Labor Law Guy

Old Approach to Health Care Reform

Posted in Federal Labor Law, Random Musings, State Labor Law by laborlawguy on December 17, 2008

Recently, I wrote about a fresh, holistic approach to health care that could well serve as the basis for a real reform effort.  However, more likely what will happen is the Feds will copy the Massachusetts model for health care reform–and get it all wrong.

The problem with all announced reform plans is that the reformers want to make health both more affordable and more accessible, but if you roll in another 50 million people into the ranks of the insured, the first problem is that there simply aren’t enough facilities or practitioners to handle them.  So something has to give–either on the accessible side or the affordable side, or both.

Which is exactly what happened in Massachusetts–both goals got trampled under weight of the unrealistic expectations and bad modeling.

You don’t have to believe me. Fortunately, there are well-respected health care professionals who can dissect the Massachusetts mess for us. Enter Maggie Mahar, author of the 2006 book Money-Driven Medicine, and blogger at Health Beat.

I’ll provide a link to her article on Massachusetts at the end of this, but let me repeat a few points she makes.

Under the Massachusetts universal health care initiative, the percentage of uninsured in 2006 (when it was passed) fell from 6.4 to 5.7 the next year, roughly equal to the rate in the year 2000 (5.9 percent).  Fewer than 500,000 Massachusetts residents are now covered who weren’t before.

Problem is, most of them can’t find a doctor and, if they’re using a state health plan, can’t afford the co-pays (20 percent) or the deductibles ($2,000 per person).  That’s why use of emergency rooms is up 40 percent in Massachusetts. If you already have a doctor, the wait to see him or her has gone from an average of one month to two months since 2006–and is rising.

Plus, the plans the state offers are so expensive–about $9,000 a year for a couple in their 50s (plus the onerous co-pays and deductibles)–that tens of thousands can’t afford the policies, so the state has “exempted” 62,000 residents from the mandate to buy health insurance.  Plus, the program is so costly that the state can’t afford to subsidize people who can’t pay even when they qualify under income qualification standards.

Like I said, it’s a real mess, which will soon be transplanted onto the national stage.  Get ready for less (health care) for more (money).

Read Ms. Mahar’s article, “On Health Care Reform Stimulating the Economy: The Massachusetts Example.”

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