In 2006, [Massachusetts] lawmakers seeking to broaden health coverage made it illegal to be uninsured. It works like this: Employers have to offer you a health plan. If you are jobless or don’t like your employer’s plan, you must buy your own. If you don’t get one, you pay a stiff fine. This strategy—known as an employer and individual “mandate”—forms the backbone of the national health reform bills now making their way through Congress.


On paper, the experiment was a resounding success. According to an Urban Institute estimate, the number of uninsured residents quickly fell from 13 percent to 7 percent following the law’s passage.

And yet, something strange happened. Despite having health insurance, roughly one in 10 state residents still failed to fill prescriptions, ended up with unpaid medical bills, or skipped needed medical care for financial reasons. Hundreds of millions of dollars were spent to insure more Massachusetts citizens, but many people still weren’t getting necessary care. What happened?

Assume you’re looking to buy insurance. The state has a handy Web site where you can find the cheapest plan. For a young family of four, that plan costs roughly $9,500 per year, which doesn’t include a minimum annual deductible of $3,500 before many benefits kick in. (The state helps cover some of the premiums for those who make very little money, but many still have to pay the other fees.) And if anyone is hospitalized or needs a lot of specialized care, you also pay 20 percent of that bill. In this relatively cheap plan, the family can be liable for an extra $10,000 per year of medical costs. This sort of “high deductible” health plan is clearly structured to discourage medical care.

The article goes on to detail the effects of the program, parts of which may end up in Obama’s plan. The author’s conclusion?

The expensive Massachusetts plan is not well-designed to systematically improve anyone’s health. Instead, it’s a superficial effort to clear the uninsured from the books and then clumsily limit further costs by discouraging care.




  1. Sea Lawyer says:

    #34, Named, it’s really not any different than the dozen other tax credits for various things (e.g. education) that exist. Whether they are truly effective in their goal is debatable, but they sure do let politicians brag to the electorate that they’ve done something, which is really all that matters in the end.

  2. Mr. Fusion says:

    Liberty Loser,

    As I said before, you have no new ideas. All you right wing nuts can propose is more tax cuts / deductions / rebates / etc.

    Although Named is another person, he is not I. Nor am I he. Thank you for the compliment of comparing me to someone as intelligent, literate, and clear headed as Named. I am honored.

    Now, if only you had some intelligence, …

  3. Named says:

    35, Sea Lawyer

    Very well put. Unfortunately, health care is one of those things that should be more direct than a tax credit. What good is a tax credit to those that cannot outlay the initial funds? Its practically an insult at that point.

    36, Mr. Fusion

    Thank you for the compliment!

  4. LibertyLover says:

    Fusion/Named:

    #34Wow. You are so clever. And what happens with 9500 is not available to pay initially?

    Um, that’s where the greed comes in. If the insurance company wants the money, they’ll work a deal with the customer, knowing the government is going to pay the bill.

    Like VA loans. They’re guaranteed.

    Would you like me to introduce you to Wall Street and Haliburton? One got 700 Billion for fucking around and the other got the country of Iraq. So, the NEED constituted the GET indeed. Health care is public protection which is a mandate of the government.

    You are comparing healthcare to that monstrosity? You’re really desperate.

    And what’s will the cell phone talk? I’m still not getting it?

    Good one.

    Although Named is another person, he is not I

    Good one.

    All you right wing nuts can propose is more tax cuts / deductions / rebates / etc.

    Wouldn’t you rather just pay out $9500 instead of $9500 + 25% ??

  5. LibertyLover says:

    So, tell me. Why do the words, “tax cuts / deductions / rebates” cause a democrat’s sphincter muscle to contract?

  6. MikeN says:

    $10,000 a year for health insurance? In the last 20 years, I’ve maybe spent $1000 on health care, and it’s probably closer to $100. Why should I have been forced to spend $50,000 in that time, just so the government can use the money on someone else?

  7. right says:

    Where I am, I pay $54/month for full medical coverage. Emergency, hospital stay, surgery and never see a bill.

  8. Named says:

    38, LL
    “Um, that’s where the greed comes in. If the insurance company wants the money, they’ll work a deal with the customer, knowing the government is going to pay the bill.”

    Right. So cut out the greedy middle man and deal with single payer only. Cheaper in the long run. Good idea Liberty Lover! I’m glad you finally saw the light.

  9. LibertyLover says:

    #42, Nice Try.

    Just saying there is a middle man doesn’t make it so.

  10. Named says:

    42,

    “Just saying there is a middle man doesn’t make it so.”

    Uh… there IS a middle man. The insurance company. You stated it yourself directly.

  11. LibertyLover says:

    #44, The insurance company is there whether the government pays on behalf of the citizens or the citizens pay them on behalf of themselves.

    Unless you are suggesting the government get into the insurance business as well as the automobile industry . . .

    By taking less taxes, you are encouraging responsibility in finding a good insurance plan.

    Unless you think nobody is smart enough to do that . . .

  12. Named says:

    45,

    the problem with private insurance currently is that they have limitless power to allow or deny your claim. Switzerland has mandatory private insurance, but the companies cannot decline membership for any reason. Everyone must have insurance and everyone CAN get insurance. It is different in the US. It is the insurance companies policy to not pay out if possible. It’s not good for business.

    So, in light of the government not being able to change insurance companies practices, then yes, they should abolish them for say 15 years and take over the task. Then the government can start to re-introduce mandatory private insurance where everyone is GUARANTEED access.

    Single payer systems are successful. No system is flawless. When a system can help 95% of it’s members instead of 50% that is considered a success.

  13. LibertyLover says:

    #46, You are living a fantasy if you think you can do what you want. There is no way any system can provide insurance for 95% of the people and give the kind of coverage currently available through private insurance.

    If you dig deep enough, you’ll find your European paradises refuse long term care quite frequently if it starts to get too expensive. Everybody has an upper limit associated with their care. And everyone pays out the nose for the privilege.

    What makes you think it can be done here? I still haven’t heard an answer to that other than “Billy gets to go, why can’t I?”

  14. Named says:

    “What makes you think it can be done here? I still haven’t heard an answer to that other than “Billy gets to go, why can’t I?”

    Why? Isn’t America is the greatest, richest, most intelligent nation on earth? And if dummies like the rest of the industrialized world can do it, surely the greatest nation on earth can too!

  15. Named says:

    48 was for you LL, #47

  16. LibertyLover says:

    #48, Sigh.

    If that’s the case, why haven’t we gone that route already?

  17. Named says:

    50,

    Obviously because health care lobbyists pay a lot of money to politicians so it doesn’t happen. Remember your lovely GREED factor? Well, it’s not always a “good thing”. Sometimes it kills a lot of people, keeps them sick, or bankrupts an entire country and global financial system… in case you forgot about that.

  18. LibertyLover says:

    #51, Again . . . why haven’t we led the world?

  19. Named says:

    52,

    “Again . . . why haven’t we led the world?”

    “Obviously because health care lobbyists pay a lot of money to politicians so it doesn’t happen.”

    Now we can start the loop. You ignore the answer and ask the question again. I’ll comment with the corruption of your politicians. Rinse, repeat.

  20. LibertyLover says:

    #53, Obviously you don’t understand irony.

    (We’ll move on past that for now.)

    So, you think these other countries are better off than we are?

  21. RTaylor says:

    This thread proves it’s folly to make a rapid decision. Spend another year in healthy debate. This is a major entitlement program. Once this law is enacted, generations will have to live with it. Nothing perfect will come out of Washington, it never has. In the end it will still be a camel instead of a horse. At least find enough food for the critter.

  22. brm says:

    My ex has been living in Massachusetts for a couple years. She just graduated, so is pretty much broke – just scraping by while she builds up a resume.

    She is seriously worried about being fined for not having had health insurance since graduation.

    Of course, she won’t be able to afford the fine any more than she can afford the insurance.

  23. LibertyLover says:

    #56, Then she’ll probably end up in jail. Put there at the point of a gun.

  24. Sea Lawyer says:

    #55, RTaylor, typically, the people who craft and vote on these bills are doing so with only a single goal in mind, and minimal consideration is given to possible secondary effects.

  25. Phydeau says:

    #54 LL So, you think these other countries are better off than we are?

    You’ve lost the argument, LL. Those other countries are clearly better off than us — more people covered, less spent per capita. The only thing keeping us back is the lobbying power of the insurance companies and others who are making fat profits off the current system.

    Just slink away, if you know what’s good for you.

  26. Mr. Fusion says:

    #45, Liberty Loser,

    Unless you are suggesting the government get into the insurance business as well as the automobile industry . . .

    No. I want the government get into the collection of premiums that pay for our medical and health care system. Insurance, well, in name only.

    Every other developed country in the world can do it and you have not demonstrated why the US can’t.

  27. Named says:

    54
    “So, you think these other countries are better off than we are?”

    Well, every survey that shows best cities in the world to live never rank a US city above 25th place. This survey shows the first city at 29 and 30. Honolulu and San Francisco. I wonder why…
    http://www.citymayors.com/features/quality_survey.html

    So… it appears that a lot of European and Canadian cities ARE better off…

    [Named, look at the URL you posted. Does it work? No? I wonder why not. Hmmmmmmm… – ed.]

  28. brm says:

    #60:

    “Every other developed country in the world can do it”

    I really hate this argument, no matter where it’s applied.

  29. LibertyLover says:

    #59, That’s the answer I was looking for.

    These people all want to change America because they don’t like it. We are the most powerful country in the world and it’s not because we are like the EU. It’s because we do things our way.

    I like things the way the are. It could be better — the government could be less involved in the day to day activities of the people, but I don’t feel things are so bad I want to turn us into another EU clone.

  30. Phydeau says:

    #63 LL These people all want to change America because they don’t like it. We are the most powerful country in the world and it’s not because we are like the EU. It’s because we do things our way.

    I like things the way the are. It could be better — the government could be less involved in the day to day activities of the people, but I don’t feel things are so bad I want to turn us into another EU clone.

    I can’t decide whether you’re funny or pathetic, LL. Other countries do something different which is clearly better, and you don’t want to do it, solely because that’s not the way we’ve always done it here in the U.S. And we’re the most powerful country in the world, dadgumit, so every single thing we do is, by wingnut logic, better than everything any other country does.

    So Americans keep dying and get sick more and spend more than Europeans, but because single payer is one of those sissy European ideas, you don’t want to do it.

    Words fail me… that is so retarded.


2

Bad Behavior has blocked 7585 access attempts in the last 7 days.