward in fixing the underlying problem of why healthcare costs so much.
(disclaimer: I live in Mass. and my health insurance has not gone down. In fact it went up)
So, from here on, Massachusetts residents are obliged by law to make money for a profit-oriented company (that may or may not actually cover their ailments).
That was my first thought too! Why not start by removing any requirements for Medicaid? Just remove any checks---whoever applies gets it. And if folks ever admitted into hospital, that application is automatic for them. That would ensure everyone is covered. Would need to pump more money into Medicaid, but, eh, there's gotta be costs... But in my view, much better then pumping the same money into a for-profit entity.
"If anything can go wrong, it will." - Murphy
Does this mean that someone who is denied health insurance in any other state will be able to move to Massachusetts and be guaranteed to be approved for health insurance? Will high risk people who are denied in other states have higher insurance premiums to pay than "lower risk" insurees in Mass?
Will there even be an application process if accepting me is compulsory? Will this give insurance companies less loopholes to try to out of paying for my expensive procedure. For example, as pointed out in "Sicko", insurance companies routinely deny expensive insurance procedures by finding things on the insurance application to invalidate their contract with the patient. If one can argue to a judge that the insurance company had to approve them no matter what, I'd assume that this makes Massachusetts a much safer place to be able to depend on the health care and insurance that you are paying for than anywhere else in the country.
I think these are pretty important questions, but I can't seem to find the answer anywhere.
This is simply a mandate that each resident carries some form of health insurance. Read that again: this is not subsidized health care; this is simply a law that creates an annual tax penalty for residents who cannot prove that they are insured. Bottom line - it ensures that any health insurer who operates within Massachsuetts is virtually guaranteed to earn business from the constituency here.
In the first year of this program, residents who elect to defy the mandate and do not purchase coverage will be subject to a paltry $219 lien on their taxes as punishment. Given that this is far less of an economic burden than paying the mandated premiums, anyone who can do math and is healthy would be advised to consider paying the penalty. Anyone who doesn't fit into either of those two categories probably already has health insurance - and those who don't more than likely exist at polar ends of the economic spectrum: they either print their own money and can pay for health-care as needed or they are poor and can't afford the tax penalty or the premium. Of course, for this group (earning 30K or less per year as an individual and 60K per year or less as a family of 4) - the premium costs are gratis under the new Massachusetts law.
Massachusetts has found a way to make public health policy in this country even more ludicrous than it already is. They have taken a system that was a dangerous marriage between public policy and corporate interest and have fully endorsed the idea that health insurance should be the business of private enterprise and that mandating the purchase of that insurance by enacting silly laws and tax penalties is the business of the state. Taken together, the whole thing seems rather sinister at the surface, and that's because it is. It shows either an utter disregard for the concept of insurance or a determined attempt to exploit the public ignorance of personal risk assessment. It's hard in fact to find ANY real benefit for the citizens of Massachsuetts in this mess.
The sales pitch by proponents of the legislation is that it will lower the average premium cost for the entire populace; as healthy individuals are forced to subscribe to an insurance plan, the revenues generated from their participation will offset the increasing costs of paying out benefits to subscribers who are sick. This really is like any other insurance that you can buy: the insurer needs to have as many (if not more) low risk subscribers who pay their premiums such that formerly low risk subscribers who become high risk can be paid the proper benefit when the time comes. But in this instance, the insurance industry won't have to break a sweat to get those low-risk subscribers on board. In fact, they don't even have to get off the couch - the statewide mandate ensures that unless there is some pandemic that makes everyone in Massachusetts sick, there will always be a pool of low-risk subscribers who generate a reliable revenue stream.
People wonder how this is a bad thing? Why would decreasing the average cost of health insurance for all individuals actually be a detrement to people? Well, first of all - because everyone must participate or be penalized financially, this is less of an insurance system and more of a welfare system: everyone is putting their money into the pool, and those who need the money more than others are allowed to take from the pool. In this case however, the twist is that the people responsible for managing this money are actually taking ownership of it and making business decisions on its use. While in a government-regulated welfare program revenues can have no other purpose than to cover expenses, insurance companies have a profit motive - an extra hand that dips into the pool of contributed funds every so often and takes a little something for itself. This isn't in and of itself evil - we deal with big corporations every day. However, there aren't any laws out there that require me to buy $10 of goods at Wal-Mart each day, that is precisely what Massachusetts has done with health insur
I'm from Australia here, and I've never understood how the US health care system worked until I saw Moore's documentary, SiCKO.
I would watch American movies and TV shows, and wouldn't understand when you guys talk about, getting a job with 'health benefits'. Here in Australia, the only thing I worry about getting a job is if it pays right.
If I go to the GP (family doctor in the US), or need to go to the hospital, paying the bills is the last thing on my mind. It's all taken care of. Medicines are also subsidised by the government. You collect virtually any prescription for $3.
Honestly, I was surprised you guys let it get that bad. Then again, I wasn't surprised the reason it went the way it did: through greed and politics.
(I am a licensed insurance agent)
:)
Those middle class people in Massachusetts who have pre-existing conditions, will be driven into homelessness. For absolutely certain. No questions asked. Out the door and to the loaves and fishes NOW.
These people will pay $1000 premiums per month - I work with these insurance companies and I see it happening daily in California - and in many cases their contractually agreed upon coverage will get denied.
The raw numbers cannot be denied, and cannot be resisted. The numbers - the the number of people with pre-existing conditions, their income, and their health insurance premiums - all clearly say that a large number of lower and middle-middle class will start paying fines, or going homeless, or leaving Massachusetts.
This is all out war on the middle class, and many will leave, and when they do, the rich will be paying more to support the health care-driven tax increases to support the poor and then the rich will start leaving and badebadebadethatsallfolks!
I hope this law is rigorously enforced. Tie it into SSN's and whichever SSN isn't insured, fine 'em. That'll bring quite a swift end to this law.
--- Grow a pair, liberals... stop letting the Republicans bully you!
the United Kingdom spends eighty billion pounds a year on healthcare
Hm, nominal spending is more than that. Now I don't know much about the NHS (other than that it doesn't work) but I do know a bit about government contracts in the UK, and I would be very surprised indeed if more than about 50-60% of that went on anything of even peripheral value to healthcare.
Here, the Times (rapidly becoming a tabloid but never mind) has something on it:
Annoyingly chatty but probably basically correct article.
To put it another way, the UK NHS is like the US DoD; they're both ways to funnel money from the taxpayer to those who position themselves to recieve it. The NHS, however, which is regarded almost with veneration by most British people and which doesn't have to fight actual wars, is far more corrupt; buildings built, bought, sold and knocked down within the space of a few years, and so on. But the NHS long ago passed the point where it's powerful enough to keep going forever -- it's quite a political power broker in fact, which is why you *do* get reasonable free healthcare from it in much of Wales and Scotland.
Meanwhile, in England, health care does cost money -- you pay over the counter for even a basic dental checkup. You don't want to? Then take out some private health insurance. It's a fast growing sector in the UK. Good!
I imagine that there are people who find it hard to afford, though, what with all the taxes they're paying. And that's bad. But what can you do?
Whence? Hence. Whither? Thither.
...to tax everyone, and have the state provide the healthcare, like in Australia, the UK and most other sensible Western countries?
Compulsory health insurance will just make the insurers raise their prices, because they know that everyone just has to put up with it.
-- Even if a god did exist, why the fsck should I worship it?
It compares pretty well. Two years ago the US spent (in nice round numbers) USD5200 per person on healthcare. At current exchange rates, that's GBP2600-ish. Using a two year old exchange rate it was GBP4200.
I will disagree with you. I cut myself last year. It wasn't particularly deep, but it scared me enough from the huge gash it left behind. Only the skin got cut, but because it was on a Sunday, my doctor's office was closed, and I had to go to the hospital. I had to get 20 some stiches (actually, just staples). I never saw a doctor, just a type of nurse. I also got a tentanus shot and 2 X-Rays done to make sure no metal was left in the wound. I was expecting the cost to be $1000 max, probably less as it was just 45 minutes. My doctor said he would have charged me $250 for the same service.
/.er is a rare thing. Don't stare at me too much.)
I got a bill for $3000. I got this bill because I was uninsured. I know the insurance would have paid only $500 but the hospital screws you if you are uninsured. This system would bankrupt me if it was anything more serious. I'm a person too poor for insurance, but still have assets (a car) and thus don't qualify for government help (until I'm broke - i.e. lose my car). I could not fight the bill - I was told that since they did not bill me fraudulently (no double billing basically), the bill was what it was.
I can't go to the doctor for fear of high bills. Even if it would be cheaper in the long run. If I need to get tests done, I can barely afford it, I'm just scraping by. I am young and relatively healthy, but I still have issues time to time. It makes me sick to my stomach when I think of how much I get charged as a private person and what the breaks the health insurance industry gets. It's downright unfair.
Since I have relatives up there, I am moving to Canada soon. I know many Canadians complain about the system, but none would trade it in for the American system. I see the light, I'm moving out of here. I won't miss it. I'll pay the higher taxes if it means that I don't have to worry about rotting in the street or being close to my death before I get help. Fuck all of you blasting Socialized Medicine - it's a safety net for people like me - like the original poster of this thread said: healthcare is a necessity, not a luxury - unless you don't mind dying early or being crippled for life.
(Yeah, I know being a poor
I'd prefer to skim-read and then write a post about my cock, actually.
Is that it is primarily corrective instead of primarily preventative.
"God fights on the side with the best artillery." - Napoleon, Marshal of France - speaking truth to power
I'm a Canadian that used to live in the USA. One of the things that always amazed me is how your health insurance can obligate you to stay working for a company.
:(
Essentially, once you're diagnosed with a disease or condition, it's impossible to change to another provider because they won't cover pre-existing conditions. This means that if you leave a job (or are fired), you have to personally keep paying very high rates to your old company's provider in order to keep insurance. Your new employer (if any) will usually not take on those costs, because they have their own provider and plan - which you don't qualify for due to the pre-existing condition. It's a vicious circle.
However, I lived in Massachusetts as well, and I did like some aspects of the co-pay system there. In Canada, anyone can go to the doctor whenever they like, and it's free. So, you get mothers dragging their kids to the doctor every time they sneeze, and all kinds of other useless visits to hospitals and so forth. Having even a token co-pay (exempted for those below poverty) reduces needless visits. I think most visits on my plan in the USA were $10 or something, which is enough.
So - my ideal world would be the Canadian system, plus a small co-pay. Unfortunately most of Canada's best doctors move to the USA so they can get rich instead.
MadCow.
I used to have a sig, but I set it free and it never came back.
You're going to track down the elected official who appointed the bureaucrat who appointed the bureaucrat who fucked up a huge federal program, and vote for his one opponent up to 4 or 6 years later, for that and that alone, in spite of every other political issue? When are you going to get around to that? After you finish voting out of office the idiots who wrote the federal laws specifically to benefit (even create) Aetna and Kaiser? Shit, if I don't like a company, I just vote against them then and there by not buying their services anymore. And I don't even have to count on 51% of everyone else voting the same way as I do to make an immediate impact in the service I get. Of course, the very same politicians who you haven't gotten around to voting out of office keep passing stupid health care laws that make it difficult for me to do that with health insurance companies...
Good idea. Let's nationalize the farms before everyone dies of starvation.
In Repressive Burma, it's not just your connection that dies. slashdot.org/comments.pl?sid=314547&cid=20819199
"And yet everything has a value."
Unobtainium is worthless. Next up, a rant....(not aimed at "you" personally).
The Australian system is similar to the UK's NHS, so much so that we look after each others tourists for "free". I was an asthmatic teenager when the "establishment" told us universal health care was a communist plot that was crippling the UK and would bankrupt the country. 30+yrs later and we are far from bankrupt, we have "world class" prevention, care, teaching and research. I belive "the system" saved my son's life and it definitely kept me out of bankruptcy.
As for footing the bill for "non-taxpayers" (depending on political expediency the Australian term for non-taxpayers is either "bludgers" or "battlers").
I spent all of my 20's at the "trailer trash" end of the socio-economic scale. Happily, I am now in the "high income" bracket where I am supposed to "top up" with private cover for stuff such as dentistry and silcone tits - personally I prefer the extra $500 "fine" at tax time and pay for my own dentistry...anyway...When you do the math it turns out I am paying to cover 5-6 non-taxpayers, yet I have only two (grown) kids and I'm no longer married (to the lazy bitch...sorry...that just slipped out, see the "political expediency" comment earlier).
The reason I am not only glad but proud to pay the levy is that I hope the system works for those 5-6 people as well as it did for me in the past. The reason I don't buy "mandatory top up" insurance is because it is medicinal "fluff" that I can afford. Most of all I don't want a return to the partisan politics where one side refuses to acknowledge the inherent "social evil" in a system that can routinely take eveything the patient's family has, and then promptly hang the patient with red tape.
How do my costs compare to the cost of similar cover in the US?
From comparing notes with one or two US slashdotters in the past I belive my 1.5% levy on taxable income is considerably less than HALF of what similar cover (and care) would cost in the US, the exact ratio varies from state to state. Not very scientific I know, but I also know that the death rate from asthma in the US has now overtaken that of Australia, this is despite Australia having one of the highest incidence rates in the world. Make what you will of the facts and figures and competing "-isims", I know first hand it's not me and my five "battlers" who are getting "ripped off".
And did you exchange a walk on part in the war for a lead role in a cage? - Pink Floyd.
"People who can afford it don't want to go on waiting lists if they are in a life threatening situation."
If you are in Australia and also in a "life threatening" medical situation you are taken the BEST CARE POSSIBLE, even if this means putting the patient in a fucking helicopter to get to a surgeon who can (say) unblock the vien in the patients temple. Note also that the "best care possible" is almost certainly going to be a public hospital and treatment will be "free". The helicopter and the cable-TV above the hospital bed are not "free" but everything else is, including drugs and outpatient care. BTW: Ambulance cover for said helicopter is dirt cheap due to the regulatory absence of middle-men.
"Which is why private insurers still do good business in a market where free health care exists."
The reason "insurers still do good business" in Australia is beacuse the taxman gives those who have it a $500 rebate and "high income earners" who don't have it are "fined" an extra $500 on top of the flat 1.5% levy on taxable income - I pay the $500 corporate walfare contribution and I am still getting a much better deal financially than any US citizen. I say "corporate welfare" because the levy was introduced obstensibly to save what was left of the rapidly shrinking private industry from "totally collapsing".
IMHO: The primary reason why we have such "world class" care at bargain basement prices is that UHC is no longer a partisan issue in this country and it has been that way for at least the last 10yrs. As often displayed by the US military, a bipartisan attitude puts "mission before cost" particularly in a "life threatening situation".
All the predictions of long waiting lists, financial ruin, communist plots, medical brain-drains, ect that we are seeing in the current US debate were also made in Australia during the 70's. In Australia the dire prdictions failed to materialize, what happened instead was the miles of red tape and army of middle men all but evaporated and our national health outcomes have for decades consitently hovered around the top of any serious study you care to mention.
I'm not saying we don't have our own inefficientcies and injustice, I'm just thankfull "bankruptcy to pay for health care" is not one of them.
And did you exchange a walk on part in the war for a lead role in a cage? - Pink Floyd.
"(Things depending on donations... well, good luck.)"
Slashdotters make their own luck. Whenever I need a kidney, I spread roofing nails on I-95.
Just one data point from a Massachusetts resident. A neighbor who is an oncologist and experienced observer of the scene said one of the main impetus for the Massachusetts plan is the reduced number of very wealthy individuals from Saudi Arabia who since 9/11 no longer come with their cash to the Boston area for top-flight medical care: they are more likely to go to Germany or Switzerland now. These were the people that were replenishing (indirectly) the free care pool which has been dramatically drying up over the last few years. For many decades this was a generous and essential ingredient of the health care environment here. It sounds odd, but this is one of those backstories you would only hear from someone in the arena, and certainly not from the media.
... see the movie Sicko.
The parent comment, and others, minimize the issue. The issue is fraud by the medical profession. The medical system in the U.S. is broken.
Okay, this is an exaggeration to try to be funny: If you open your window on a quiet night, you can hear the crying of hundreds of people. Film studio executives in Hollywood are crying because they have to spend $20 million to market a movie that cost $20 million to film, but Michael Moore is invited to sell his movie Sicko from the podium in the U.S. federal government's House of Representatives, and the New York Times publishes a photograph, shown in the NYT article For Filmmaker,`Sicko' Is a Jumping-Off Point for Health Care Change. Quote from the article: "Even the haters agree this film is genius!"
When I last checked Fandango.com, there were 1651 "must see" ratings, 115 "go" ratings, and only 62 lower ratings. Sicko is the highest rated movie ever, apparently.
Complaining about Michael Moore is evidence of ignorance. He does the best he can. Do not demand that your evidence be sugar-coated and delivered on a silver plate. Get it where you can, and cross-check it carefully, or know you are purposely avoiding being part of the solution to the problems.
For those whose real purpose is having a way to act out their anger, while hiding it from themselves, get help. Work on resolving your anger, rather than listening to anger sellers like Rush Limbaugh.
One last thing: If you had educated yourself about what the U.S. government is doing and has done, you would have known that Michael Moore's movie Fahrenheit 451, while faulty in presentation, was entirely based on fact. For example, George W. Bush really does hold hands in an affectionate way with Saudis who control the Saudi government. Osama bin Laden's major complaint was that the U.S. government was supporting a Saudi government he thinks should be replaced. I'm against violence from any source, but certainly a Saudi citizen like bin Laden has a right to object to a regime in his own country that many Saudis say is repressive.
Not just factually dubious, factually bullshit.
It is so interesting hearing conservative whack jobs talk about the bottom line as the ultimate measure of success in an endeavor. Then have them develop selective hearing loss when the bottom line is revealed for a social justice policy like universal health insurance. For example, average life expectancy at birth in the UK is 78.7, in the US its 78. Average spending on health care in the US as a percentage of GDP is 15% in the UK its 9.4%. (And remember for that 15% we don't cover about 15% of the population, while the UK covers 100%.)
So either the British are significantly healthier than us, it is cheaper to provide inexpensive preventative care for all in the long run, or there is a large sucking sound that is coming from the health insurance industry and Pharma taking about 30% off the top of what we spend.
I will tell you the only two thing that is keeping my partner and I from immigrating to Canada is the fact that it would be hard(er) to take his parents with us and I hate cold weather. With global warming and time, Canada looks a whole lot better. And this is a sentiment that I have heard from a lot of my colleagues. Few physicians want to work in a system where 15% of people are uninsured, where people die for lack of simple basic preventative care, where in order to write your patient an rx for an antibiotic, you have to check one of a thousand formularies to determine which they will pay for. For a group of people who, when they started medical school were largely idealistic and wanted to help people, this is a soul-crushing system. However our kids, parents, whatever obligation prevents us from moving. But leave it for a few years, and you may find that the trend of Canadian Physicians emigrating to the US, which slowed and then halted in 2004, may reverse course with US physicians emigrating to Canada.
Nick