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The Almighty Buck Government Politics

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."
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Massachusetts Makes Health Insurance Mandatory

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  • by Ckwop ( 707653 ) * <> on Wednesday July 04, 2007 @05:06AM (#19741249) Homepage

    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.


    • Re: (Score:3, Insightful)

      by timmarhy ( 659436 )
      i've said it before - capitalism is not applicable to everything, becuase not everything has a price.
      • And yet everything has a value.

        • Re: (Score:3, Insightful)

          by rxmd ( 205533 )

          And yet everything has a value.

          When talking about the cost of healthcare, it doesn't help much to know that if you can't quantify it. What's the value of not having a broken leg? Your daughter not having measles? Your other daughter not having bone marrow cancer?
        • Bludgers vs Battlers (Score:5, Interesting)

          by TapeCutter ( 624760 ) on Wednesday July 04, 2007 @08:15AM (#19742255) Journal
          "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" [].
          • Re: (Score:3, Interesting)

            by Lumpy ( 12016 )
            Here's some facts though. The healthcare insurance talked about in the article is not what you have it's forced purchase of a comapny's services.

            The rich and the poor have no problems. the guy just barely making by and not below the poverty line get's screwed hard as now he has to come up with $100-$300 a month to buy the mandatory health insurance.

            It's a "law" designed to screw people into buying an overpaid and under delivering service.

            They want it fair, then they can raise the taxes in that state and
            • Re: (Score:3, Interesting)

              by Cocoshimmy ( 933014 )
              Good post. I agree, that this does not help the problem but simply helps the revenues of Health Insurance companies. In fact, it will probably result in an INCREASE in premiums for residents of the state. I also agree, that a healthcare tax is what is really needed in conjunction with the government acting as the insurance company for the public similar to medicare but state run. This would force prices down and provide people with a reasonable alternative. Honestly, I could care less if it drives the
    • Re: (Score:3, Insightful)

      by pytheron ( 443963 )
      A government that employs socialised healthcare is investing in the countries future also. The majority of people that will be cured under this system will go on to pay taxes for the rest of their life, increase population etc. which brings in more tax payers. It's a long term gain, but a gain nonetheless.
    • by stirz ( 839003 ) on Wednesday July 04, 2007 @05:28AM (#19741357)

      I mostly agree with you, Simon. Isn't it strange that, on one hand, the US spend money on humanitarian goals to help the Third World to fight hunger and desease but, on the other hand, lots of their own people don't even have access to proper medication?

      Social, tax funded, insurances for everyone to back anyone who gets unemployed, injured, seriously ill or who gets too old to work, are the prime achievements that make me feel secure here in Europe. In most aspects, European countries imitate concepts coming from the US, but when it comes to healthcare I think the US should have a close look at their friends in the Old World.


      (please excuse my bad English)
    • by the_skywise ( 189793 ) on Wednesday July 04, 2007 @05:44AM (#19741441)
      Okay, first -- it's not a "broken" system. I know that's the pervasive view of thought du jour but it's NOT. I've got several friends going through various stages of issues/diseases/cancer and several different income levels, one without insurance and all are getting excellent treatment and aren't being financially ruined.

      Are there problems with the system? Sure. But there are problems in the socialized systems as well of people not getting healthcare either due to rationing. Do we say those systems are "broken"?

      Second, collective bargaining isn't a panacea to medical issues. Sure if the country buys one million flu shots in one batch to the lowest bidder you're going to get a better price deal. But the reality is that FEWER companies now produce flu shots so the price gets locked down to whatever those one or two companies can give. If THEY collectively join forces and set the price, well that's that for price trade.

      The major problem with socialized medicine is that it takes control/responsibility of my medical life out of MY hands and puts it in control of the government. It's amazing that slashdotters will rally about private information being used by credit bureaus and how the government is big brother looking in on internet browsing sessions but when it comes to medical information, oh hey, let the government do it they can be trusted.

      To paraphrase Franklin - "Those who would sacrifice liberty for [medical] security deserve neither"
      • Yes its broken (Score:5, Insightful)

        by Anonymous Coward on Wednesday July 04, 2007 @06:46AM (#19741735)
        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.

        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 /.er is a rare thing. Don't stare at me too much.)
        • Re:Yes its broken (Score:5, Informative)

          by CmdrGravy ( 645153 ) on Wednesday July 04, 2007 @07:36AM (#19742015) Homepage
          I live in the UK and I think it's interesting to read your experience and contrast it with mine where there is a nationalised health service.

          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: (Score:3, Insightful)

            by Azghoul ( 25786 )
            I find it astounding that you guys can suggest with a straight face that it "cost you nothing"........
            • Re: (Score:3, Insightful)

              by Draknor ( 745036 )
              I find it astounding that you guys can suggest with a straight face that it "cost you nothing"........

              What is equally astounding are the US citizen's who think the they aren't paying for the poor /.'er who cut his hand and had to go to the ER. Now maybe he could scrape enough together to pay the $3000 bill. Most poor people can't. And the hospital will either send them to collections, or just write it off. And guess who pays for that ER time? You do (assuming you are an American citizen paying taxes an
            • Re: (Score:3, Informative)

              by kypper ( 446750 )
              I'm sorry, that's what we living in socialized medical systems say, but it's not what we mean.

              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.
    • by master_p ( 608214 ) on Wednesday July 04, 2007 @05:47AM (#19741453)
      "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?"

      Most unemployed people are not lazy bums who don't want to work. They are people with psychological problems who feel being outcast from society, and don't belong anywhere.

      And the poor people are not only the jobless ones, but those that work for minimum pay, because of being unlucky to be born in the lower classes.

      It's a shame to even ask that question. It shows a profound lack of understanding of how the world operates. It's that kind of ignorance that politicians exploit in order to get elected.

      • by hazem ( 472289 ) on Wednesday July 04, 2007 @06:25AM (#19741647) Journal
        And the poor people are not only the jobless ones, but those that work for minimum pay, because of being unlucky to be born in the lower classes.

        Didn't you know? There are no classes in the US. /sarcasm
    • Factually dubious (Score:4, Interesting)

      by kahei ( 466208 ) on Wednesday July 04, 2007 @05:51AM (#19741481) Homepage
      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?

    • Studies have shown that healthcare is not perfectly inelastic. A 1970s RAND study, the most comprehensive one ever conducted (in that it utilized a true double-blind experimental setup spanning multiple years and involving thousands of participants at a total cost of $300 million dollars), demonstrated that people that have insurance with lower copays do, on average, rack up a lot higher healthcare expenses than those without insurance. (I forget the exact numbers, but it was something like people with 20
    • > "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?"

      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 a
    • by bheer ( 633842 ) <<rbheer> <at> <>> on Wednesday July 04, 2007 @06:37AM (#19741695)
      > 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's the good side of the NHS. The dark side of the NHS is quotas -- because of budget limitations they have very long waiting lists, and Brits have recently taken to travelling to South Africa or India for care that they need urgently. Doctors are less willing to recommend surgery and more willing to tell the patient to wait the problem out.

      Another dark side is cost control. Cost control sounds great in theory but in practice means keeping salaries for health workers down, and getting by with inadequate staff. This has led to poorly maintained hospitals in many areas, and the current MRSA scare in the UK.

      Finally, because of the pay issue, the best and brightest doctors have emigrated, often to America. The NHS (as I'm sure anyone who's been following the UK carbombers story will know) is quite dependent on foreign doctors because they find they pay scales attractive. (This isn't to say recruiting foreign doctors is bad, just that the pay is better elsewhere.) IMHO this is one reason why a lot of brilliant Brits my age have chosen careers like law or business.

      Anyway, some form of universal health care is good to have, but if anyone thinks the NHS is a paragon, please think again (or ask some Brits who're -- unlike the chap in Sicko -- not Labour Party ideologues). And also, consider the Swiss model [], which is pretty similar to the Mass. model: it gives a high degree of choice while charging transparently and competitively for health insurance, thus creating market pressure to keep costs down.

      • Some of the health care reforms and HMO take-over in the 90s drastically lowered Doctor incomes. They had to change how they practice medicine, and start ordering extra tests to keep their incomes up, etc. This caused a temporary savings in spending as they ratcheted down reimbursements, and then an increase as they over treated... basically, the doctors had become accustomed to a lifestyle and kept supporting it.

        However, the newer, younger doctors, were unable to start practices as easily in the 80s, as
    • by Frogbert ( 589961 ) <frogbert @ g m a> on Wednesday July 04, 2007 @06:56AM (#19741787)

      "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?"
      As I am living in a country that has a similar system I guess that makes me one of those people busting my gut supporting the unemployed. So I feel qualified to Answer.

      I don't care, in fact I'm happy knowing that people in my country get medical care when they really need it, yes our system could be better and the care could be more extensive but it is there when you really need it. If people get into a car crash and lose a loved one the last thing that they need is the added burden of paying a hospital bill at the end of it. I'm also reasonably sure that stressing over debt doesn't make a ideal recovery environment for a sick person.

      I'm not buried in tax to support this system either, how much do I pay? 1.5% of my taxable income, something like $10 a week, if that. I know for a fact this is cheaper then most private health insurance companies offer here, and I have the peace of mind knowing that one day if I get super sick someone is going to take care of me, I know my children will have a full set of vaccinations when they need them and I know that I'm STD free because I got tested for all of them (well the big ones) for free. If I wanted to go to a doctor tomorrow I could call them in the morning and be in that afternoon, no money necessary, I can also choose my doctor.

      Oh and before people ask, if you get private health insurance guess which tax you don't have to pay?

      The system works, no it isn't perfect but it is a damn sight better then the US system.
    • You don't have to go all the way to Europe to find an example of socialized health care. Try up North in Canada. Canadians generally like to complain about the short comings of medicare. The popular perception amongst Canadians and Americans alike seems to be that, if you're able to afford it, care in the U.S. is better. However, some studies [] have shown that this isn't the case at all, and the quality of care is actually about equal or even better in Canada in some areas. This seems difficult to belie
    • "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?""

      My answer to that is simple - no, I wouldn't feel ripped off. My happiness doesn't depend on the suffering of others. I don't want people having to suffer needlessly because they happen to be poor, lost their jobs, or are too ill to work. I'm a compassionate human being who doesn't mind paying taxes if it supports the common good.

      The problem with medical care in this country is everyone is looking out for number one. People are just plan selfish. There's no empathy for fellow Americans. Look at the mess still going on down in New Orleans for just one example. We've lost the compassion we once had for those less fortunate.

      Everyone that whines about the possibility of having to pay taxes for medical care better pray hard they never loss their medical insurance. Better yet, hope your insurance company doesn't drop you the second you get a costly, life threatening condition. Imagine being told you had treatable cancer one day and getting a notice that your insurance is being dropped the next. Imaging having to go deep into debt to pay for your care and then being told 'tough luck' by callous, uncaring Americans around you.

      If we weren't paying hundreds of billions of dollars to fight a war in Iraq, we could easily pay a two hundred billion medical bill. If we weren't building highways to nowhere we could easily pay for national coverage.

      The problem with this country is we have our priorities all screwed up. Instead of trying to solve the problems of the world we should be spending our hard earned tax dollars trying to solve the problems we have right here at home. It's a disgrace we're not number #1 in infant care, education, or elder care for our retirees. We shouldn't even be talking about caring for our people - it should be a given. How can we be an example to the rest of the world if our own country is in such poor condition?
      • Re: (Score:3, Interesting)

        by gweihir ( 88907 )
        You make a lot of valid points.

        How can we be an example to the rest of the world if our own country is in such poor condition?

        Simple: The US has long ago stopped being an example. As a European I can say that most people here that have actually looked at the US find it backwards and vastly inferiour in quality of living, education, infrastructure and other aspects. Not to want to look down on your country, but I believe one primary reason for this is that most US citizen still believe the US is the "greates
    • Re: (Score:3, Informative)

      by eclectic4 ( 665330 )
      "he United Kingdom spends eighty billion pounds a year on healthcare, funded directly through taxes."

      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 t
    • Re: (Score:3, Insightful)

      by cfulmer ( 3166 ) had an interesting anecdote about France's healthcare system:

      "Conversation at lunch revealed that the neighbor, who had a history of heart trouble, suffered severe chest pains a few weeks ago. He wisely went to the hospital seeking treatment. He was told that there was no space available for him. He was advised to go home and call back later to see if a room might have become available. He did so, but was told repeatedly that the hospital remained full to capacity. Several days later this
  • Great. (Score:2, Interesting)

    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).

    Wow, that's progress.
    • Re:Great. (Score:4, Insightful)

      by Prof.Phreak ( 584152 ) on Wednesday July 04, 2007 @05:19AM (#19741329) Homepage
      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.
  • by Zarhan ( 415465 ) on Wednesday July 04, 2007 @05:11AM (#19741271)
    ...what's the point in having insurance for all, if insurance companies will just deny all the claims due to conditions obscured in legalese?
    • Re: (Score:3, Interesting)

      by Tatarize ( 682683 )
      Well, actually... that's just half the problem. It's so much cheaper to just give the hospitals all the money for the services rendered than to force private citizens to get insurance. I am very opposed to the government requiring us to get certain services unless they are themselves offering the services directly. This law really does just feed the health insurance industry without providing the needed care. We could do the same exact thing without the paperwork and for cheaper if we let Medicare cover it.
  • by line-bundle ( 235965 ) on Wednesday July 04, 2007 @05:15AM (#19741305) Homepage Journal
    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)
    • Re: (Score:3, Insightful)

      by Tony Hoyle ( 11698 )
      In the UK having not having car insurance is illegal (OTOH if they catch you they normally just take the car off you and crush it).
      It's fairly analogous - companies having a legal right to your money mandated by the government. Competition doesn't help much.. there are lots of insurance companies but they all charge the same fees, so unless someone breaks ranks and starts offering really cheap insurance then the price will stay the same, more or less.

      Can't imagine mandatory health insurance.. I had that th
  • by Rhett ( 141440 ) on Wednesday July 04, 2007 @05:25AM (#19741349) Homepage
    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.
    • Re: (Score:3, Insightful)

      by lawpoop ( 604919 )

      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?

      I don't know the answer for sure, but probably yes.

      The idea behind insurance is to spread the risk of a venture around a group of people. The cost of driving a car, the cost of owning a home, and the cost of living. It's not unlike the Amish coming together and helping out a family who has a sick member -- the cost of care is shouldered by the community.

      However, insurance companies have taken that 'community support' -- the money people pay in -- and then *excluded* people from the insurance pool. So t

  • by JavaSavant ( 579820 ) on Wednesday July 04, 2007 @05:29AM (#19741365) Homepage
    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
    • by RyuuzakiTetsuya ( 195424 ) <taiki.cox@net> on Wednesday July 04, 2007 @06:41AM (#19741721)

      As a libertarian, the whole arrangement is patently offensive to me. Health policy in this country has always been about providing it as a welfare service to those who can't afford insurance while at the same time allowing the rest of us to decide as to whether our own situation dictates whether or not the purchase of health insurance is a gamble with some positive expectation. At least in a welfare system, there is no facade as to how taxation is used to provide services to the population as a whole. Massachusetts' system however is a tax where the collector is private enterprise with a profit motive. Taken together, the law should be enough to offend everyone. In Massachusetts' however - not enough people seem to be paying attention.
      Oh my god, it's a Libertarian who gets the fucking point.

      As a Liberal, I'm frequently shocked by Libertarians utter disdain for public services(I'm looking at you Ron Paul) and blatant misrepresentation of what Government is, or even that it can do a good job(I'm looking at you Penn Jilette). However, as it can be easily shown, no matter how bad Government is and no matter how infinite it can be incompetent, there is no shortage of examples from within the private sector of private businesses and Non Government Organizations screwing up just as badly. The major difference of course, is accountability. We can hold our Government more accountable for it's actions through elections.
      • by Xyrus ( 755017 ) on Wednesday July 04, 2007 @08:49AM (#19742493) Journal
        "We can hold our Government more accountable for it's actions through elections."


        Bwahahahahahahahahaha....ooooo....bwahahahahahahah a...*giggle*

        Oh, that was a good one! I think I blew a kidney on that one.

        Um. Oh wait, you must be new here. I'm sorry but we don't do that here anymore.

        • Re: (Score:3, Insightful)

          by Stiletto ( 12066 )

          When was the last time you voted a CEO out of his job because the company provided poor service? That power is usually reserved for the shareholder class, who are frequently not even the company's customers or are ever affected by poor customer service.

          When was the last time you, personally, had a hand in holding any corporate executive responsible for ANYTHING bad they did? "Not buying their product" doesn't count. We're talking about monopolies (health care).

          On the other hand, much of Congress was just
  • by Opportunist ( 166417 ) on Wednesday July 04, 2007 @05:39AM (#19741421)
    I consider it a step in the right direction. Yes, it's "socialism at its finest", but it's a matter of being human, IMO.

    Yes, the ones that need this the most are also the ones that can hardly pay for it. So you, the healthy guy, spend more on your insurance than you'll ever get out of it, most likely. Still, I prefer being healthy and "ripped off" to being sick and "enjoying" my stay in the hospital on someone else's expense.

    But that doesn't mean that we have to "level" the field. You can still get "better" plans for more money. Here, the solution is simple: You have a standard insurance. Which covers most of your medication, operations and a stay in the hospital. You want more, you can get more, you just pay more. You want a certain doctor? Pay for it. You want to lie alone in a room in the hospital? Pay for it. You want certain medicaments instead of the standard? Pay for it. You want painkillers where there are usually none required (like in most tooth related issues)? Pay for it.

    Yes, the "extras" cost more than they're worth. Most of the time (a shot of painkiller for a simple tooth drilling costs about 15 bucks, a room for yourself in a hospital is a few hundred bucks extra a day). But that's how it works here. You get what you need from your health care. You want comfort? Pay for it.
    • Re: (Score:3, Insightful)

      Yes, the ones that need this the most are also the ones that can hardly pay for it. So you, the healthy guy, spend more on your insurance than you'll ever get out of it, most likely. Still, I prefer being healthy and "ripped off" to being sick and "enjoying" my stay in the hospital on someone else's expense.

      You're the closest I've seen to bringing home a point I see about national health care. Thing is that national health care is the ultimate HMO. Difference is that your monthly premium is a percentage of your income, not "how sick/old/risky are you". In the US, it doesn't matter how much you pay per month, if you ever have a claim, you're a freeloader. Just like the homeless bum who it'd be oh-so-horrible if he got treated on your dime. Because any (serious) claim in the US medical industry costs mo

    • Re: (Score:3, Insightful)

      by Lumpy ( 12016 )
      How can you consider it a step in the right direction, did you EVEN READ THE ARTICLE??

      You as joe blow are FORCED to go and buy health insurance or you will be FINED by the state.

      anyone that finds that a step in the right direction is completely and utterly nuts.

      The law is insurance lobbying at it's finest and disgusting at every step of the way.

      if you are rich you already have health insurance, if you are poor you get to suckle off the government teat for free health insurance, everyone in between is screwe
  • by SySOvErRiDe ( 646513 ) on Wednesday July 04, 2007 @05:42AM (#19741431)
    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.
  • by The Fanta Menace ( 607612 ) on Wednesday July 04, 2007 @05:53AM (#19741485) Homepage 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.

  • by occamboy ( 583175 ) on Wednesday July 04, 2007 @06:09AM (#19741561)
    A few comments from this Massachusetts resident...

    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.
  • by jonwil ( 467024 ) on Wednesday July 04, 2007 @06:12AM (#19741573)
    Here are my ideas based on what I know about it (I don't live there but I have watched enough US hospital shows on TV to know a little about it :)
    1.Completely ban health insurance companies from specifying which treatment options a patient must take if they are to be covered (e.g. "you must use our preferred hospital" or "we wont cover you for that really expensive test even though the doctor says you should have it") or from charging differently based on what options are picked. This change doesn't mean they have to provide coverage for stuff like baldness cures (ala that one Simpsons episode) or whatever other non-life-threatening treatments they don't currently cover

    2.Do whatever is necessary to increase choice of provider. If there are more options for people to pick from then we will see insurance companies competing for business (here in Australia, health funds spend big money trying to convince you to switch to their policy)

    Those 2 provisions would be a good start in fixing the system. Feedback from those who know more about the system would be nice :)
  • by N8F8 ( 4562 ) on Wednesday July 04, 2007 @07:22AM (#19741921)
    Is that it is primarily corrective instead of primarily preventative.
  • by MadCow42 ( 243108 ) on Wednesday July 04, 2007 @07:28AM (#19741961) Homepage
    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. :(

  • by bryan1945 ( 301828 ) on Wednesday July 04, 2007 @07:31AM (#19741983) Journal
    So for now you are required to get insurance. What next, required genetic testing? Pre-natal screenings for possible conditions, requiring you to get an abortion if the fetus is not "in the acceptable range"?

    Yeah, I know it's way out there... but have you seen Gattaca? The rate the US is going, I'm... disturbed.
  • by Ihlosi ( 895663 ) on Wednesday July 04, 2007 @08:13AM (#19742245)
    It's not a good system, but everything else is worse.
  • Details unclear (Score:3, Interesting)

    by interglossa ( 1110251 ) on Wednesday July 04, 2007 @12:21PM (#19744401) Homepage
    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.

"Let every man teach his son, teach his daughter, that labor is honorable." -- Robert G. Ingersoll