The lesson to be learned from all this is that the US is a failed state as far as affordable health care is concerned and that it shows no sign of being able to remedy that fact. The auto union for example seemscontent to let their health costs fall upon the union rather than campaigning for a universal plan.\
--- "Steven L. Robinson" <srobin21 at comcast.net> wrote:
> Health insurance lessons from Mass.
>
> Universal Coverage Tougher in California
>
> By Mike Zapler
> MediaNews Sacramento Bureau
> October 13, 2007
>
> Sacramento - As Gov. Arnold Schwarzenegger and
> legislative Democrats wrestle
> over universal health care, one overriding issue is
> holding up a deal: how
> to provide decent, affordable insurance to everyone
> without breaking the
> bank.
>
> A state on the other coast is learning firsthand how
> vexing that dilemma can
> be.
>
> Massachusetts captured the nation's attention last
> year when a Republican
> governor, Mitt Romney, and Democratic-dominated
> Legislature teamed up to
> pass a law they said would all but eliminate the
> ranks of the uninsured. The
> plan resembles Schwarzenegger's universal health
> proposal in some important
> ways: Both require everyone to carry insurance, make
> it more accessible
> through free or subsidized coverage for lower-income
> people, and penalize
> employers that don't provide insurance for workers.
>
> Eighteen months later, a few things stand out about
> the Massachusetts
> experience. Roughly a third of the state's uninsured
> have enrolled in
> coverage, a group that includes some of the neediest
> people. At the same
> time, the high costs of health care already dealt
> one blow to the program,
> and skeptics say the initiative may buckle under
> money pressures in the
> coming years.
>
> "We're covering more people, but it's not
> sustainable over the long haul.
> The law does nothing to control costs," said Alan
> Sager, a professor of
> health policy and management at Boston University.
> Still, he added,
> "Massachusetts is much better off with this law than
> without it."
>
> About 200,000 people who were uninsured a year ago
> now have coverage, state
> officials say, a remarkable feat in the eyes of
> many.
>
> "People who were uninsured and using emergency rooms
> for care have jumped at
> the chance to get health insurance," said Brian
> Rosman of Health Care for
> All, a Massachusetts advocacy group.
>
> But all but a fraction of those who've become
> insured so far have signed up
>
> for free or heavily subsidized insurance. The bigger
> challenge - reaching
> those who don't qualify for government help and must
> buy insurance on their
> own - is proving more difficult.
>
> In short, Massachusetts is struggling to reconcile
> the law's central tenet -
> a requirement that everyone in the state carry
> insurance - with the high,
> ever-growing cost of health care. That issue is at
> the crux of health care
> negotiations in California, too. Gov. Arnold
> Schwarzenegger wants everyone
> to have to carry insurance, much like the
> Massachusetts plan does; Democrats
> say there must be some assurance it will be
> affordable.
>
> But defining what's affordable, the Massachusetts
> experiment shows, isn't
> easy.
>
> Earlier this year, officials exempted about 60,000
> people (estimates of the
> uninsured there range from roughly 400,000 to
> 650,000) from the health care
> mandate after concluding it would eat up too much of
> their income. Concerns
> about affordability are expected to escalate in the
> coming months, when
> residents will face fines of hundreds of dollars -
> and, later, thousands -
> if they fail to buy insurance.
>
> How people respond to that requirement could
> determine whether the
> Massachusetts effort ultimately succeeds or fails.
> There are also questions
> about whether the state will have the money to keep
> pace with rising
> insurance costs.
>
> The state agency enforcing the health initiative has
> launched a full-fledged
> ad campaign to educate people about the law.
> Massachusetts residents soon
> will have to show proof of health insurance on their
> state tax returns, an
> idea that Schwarzenegger also has embraced.
>
> "The theme of the ads has been to purchase health
> insurance because you're
> better off with it," said the agency's spokesman,
> Dick Powers. "A couple of
> weeks ago we started to harden that message: If you
> don't buy it, you'll
> face a penalty." "
>
> The fine for not obtaining insurance would be about
> $216 this calendar year,
> but in subsequent years the state intends to fine
> people half the cost of a
> minimum insurance plan.
>
> Even the insurance that officials have deemed
> affordable could be a stretch
> for many families. The "cheapest" insurance plans
> offered through the state
> program lack prescription drug coverage and include
> an annual deductible of
> $2,000 for individuals and $4,000 for families
> (check-ups and other
> preventive care are typically excluded from the
> deductible).
>
> That means people with significant medical needs
> could be forced to spend
> upward of 10 percent of their income on health care.
> Democrats in the
> California Legislature, by contrast, are pushing for
> an out-of-pocket cap of
> 5 percent.
>
> Also of concern, Massachusetts tackled health care
> from a much stronger
> position than California is in now. Only 7 percent
> to 10 percent of Bay
> State residents were uninsured at the start,
> compared with 18 to 20 percent
> here. A higher percentage of people are insured
> through work than is the
> case in California. And Massachusetts already had in
> place regulations on
> insurers that Schwarzenegger wants.
>
> "Massachusetts faced far fewer hurdles in reforming
> its health care system
> than California does," said Carmen Balber of the
> Santa Monica-based
> Foundation for Taxpayer and Consumer Rights, which
> is tracking
> Massachusetts' efforts and which says California
> needs to regulate insurance
> rates as part of any health care overhaul.
> "Nevertheless, as far as the
> affordability of health care goes, it's not working
> there."
>
> But Celia Wcislo, who sits on the Massachusetts
> board that's implementing
> the law, said the panel spent many hours debating
> the balance between
> affordability and the need to insure people.
> Critics, she said, are
> premature in declaring the law a failure.
>
> At the same time, she acknowledged that the program
> may be on shaky
> financial ground. Health care costs continue to rise
> at a faster clip than
> inflation. And the plan assumed that about 7 percent
> of the state's
> residents were uninsured - on the low end of
> estimates, Wcislo said.
>
> Whatever its flaws, it's clear the Massachusetts
> plan already has helped
> tens of thousands of uninsured residents get
> coverage. They include people
> like Jim Farioli, a 61-year-old Springfield resident
> who lost his job as an
>
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