If it weren't for the MA health care system, I would be screwed.

[Kat45]

Some folks here make negative comments about what they call "RomneyCare," but in my experience, it works. Of course it's not perfect, but as I said, if it didn't exist I would have no health care at all.

My job got eliminated a year ago December and except for a low paying, life-sucking part-time, benefit-less for-now job, I have not been able to find employment. Because of what MA has done regarding health insurance, I have been covered all year. I am fortunate to have not had any serious health care issues this year, but routine care is important as well. Because of MA health care, I was able to get a mammogram. I got a colonoscopy. I got a pap smear, which all women should have annually but is even more important for me as a follow up to surgery that removed cancer cells a few years ago. Because of that gynecological appointment, my savvy doctor decided to measure my height, which had shrunk by an inch, and then sent me for a bone density test. That test showed that I have osteoporosis for which I'm now taking medication, affordable because of my health insurance.

If I didn't live in MA, I would not have had this insurance coverage and would not have received that medical care. As a single woman with no children, I was not eligible for Medicaid. Massachusetts has an entity called the Commonwealth Connector through which one can get insurance. Commonwealth Care is the program with subsidized plans for low or no income people. Commonwealth Choice is an exchange through which one can purchase a policy. I applied for the former and while I was waiting I decided to use money I'd saved to purchase a plan through the Choice piece. It cost me around $300 a month, which seemed reasonable considering how expensive health insurance tends to be. The next month I was approved for Commonwealth Care, which provided a plan with a fully subsidized premium. Yes, there were co-pays but they were similar to the amounts I paid when I got my insurance through work. When I started working part time, I had to pay $77 a month for the premium; I wasn't happy about it but it seems reasonable enough considering the cost of health insurance. Commonwealth Care places you in a tier for type of plan but you do have a choice of several plans. The differences in the tiers seem to mainly involve amount of co-pays. Commonwealth Choice also offers several plans at different price points for your purchasing choice. So far, I did not have any problem of the plans refusing care. With both Choice and Care, they are group plans, not individual plans. There was no regard for health status or pre-existing conditions. Individual plans are pretty much useless because they are way too expensive and give too little coverage--if they'll even take you at all. So I am extremely grateful that Massachusetts passed its health care bill. My main fear is that they will end up cutting back because of the state of government finances these days.

[AllieB]

1. kick

[Phoebe Loosinhouse]

2. Do you think MA voters don't like HCR because they are afraid that it will supplant

a system that is largely working?

All the MA posters have been screaming from the top of their lungs that the issue sinking Coakley is support for HCR. I think your post is the first one that has made it clear to me that perhaps a lot of them are thinking, don't screw up what we have, it works.

I think most of the uninsured in the rest of America would be grateful to have a halfway decent plan that cost $77 a month with no pre-existing exclusions. Shoot, after reading your post I would consider moving to Massachusetts!

[Kat45]

4. I don't know. I'm curious about that myself.

At this point, I don't know what is in the national bill and of course we don't know what will be in the final version. I remember reading that one thing they were considering would make it so states couldn't have their own plan. I wasn't happy to hear that and I don't know what happened with it. I am concerned about that but right now I'm not throwing out the HCR idea because I keep hoping the reconciliation will somehow improve it. Maybe I'm being too hopeful, I don't know.

[druidity33]

5. it works for me, but...

the income guidelines are really slim. It is likely that i will have to quit my job in order to qualify for the higher tier of subsidized care next year. My wife makes an ok wage and if we live on her income we qualify for CommonWealth Care. Our cost for family insurance (me, her and an 8 year old) would be around $70 a month. If i work (take home pay around $300 bi-weekly), then our insurance goes to $450 a month. It's hardly worth it. I'd be working 20-25 hours a week in order to earn around $200 a month.


Do we want a system of health insurance (not health care) that inspires me to quit my job so that i can get a better subsidy?


:shrug:

[Kat45]

6. I hear you.

Not a great situation. But I'm still grateful to be able to get health insurance/health care because without this system I'd have squat.

[HughMoran]

3. K&R

[graywarrior]

7. When I saw Bill Clinton the other day, he said HCR would be following the

model of the MA bill.

[Phoebe Loosinhouse]

8. That is really interesting.

And this OP is the first detailed and good description of Mass Healthcare I have seen.

I just have to chuckle at the irony of after all this we are getting Romneycare - and I am not saying that as an insult- it's just funny how that is what we get after all the months of committees and behind the scenes wheeling and dealing, etc.

I bet Mitt Romney appreciates the irony.

[eridani]

9. It sucks pretty badly for older and chronically ill people who aren't old enough for Medicare

http://www.pnhp.org/news/2007/september/health_reform_failur.php


And 244,000 of Massachusetts uninsured get zero assistance - just a stiff fine if they don’t buy coverage. A couple in their late 50s faces a minimum premium of $8,638 annually, for a policy with no drug coverage at all and a $2,000 deductible per person before insurance even kicks in. Such skimpy yet costly coverage is, in many cases, worse than no coverage at all. Illness will still bring crippling medical bills - but the $8,638 annual premium will empty their bank accounts even before the bills start arriving. Little wonder that barely 2 percent of those required to buy such coverage have thus far signed up.

While the middle class sinks, the health reform law has buoyed our state’s wealthiest health institutions. Hospitals like Massachusetts General are reporting record profits and enjoying rate increases tucked into the reform package. Blue Cross and other insurers that lobbied hard for the law stand to gain billions from the reform, which shrinks their contribution to the state’s free care pool and will force hundreds of thousands to purchase their defective products. Meanwhile, new rules for the free care pool will drastically cut funding for the hundreds of thousands who remain uninsured, and for the safety-net hospitals and clinics that care for them. (Disclosure - we’ve practiced for the past 25 years at a public hospital that is currently undergoing massive budget cuts.)

Health reform built on private insurance isn’t working and can’t work; it costs too much and delivers too little. At present, bureaucracy consumes 31 percent of each healthcare dollar. The Connector - the new state agency created to broker coverage under the reform law - is adding another 4.5 percent to the already sky-high overhead charged by private insurers. Administrative costs at Blue Cross are nearly five times higher than Medicare’s and 11 times those in Canada’s single payer system. Single payer reform could save $7.7 billion annually on paperwork and insurance profits in Massachusetts, enough to cover all of the uninsured and to upgrade coverage for the rest of us.

Statement of Rachel Nardin, MD., President, Massachusetts Chapter of Physicians for a National Health Program, neurologist at Beth Israel Deaconess Medical Center in Boston, and assistant professor of neurology at Harvard

The study we released on Feb. 19 also reminds us that having health insurance is not the same thing as having health care. Despite having coverage, many Massachusetts residents cannot afford care. In some cases, patients are actually worse off under the reform than they were under the state's old system of free care because their new insurance has far higher co-pays for medications and care. According to a recent Boston Globe/Blue Cross Foundation survey, 13% of people with insurance in our state were unable to pay for some health services that they had received and 13% could not afford to fill necessary prescriptions. The reform does not appear to have reduced the numbers of people who were unable to get care that they needed because of the cost.

I will close with the story of one Massachusetts patient who has suffered as a result of the reform. Kathryn is a young diabetic who needs twelve prescriptions a month to stay healthy. She told us “Under Free Care I saw doctors at Mass. General and Brigham and Women's hospital. I had no co-payments for medications, appointments, lab tests or hospitalization. Under my Commonwealth Care Plan my routine monthly medical costs include the $110 premium, $200 for medications, a $10 appointment with my primary care doctor, and $20 for a specialist appointment. That's $340 per month, provided I stay well.” Now that she's “insured,” Kathryn's medical expenses consume almost one-quarter of her take home pay, and she wonders whether she'll be able to continue taking her life saving medications.