Tomorrow’s Connector meeting is expected to approve standards for “minimum creditable coverage” – MCC. The MCC decision will also influence the offering in the Commonwealth Choice plans, the health insurance plans to be offered by the Connector to individuals and small business. The Commonwealth Choice plans were approved at the previous meeting with the proviso that they would be changed in necessary to comply with MCC.
One of the key issues is whether some prescription drug coverage must be included in MCC. On Saturday, Dr. Stephen B. Soumerai published an op-ed in the Globe explaining the value of including prescription drug coverage:
Prescription drugs remain the key to modern medicine. They prevent suffering and death of individuals living with chronic conditions such as diabetes, cancer, asthma, depression, and heart disease — diseases that affect the young as well as the elderly. Those who don’t have drug coverage skip doses of medicines that they need or go without food to afford them. Skipping medicines to save money is linked to a 50 percent increased risk of heart attacks and strokes and unnecessary hospitalization.
The public agrees. The Herald today reported the results of a survey commissioned by the Massachusetts Biotechnology Council, which found that 72 percent of state residents would be willing to pay either an extra $20 or $40 for drug coverage.
And Connector Executive Director Jon Kingsdale pushes back in a Globe op-ed today against criticism of Commonwealth Choice plans for their high deductibles. He points out that the plans are significantly better than what is currently available on the market for individuals:
All told, then, the Connector has successfully cut the monthly premium consumers pay today by half, and slashed the deductible by almost two-thirds. The result is not cheap — healthcare never is — but it’s far more affordable than anything available today. And the Connector is looking to make it even more so, by working with employers to allow employees to pay for insurance with pretax dollars. This would further reduce the $175 premium to a net cost of about $109.
Details, I couldn’t agree with you more! And there are countless others like us; they just don’t blog. Hopefully they vote and call their legislators, though.
You might be interested in the several reply comments to a poster on the new NPR-WBUR “CommonHealth” blog. In this thread the issue you raise (the imperative of access) is addressed in the comments http://blogs.wbur.org/commonhealth/?p=21#comments
Still they keep talking about premiums and not the access to care. Will the people that purchase these plans have access to every hospital and every doctor in Massachusetts? What will happen when a health plan member wants to utilize a facility that is NOT within the prescribed network? Who will pay that bill? What are the deductibles and OOP max in those situations?
What the Connector board and this site have boiled the health care issue in Mass. down to is premium price. Since none of these people are going to be forced to purchase these plans, they apparently aren’t concerned with doctor and facility access. It’s all premium price, smoke and mirrors. When someone goes under the knife, do you really think they are concerned with their premium and OOP expense. What they are only concern should be is that the doctor performing the procedure and the facility where it is being performed are world class and the finest available.
So far I see no discussion on this most important issue.
Please take care to not mislead about the cost; premiums are only one part of the cost of coverage. For more on this a Letter to the Editor from the Boston Globe Sat. 3/17/07:
“JAMES ROOSEVELT, chairman of the private insurers’ trade organization, dismisses worries about the affordability of the state’s mandated health plans (” Misinformation and fear muddy healthcare debate,” Letters, March 13). He trumpets the fact that plans without deductibles will be available. What he doesn’t say is that these plans will have huge copayments. In the “basic” no-deductible plan, patients will have to pay 35 percent of the total cost of hospital care, X-rays, lab tests, and outpatient surgery. Even a simple appendectomy would cost thousands out-of-pocket. Few of the uninsured could afford this, especially after forking over premiums of between $3,028 (for a 26-year-old) to $6,056 (for a 56-year-old).
The Connector (the agency running the new health reform) and the insurance companies boast about the low-cost, quality coverage they’re forcing the uninsured to buy. But they admit, in insurance speak, that the new plans have 60 percent of the actuarial value” of a comprehensive plan. Stripped of jargon, this means the uninsured will get 60 percent of the coverage people like Mr. Roosevelt have for their families. And he could afford high copayments and big deductibles. Our patients can’t.
Drs. STEFFIE WOOLHANDLER and DAVID U. HIMMELSTEIN
Cambridge”
link to Letter online http://www.boston.com/news/globe/editorial_opinion/letters/articles/2007/03/17/promises_promises_in_healthcare_reform/