Comments on: The Bids Are In, II: So What Does This All Mean?

By: working nurse

working nurse — Tue, 06 Mar 2007 12:18:24 +0000

admin says: “And individuals decide themselves on that tradeoff”

WRONG WRONG WRONG

Very misleading to say that. People are BEING FORCED to choose between limited options; this reform approach is creating a stacked deck to satisfy propping up/building on the private insurance industry that by its very nature treats healthcare as a commodity rather than as a public good.

“Essentially, the cost has been shifted from the premium to the deductible but remains about the same.” (as a previous commentor rightly points out).

The Emperor Has No Clothes and the minions are smiling and saying “oh, doesn’t he look nice”.

Please inform yourself of a smarter, more cost-effective, clinically effective and more civilized approach to universal health reform and sign on to help make it our reality. Visit http://www.MassCare.org/about. Thanks.

By: admin

admin — Tue, 06 Mar 2007 03:30:07 +0000

Response to Ted:
The deductibles vary. Some plans have deductibles as high as 2K and others have none. There is a clear tradeoff between lower premiums and higher cost sharing. And individuals decide themselves on that tradeoff. The Globe article also clearly showed there are individuals who prefer higher deductibles, and regard the deductible limit for Connector policies as too low. Enforcement of the individual mandate must be based on both the premium and the deductible.

By: Ted Behr

Ted Behr — Mon, 05 Mar 2007 23:23:37 +0000

Today’s Boston Globe (Monday, March 5) reports that the likely deductible for these lower premiums will be around $2000 for an individual. This doesn’t make the lower premiums look so good any more. Essentially, the cost has been shifted from the premium to the deductible but remains about the same. Also, as noted in the Globe, such high deductibles will keep people from using the insurance that they are being forced to purchase. This doesn’t look like reform to me. How can we justify requiring people to purchase a product that they then will not use?

By: Self-Employed

Self-Employed — Mon, 05 Mar 2007 04:39:18 +0000

If you are stuck with an HMO, the company decides exactly what you get (or don’t get). This is why some families have to run spaghetti suppers to raise funds when their child needs a transplant. Some call that community spirit; I call it begging. Want to sue an HMO? The Supreme Court has said you can’t. If you don’t have an HMO now, it may be better to just keep your policy and pay the penalty. Also, my insurance representative suggested I keep my current plan because the current law will probably be struck down.

I have a PhD in economics, and it’s Econ 101 that a small group of suppliers will (legally) collude in a protected market. You can expect to see huge increases because the state has jimmied the rules to exclude out-of-state providers. By requiring no lifetime maximums and the two doctor visit rules, no nationally available plans can compete. The rates that are being offered are teaser ones.

There are a few other nasty implications of this law: If your employer pays your health insurance and you lose your job your FIRST expense will be having to buy health insurance. This comes before food, housing and your children’s clothes. Should you choose to feed your children over carrying “approved” insurance, Mass DOR will have the authority to fine you. Oh, and if you do get seriously sick, you’ll need to fork over $2000.

Another nasty complication are workers who are employed by out-of-state firms. When I contract with these firms, they don’t cover benefits. This means that (if they employ enough people in Mass.), they will get a fine. This puts me at a competitive disadvantage since these firms can hire workers from other states. This is also another reason for firms not to locate to Mass.

The simple fact is this: If Mass. would deregulate its insurance market, you could find cheaper and better plans from national providers. Instead, fines are levied. And all of these fines and mandates do *nothing* to expand the available supply of health care. Greater demand + steady supply = higher prices.

I appreciate the idea behind the Mass. regulations — and this open forum which allows for a free exchange of ideas.

By: Sue

Sue — Mon, 05 Mar 2007 02:47:21 +0000

I live in Federal Public Housing and work parttime for a non-profit. My rent is recalculated once a year through my gross income. Now, I’ve been told that my premiums will be paid with my pre-tax dollars. My rent will be calculated (and most likely, increased) with these pre-tax dollars which essentially I won’t have to begin with because it is paying for something that I will legally have to have. Unfortunately, this has the potential to create financial hardships for others like myself.

By: Details

Details — Sun, 04 Mar 2007 14:45:56 +0000

I think the more important questions are yet to be answered than just the premium

What if someone wants to go outside of network for their treatment? Who pays the bill, the client or the health plan?

Who determines what is medically necessary, the doctor or the health plan?

If the health plan determines the answers to these questions, they can offer lower premium pricing in return for limiting their exposure or not allowing care at the more expensive, more experienced providers.

Lastly, I think the premium increases next year will be along the lines of 30-40% at a bare minimum. The health plans had the premium figure correct at the $350-400 range. Since the state has forced them to reprice these plans in order to participate in this marketplace, the health plans will be forced to raise their prices in order to be profitable.

By: average Joe

average Joe — Sun, 04 Mar 2007 14:06:35 +0000

I object to your use of the term 600% of the fpl. Let’s be serious here. The average income in Massachusetts is below that figure and it would be more honest for you to compare incomes to the average than the federal poverty level. Real people don’t like to be related to how close or far away we are from poverty but rather the average. Someone at 400% of the fpl is closer to the average income than the poverty level. Isn’t most of Massachusetts below 600% of the fpl?

By: working nurse

working nurse — Sun, 04 Mar 2007 13:44:18 +0000

Details are what matter. Thanks for details on what’s known thus far and more when it’s available.

Advocates want reform that will help patients, families and communities, not “reform” that largely serves the people and the co’s who in john’s words “don’t want to play in this market” (at the expense of real people in need).

This very real and ever-present tension is what much of the Chapter 58 criticism has rightly been about.

Advocates and activists will stay tuned and stay active working for reform that helps people not profit-makers.

Beyond what works in Chapter 58 more reform will certainly be needed. Many details on this can be found at http://www.MassCare.org/about

By: Celia Wcislo

Celia Wcislo — Sun, 04 Mar 2007 12:59:24 +0000

I couldn’t agree with you more. As a member of the Connector Board, these new sets of bids are realistic, and move us a step forward in providing everyone in Massachusetts with the opportunity to be insured. While these low cost plans do not provide people with the “first dollar” coverage many people are use to in this state, they will give people access to preventative care as well as protection against financial crisis if they are very sick. These plans will help you NOT get very sick by helping you see a doctor to prevent illnes, as well as protect you financially when things go very wrong.

I personally want to thank members of the ACT! coalition-HCFA, GBIO, MHA, League of Health Centers, Partners, and all the other hospitals and consumer advocates who have worked tirelessly to help the Connector Board “do the right thing”. With these lower prices, and with the Governor’s commitment to making sure all plans end up covering prescription drugs, Massachusetts is once again about to be a beacon for everyone across the nation in covering everyone with decent health insurance.

Thank you guys for being the wind behind our back!

By: Celia Wcislo

Celia Wcislo — Sun, 04 Mar 2007 12:49:34 +0000

This step has made health care reform a practical reality now. We can insure every citizen, and, as the Governor said at the press conference, all of us want to find a solution to providing drug coverage for everyone. The members of the Connector Board have always voted to provide precription coverage. Now, with the prices in, we have the numbers we need to make it happen. Thank you to HCFA, GBIO, MHA, Partners, the League of NHCs, and all the others who have pushed us (the Connector Board) to get it right.

Step by step, we are insuring every resident. 110,000 covered, with several hundred thousand to go!