Massachusetts Makes Health Insurance Mandatory 779
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."
Making something illegal doesn't fix it (Score:4, Informative)
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)
its about time (Score:1, Informative)
Re:Nope. It's 105 billion pounds. (Score:2, Informative)
Re:Socialised Healthcare is the future for the US (Score:3, Informative)
If people wish to pay for private healthcare to supplement what they can get on the NHS I don't see that as either a problem or a failing of the NHS, it simply means people who can afford to pay for it can get things like hip replacements more quickly and reduces the strain on the NHS allowing those who can't pay to also get their new hips more quickly. Those who can't afford private healthcare will still get the same procedure but they may have to wait a little longer. A lot of people argue this is unfair and creates a two tier system for the haves and have nots, which it does, but basically life is unfair and the current system is the most effective way we have for ensuring everyone is looked after.
Re:Nope. It's 105 billion pounds. (Score:3, Informative)
Re:Socialised Healthcare is the future for the US (Score:3, Informative)
How, precisely, would you be hurt by national and guaranteed health insurance for basic services? You know, prescriptions, checkups, urgent care, sports injuries, minor illnesses? The costs for these services are too high in the US, and you can scarcely call the service "inadequate" or that private health insurance is a superior solution.
As for emergency care, it's emergency care and it has to be provided. Part of the reason costs for the upper middle class are so high is because it's wrong not to provide emergency care to those who need it, even if they can't afford it. Someone has to pay for those losses those, and it's those who can pay for fancy private health care who have to foot that bill. Incorporating it into a tax-funded government service would only lower premiums for the middle class, now relieved of that burden.
You claim that you'd pay double if you needed superior care to what the government plan offered. That's simply not true. Look at the numbers in those "inadequate" other countries; for those with supplemental private insurance, are they paying any more than you are now in the US? Nope. If you desired more coverage or special treatment, you'd be paying the difference of the two. Your $11,000 health insurance plan is obviously superior to a government plan at $3000 per year. But if you had those basic and emergency services covered, $3000 of that plan would be paid for you, and the "free market" can be used to patch the holes with an $8000 plan. You'd be an idiot to buy a health insurance plan that duplicated government services where "inadequacy of care" is irrelevant. ER care is ER care, no matter how good your insurance is. Basic care is pretty tough to screw up. It's the middle part where national health care might be lacking, and why wouldn't the "free market" respond to that with services to meet those needs? What would be the purpose of them offering services you already get as a taxpayer?
If your response is that the insurance companies are greedy and would use it as a "free profit machine" then perhaps part of the national health care plan would include a ban on insurance companies charging for basic care in their premiums. The "free market" would then price the "differential insurance" at what the market would bear. If their pricing works for you now, it should work for you there, as well.
Romney Just Took The Credit (Score:3, Informative)
First off, this wasn't Romney's idea at all - the entire thing was proposed and implemented by the (extremely Democratic) state legislature. The MittFlopper had zero to do with it - absolutely nothing - he simply made sure to grab credit at the time (now he's distancing himself).
Personally, I think our country is jaw-droppingly stupid to not implement single-payer health care (aka Medicare for Everyone, aka What Almost All Other Industrialized Countries Do). That being said, the Massachusetts initiative has produced a number of very affordable plans, so I do think it's better than nothing.
Studies have shown otherwise (Score:3, Informative)
feeling ripped off? (Score:3, Informative)
> the health care of jobless people when you're busting a
> gut earning a living?"
You make good points in your post and feeling ripped off is a feeling everyone gets when paying taxes.
In Ireland it is free to some extent but not totally free, however if you do incur medical costs you can claim the money back from your taxes to almost the same amount. Also certain things are free by default (eg. Eye/Dental check ups). So it is not like you are being ripped off.
Re:From an outside perspective (Score:1, Informative)
1. The vast majority of these are elective procedures (ie cosmetic). Since this isn't covered by Medicare (Medicare is our public health system), people choose to go overseas and get a free holiday at the same time.
2. Medicare and Public education are slowly being eroded by our conservative government (ironically called The Liberal Party), who are attempting to shift Australia to the American model.
So Medicare isn't the great system it used to be. The baby boom has a lot to do with it because the shift in population distribution means the system can't cope with all these now old retirees claiming pensions and going to the doctor. It seems the economic models of the 20th century were all based around infinite population growth.
Re:Socialised Healthcare is the future for the US (Score:3, Informative)
LOL, if that's overburdened, sign me up. Here in the USA, if you're not in danger of imminent death, good luck getting an appointment with any doctors covered by your insurance company within several weeks, if at all (many doctors who accept insurance in populous areas are simply not accepting new patients).
Re:Nope. It's 105 billion pounds. (Score:1, Informative)
Re:You can't shop around for ERs (Score:3, Informative)
Always best to know your enemy before you talk trash about them:
http://www.foxnews.com/story/0,2933,273875,00.htm
http://www.foxnews.com/story/0,2933,286006,00.htm
Two AP writers had this to say:
http://www.foxnews.com/wires/2007Jun30/0,4670,Sic
What a ridiculous statement... (Score:3, Informative)
In the last few years one has had a pacemaker fitted, one has had knee surgery and also a heart attack, and a third has had surgery on both knees. All three at least 80 years-old and all three had these operations and treatments in timely manner, all on the NHS at no cost to them at all. All three could not praise the staff that treated them high enough.
To suggest that the old get poor care from the NHS is ridiculous. If that were so then these people wouldn't have received the excellent treatment that has allowed them to carry on not just living, but living full, pain-free lives.
Re:Yes its broken (Score:5, Informative)
I was drunk one night walking home from the pub and decided to investigate the railway near my house a little more closely. Whilst climbing back over the fence to the road I lost my balance and fell off. On the way down I grabbed the top of the fence and unfortunately put the palm of my hand onto a rusty nail embedded in the fence. The nail ripped a large gash from the palm of my hand to just before the base of my middle fingers.
Since it was around 3AM in the morning I went to the A&E department at the local hospital ( 5mins in a car ). First of all a doctor examined the wound and picked out bits of fence and rust and then a nurse put in 15 or so stitches. I was seen by the doctor immediately and was back at my house around 40mins later. I also had a tetnus injection.
The next day I went back to the hospital where I saw another doctor ( 15min wait for that ) who checked for any nerve damage or other problems with the gash and I think an X-Ray as well and they gave me a load of bandages.
A week later I went to my local doctor to get a sick note for work ( it was my right hand ) and also saw her nurse to check it was all healing and decide when the stitches should come out and a while after that I went back to have the stitches out.
All of this cost me nothing ( except 3 weeks paid holiday from work ) and I think I got a very efficient and effective service. This is the first time I've ever been to hospital and the 2nd time I've ever seen my doctor in 30 years ( the other was for a yellow fever injection before I went on holiday somewhere ) so I really doubt I'd have been bothered to get any medical insurance if I didn't have the NHS to look after me.
Re:Nope. It's 105 billion pounds. (Score:2, Informative)
It has been well publicised in NZ newspapers.
Wrong (Score:3, Informative)
Re:Pre-Existing Conditions, IAALIA (Score:2, Informative)
There's also the simple fact that the only pre-condition you have when you first get health insurance is death, as you join when you are born, usually through your parent's existing insurance.
If there's no law in place now to prevent people being screwed over by greedy insurance companies then there soon will be. There's also an element of competition involved. Those companies that actually insure people with pre-conditions for reasonable amounts will quickly get a reputation for being fair and people will flock to them. With that many people on their books they can afford to cover those people with existing conditions.
I don't know how many medical insurance companies there are in Mass. atm. but I suspect that might be a lot of consolidation soon, especially if the number of companies is quite large.
Re:Socialised Healthcare is the future for the US (Score:3, Informative)
There are many books on this subject. Just pick one and read it. The US's military budget is larger than all other industrialized country's budgets combined. We have already spent 440 Billion and counting in Iraq. This would have easily paid for insurance for every child and many others since this disastrous war began. As that English guy said (I apologize, I forget his position), if we have enough money to kill people, then we have enough money to cure people. We certainly do. why do we select the wrong one, every time? Because there's no money in the opposite. The US is run by the dollar. This is by all definition an oligarchy, not a democracy. If fact, you would be hard pressed to find poly/sci profs not teaching it as such.
" 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 might also suggest you take a race, class and gender class at a College near you. The historicity of the "way things are" might surprise you. Fighting those forces rather than taking away health care as the deterrent, as the negative reinforcement to not be poor (and if I choose to be poor: in a free country this is a valid choice) would be the far better choice here, especially if you want to preserve a moral high ground, that we certainly do not hold anymore (US).
Look, we can watch Sicko to see the issues (even after taking out all of the Moore'isms in the movie) and hear the horror stories of the US healthcare system. #1 reason for bankruptcy in the US is health related bills. We do not live as long as they do in many other countries, our infant mortality rate isn't even in the top 35 [wikipedia.org], and these corporations that run our health care system has a sole job of finding out ways of not providing you with coverage. Period. It's making some people very very rich, and the citizens of the richest country the world has ever known doesn't want to provide health care for its citizens, just like they do in every other industrialized country, holding a higher moral ground IMO.
Factually bullshit (Score:4, Informative)
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
Re:Socialised Healthcare is the future for the US (Score:4, Informative)
US employer based health care grew directly from WWII tax and rationing policy. During the war the income tax was extremely high and rationing was in place. But workers needed to be taken care of in order to maintain productivity. Health care and other "benefits" therefore became tax exempt and were excluded from the income tax calculation. That system made sense during wartime and afterwards when much of the US had lifetime employment and society valued life differently than we do today.
Then during the 1970s in a wrongheaded approach to controlling health care costs, government encouraged the establishment of HMOs and other forms of insurance middlemen with the idea that it would be in their interest to control costs and provide the most benefits. But the government still propped up employer based health care primarily as a response to the generous benefits that were lavished on the big unions by GM and Ford and the big industrial companies. The fear amongst many older union workers was that they would lose out on benefits they were soon going to start really needing.
In the US you get to deduct health insurance expenses only if it is provided through an employer (that might change once health insurance is essentially a tax as it is now in Massachusetts), but health insurance that you buy on your own because maybe you found better insurance outside your employers plans (which the employer might have gotten kickbacks from the insurance companies to exclusively provide) doesn't get you a deduction at all. The effect of which is to hand over buying power to your employer even though they might not even be subsidizing the insurance at all, so they will generally offer 3 plans, the least of which is not likely to be chosen by those who decided on the plans, but which is most likely to be chosen by the lowest paid employees. This distortion, putting purchasing decisions in the hands of people that don't have a direct interest in what is being purchased helps to cause the ever increasing medical costs which the employers are more than happy to support with their employees money. There is also a more insidious effect in that the lower cost plans subsidize the actual costs of the higher benefit plans because the lower costs plans provide fewer benefits and charge higher deductibles making it impractical to actually use them. So, you have a system where it is the decision makers that benefit from screwing over the weakest employees in their organizations.
Far from being a system where the free market acts in a healthy and natural way to control costs, the US government has created a system where inequality rules and fear is used as the primary motivating factor in all decisions.
Which brings us to Massachusetts. In Massachusetts, we have chosen to push the current system to its logical conclusion and completely take buying power out of the hands of individuals. Individuals will now have to choose between a dozen health insurance plans which could cost as much as 10-16% of a persons yearly income for those in the middle income range (but much less a percentage for the high income persons). At the low end, the plans are basically worthless because of high co payments ($100 to 150) to discourage doctors and hospital visits and a person will still be forced to pay up to $5000 of the yearly medical bill when they actually get sick. Meaning that the lower income persons likely to choose such a plan will likely be bankrupted by an illness anyway.
The moral theory being applied here is that by at least forcing people to pay into the insurance system now even though they are young and unlikely to get seriously ill, then they will be "prepaying" for when they eventually do get old and more prone to disease. A theory which seems very convenient for the older and richer people that want to get subsidized by the young and healthy, but as we see with social security such a system works well when population is growing and soci
Re:Yes its broken (Score:3, Informative)
What we mean is that it costs nothing more than what we're paying already. Like you, our standard of living is still impressively high, and most of us are able to make enough for the necessities. The only difference is, when we get sick, the necessities include health care.
For many without this advantage, insurance is not considered a necessity (compared to food, shelter, etc), and so it is not afforded.
Re:Socialised Healthcare is the future for the US (Score:3, Informative)