Sky-Rocketing Cost of Massachusetts' Universal Health Care: Wrong for America

Unable to contain the massive health care spending increases and budget
short-falls from its Universal health care program, Massachusetts plans for the
next step: killing the goose that lays the golden egg by further cutting
reimbursements to hospitals and health care providers and rationing care to
patients.

Massachusetts Faces Costs of Big Health Care Plan
NY Times March 16, 2009

“Three years ago, Massachusetts enacted perhaps the boldest state health care
experiment in American history, bringing near-universal coverage to the
commonwealth with Paul Revere speed.

To make it happen, Democratic lawmakers and Gov. Mitt Romney, a Republican, made
an expedient choice, deferring until another day any serious effort to control
the state’s runaway health costs.

The day of reckoning has arrived. Threatened first by rapid early enrollment in
its new subsidized insurance program and now by a withering economy, the state’s
pioneering overhaul has entered a second, more challenging phase.

Thanks to new taxes and fees imposed last year, the health plan’s jittery
finances have stabilized for the moment. But government and industry officials
agree that the plan will not be sustainable over the next 5 to 10 years if they
do not take significant steps to arrest the growth of health spending….

Alan Sager, a professor of health policy at Boston University, has calculated
that health spending per person in Massachusetts increased faster than the
national average in seven of the last eight years. Furthermore, he said, the gap
has grown exponentially, with Massachusetts now spending about a third more per
person, up from 23 percent in 1980. ..

In its first full year of operation, Commonwealth Care drew higher enrollment
than anticipated, and the state found itself facing an inaugural budget gap. Mr.
Patrick and the legislature filled it by assessing insurers and hospitals,
raising the penalty on noncompliant businesses, increasing premiums and
co-payments for consumers, and raising the state tobacco tax….

Some health policy experts argue that changes in payment practices will not be
enough to slow the growth in spending, even when combined with other
cost-cutting strategies. To truly change course, they say, the state and federal
governments may need to place actual limits on health spending, which could lead
to rationing of care… "

Full article:

http://tinyurl.com/cfdtpc

For a more in depth look at the Massachusetts plan see the below article:



Mandatory Health Insurance: Wrong for Massachusetts, Wrong for America

By Dr. Paul Hsieh, MD

“In April 2006, Massachusetts became the first state in the nation to require
that all of its residents purchase health insurance. This mandatory insurance
was the centerpiece of a “universal” health care law hailed by analysts as an
“innovative bipartisan plan….

The Massachusetts plan was, in part, a response to today’s health care costs,
which are rising twice as fast as inflation, making insurance increasingly
unaffordable for many employers and individuals. Currently, approximately 47
million Americans have no health insurance.

In an effort to solve the problem in their corner of the country, Governor
Romney and the Massachusetts state legislature enacted this plan with the twin
goals of reducing the cost of health care and guaranteeing coverage for all
Massachusetts residents….

Yet two years after its inception, the Massachusetts plan has failed to achieve
either of its goals. The plan did not lower health care costs, nor did it
achieve universal coverage.

Thus, given the growing popularity of mandatory health insurance, Americans
would do well to take a close look at the results of the Massachusetts plan—and,
more importantly, at the reasons for those results. Let us look first at the
results.

The Results in Massachusetts

Although advocates of the Massachusetts plan claimed that it would lower health
care costs and achieve universal coverage, it has done neither.

Instead, the plan has increased costs for individuals and the state, reduced
revenues for doctors and hospitals, and left Massachusetts officials in the
awkward position of having to admit that their “universal coverage is not likely
to be universal any time soon.”

Costs have risen for individuals because, under this plan, as under any
mandatory insurance scheme, the government must define what constitutes an
acceptable insurance policy.

As a result, special interest groups have been given both the incentive and the
means to lobby politicians to include their pet benefits as part of the
government-approved plan.

Consequently, the state government requires all patients to purchase “benefits”
that are useless to many of them—benefits they would never voluntarily choose to
purchase in a free market.

For example, Massachusetts currently requires insurance plans to include
forty-three mandatory benefits, including in vitro fertilization, blood lead
poisoning treatment, and chiropractor services—whether or not customers want
them.

Residents must purchase alcoholism therapy benefits, even if they are
teetotalers. These mandated benefits have raised the costs of health insurance
in Massachusetts by 23 to 56 percent.

Costs to the state government have skyrocketed and are projected to run hundreds
of millions of dollars over budget.Because the mandated insurance is so
expensive, the government has had to subsidize the costs of the premiums not
only for lower-income residents, but also for residents with incomes as high as
$60,000 for a family of four—which is three times the Federal Poverty Level.

The state had expected a “significant drop in spending . . . for the uninsured”
but has since acknowledged that this “is not going to happen to any large extent
in 2009.”

Instead, overall costs to the state have risen by more than $400 million, 85
percent more than originally projected.

Because of its own rising costs, the state government has cut payments to
doctors and hospitals. According to family physician Dr. Katherine Atkinson, the
state insurance reimbursements often do not cover her expenses: “[E]very time I
have a Medicaid patient it’s like handing them a $20 bill when they leave.”

As a result of these rising costs and falling revenues, access to medical care
has dwindled for many patients. Fewer doctors are willing to take on new
patients for fear of losing even more money. Lee Sampson, a 47-year old medical
transcriptionist, had to call fifty doctors’ offices before she could find one
that would take her as a new patient.

Tamar Lewis, a 24-year old hair stylist, called more than two dozen primary care
doctors for a checkup. All of them turned her down, leaving her with no choice
but to rely on the community free clinic.22 Patients face long waits for basic
medical care—in some cases more than a year for a routine physical exam.

These long waits are not due to a shortage of doctors. As the New England
Journal of Medicine notes, Massachusetts “has the highest
physician-to-population ratio of any state, in primary care as well as overall.”

The waits are due to a government policy that discourages physicians from seeing
patients—a policy under which seeing patients can mean that physicians lose
rather than make money.

Advocates of the plan often claim that the program has succeeded because it has
decreased the number of uninsured patients.25 In so doing, however, they commit
the common error of conflating insurance “coverage” with medical care. The
government can make endless promises of theoretical “coverage,” but this is not
the same thing as guaranteeing actual health care.

As Dr. H. Carroll Eastman, medical director of the Joseph M. Smith Community
Health Center, confirms: “[W]e don’t have more doctors, but we have lots more
patients”—and the new patients have to wait two to three months for an
appointment.26 These patients know the difference between “coverage” and care….


Full article:

http://tinyurl.com/6zkcap

More articles like this:

http://www.westandfirm.org/blog/index.html

Unable to contain the massive health care spending increases and budget
short-falls from its Universal health care program, Massachusetts plans for the
next step: killing the goose that lays the golden egg by further cutting
reimbursements to hospitals and health care providers and rationing care to
patients.

Massachusetts Faces Costs of Big Health Care Plan
NY Times March 16, 2009

"Three years ago, Massachusetts enacted perhaps the boldest state health care
experiment in American history, bringing near-universal coverage to the
commonwealth with Paul Revere speed.

To make it happen, Democratic lawmakers and Gov. Mitt Romney, a Republican, made
an expedient choice, deferring until another day any serious effort to control
the state's runaway health costs.

The day of reckoning has arrived. Threatened first by rapid early enrollment in
its new subsidized insurance program and now by a withering economy, the state's
pioneering overhaul has entered a second, more challenging phase.

Thanks to new taxes and fees imposed last year, the health plan's jittery
finances have stabilized for the moment. But government and industry officials
agree that the plan will not be sustainable over the next 5 to 10 years if they
do not take significant steps to arrest the growth of health spending….

Alan Sager, a professor of health policy at Boston University, has calculated
that health spending per person in Massachusetts increased faster than the
national average in seven of the last eight years. Furthermore, he said, the gap
has grown exponentially, with Massachusetts now spending about a third more per
person, up from 23 percent in 1980. ..

In its first full year of operation, Commonwealth Care drew higher enrollment
than anticipated, and the state found itself facing an inaugural budget gap. Mr.
Patrick and the legislature filled it by assessing insurers and hospitals,
raising the penalty on noncompliant businesses, increasing premiums and
co-payments for consumers, and raising the state tobacco tax….

Some health policy experts argue that changes in payment practices will not be
enough to slow the growth in spending, even when combined with other
cost-cutting strategies. To truly change course, they say, the state and federal
governments may need to place actual limits on health spending, which could lead
to rationing of care… "

Full article:

http://tinyurl.com/cfdtpc

For a more in depth look at the Massachusetts plan see the below article:



Mandatory Health Insurance: Wrong for Massachusetts, Wrong for America

By Dr. Paul Hsieh, MD

"In April 2006, Massachusetts became the first state in the nation to require
that all of its residents purchase health insurance. This mandatory insurance
was the centerpiece of a "universal" health care law hailed by analysts as an
"innovative bipartisan plan….

The Massachusetts plan was, in part, a response to today's health care costs,
which are rising twice as fast as inflation, making insurance increasingly
unaffordable for many employers and individuals. Currently, approximately 47
million Americans have no health insurance.

In an effort to solve the problem in their corner of the country, Governor
Romney and the Massachusetts state legislature enacted this plan with the twin
goals of reducing the cost of health care and guaranteeing coverage for all
Massachusetts residents….

Yet two years after its inception, the Massachusetts plan has failed to achieve
either of its goals. The plan did not lower health care costs, nor did it
achieve universal coverage.

Thus, given the growing popularity of mandatory health insurance, Americans
would do well to take a close look at the results of the Massachusetts plan—and,
more importantly, at the reasons for those results. Let us look first at the
results.

The Results in Massachusetts

Although advocates of the Massachusetts plan claimed that it would lower health
care costs and achieve universal coverage, it has done neither.

Instead, the plan has increased costs for individuals and the state, reduced
revenues for doctors and hospitals, and left Massachusetts officials in the
awkward position of having to admit that their "universal coverage is not likely
to be universal any time soon."

Costs have risen for individuals because, under this plan, as under any
mandatory insurance scheme, the government must define what constitutes an
acceptable insurance policy.

As a result, special interest groups have been given both the incentive and the
means to lobby politicians to include their pet benefits as part of the
government-approved plan.

Consequently, the state government requires all patients to purchase "benefits"
that are useless to many of them—benefits they would never voluntarily choose to
purchase in a free market.

For example, Massachusetts currently requires insurance plans to include
forty-three mandatory benefits, including in vitro fertilization, blood lead
poisoning treatment, and chiropractor services—whether or not customers want
them.

Residents must purchase alcoholism therapy benefits, even if they are
teetotalers. These mandated benefits have raised the costs of health insurance
in Massachusetts by 23 to 56 percent.

Costs to the state government have skyrocketed and are projected to run hundreds
of millions of dollars over budget.Because the mandated insurance is so
expensive, the government has had to subsidize the costs of the premiums not
only for lower-income residents, but also for residents with incomes as high as
$60,000 for a family of four—which is three times the Federal Poverty Level.

The state had expected a "significant drop in spending . . . for the uninsured"
but has since acknowledged that this "is not going to happen to any large extent
in 2009."

Instead, overall costs to the state have risen by more than $400 million, 85
percent more than originally projected.

Because of its own rising costs, the state government has cut payments to
doctors and hospitals. According to family physician Dr. Katherine Atkinson, the
state insurance reimbursements often do not cover her expenses: "[E]very time I
have a Medicaid patient it's like handing them a $20 bill when they leave."

As a result of these rising costs and falling revenues, access to medical care
has dwindled for many patients. Fewer doctors are willing to take on new
patients for fear of losing even more money. Lee Sampson, a 47-year old medical
transcriptionist, had to call fifty doctors' offices before she could find one
that would take her as a new patient.

Tamar Lewis, a 24-year old hair stylist, called more than two dozen primary care
doctors for a checkup. All of them turned her down, leaving her with no choice
but to rely on the community free clinic.22 Patients face long waits for basic
medical care—in some cases more than a year for a routine physical exam.

These long waits are not due to a shortage of doctors. As the New England
Journal of Medicine notes, Massachusetts "has the highest
physician-to-population ratio of any state, in primary care as well as overall."

The waits are due to a government policy that discourages physicians from seeing
patients—a policy under which seeing patients can mean that physicians lose
rather than make money.

Advocates of the plan often claim that the program has succeeded because it has
decreased the number of uninsured patients.25 In so doing, however, they commit
the common error of conflating insurance "coverage" with medical care. The
government can make endless promises of theoretical "coverage," but this is not
the same thing as guaranteeing actual health care.

As Dr. H. Carroll Eastman, medical director of the Joseph M. Smith Community
Health Center, confirms: "[W]e don't have more doctors, but we have lots more
patients"—and the new patients have to wait two to three months for an
appointment.26 These patients know the difference between "coverage" and care….


Full article:

http://tinyurl.com/6zkcap

More articles like this:

http://www.westandfirm.org/blog/index.html