Healthy Policy

Massachusetts Mandate

Apparently someone was listening to my post from Monday, as Massachusetts has taken the leap and mandated health insurance for all of its residents. Ok, kidding, I know it's been in the works for months.  But I'm thrilled to see a state take such a drastic step in solving insurance problems.

Gov. Mitt Romney (R) supports the proposal, which would require all uninsured adults in the state to purchase some kind of insurance policy by July 1, 2007, or face a fine. Their choices would be expanded to include a range of new and inexpensive policies -- ranging from about $250 per month to nearly free -- from private insurers subsidized by the state.

Romney said the bill, modeled on the state's policy of requiring auto insurance, is intended to end an era in which 550,000 people go without insurance and their hospital and doctor visits are paid for in part with public funds.

"We insist that everybody who drives a car has insurance," Romney said in an interview. "And cars are a lot less expensive than people."

The health insurance as compared to auto insurance is a common meme, although I take issue with the author's phrasing elsewhere in the article that goes, "[this is] the first state to tackle the problem of incomplete medical coverage by treating patients the same way it does cars."  You know, or it's the first state to open up real options to make sure everyone can afford health insurance.  They make it sound like patients are going to treated like automobiles going through factory assembly when put like that.

In any case, this is a huge first step, and it makes allowances like I laid out in my earlier post: opening up low-cost insurance to everyone, subsidies for those who can't afford insurance, and financial punishment for those who continue to go without insurance.

In Iowa they've started a program (Iowa Care) where the uninsured are given all the information for signing up for the low cost insurance whenever they go to the hospital.  I hope lawmakers will adopt similar tactics in MA to get as many people enrolled before the deadline as possible.

What's more; this is a major experiment.  It will demonstrate how affordable these programs are, what major flaws the program didn't for see, what major benefits the program brought, even how easy or difficult it is to get the chronically uninsured into insurance.  Everything that goes on under the program will be carefully watched by universal insurance advocates. 

I would, however, really like to see an EMR initiative along with this legislation, but I guess that's too many birds to kill at once.  Hopefully HIT pushes can be adopted in the next few years.

Also, Shadowfax has more.

Reform watch: look to states

A new study (released by Families USA) estimating the economic impact for businesses under Massachussets' new plan is today's real life example for why passing federal health care reform is almost impossible. 

The study found that for every 1 company that suffers a net loss from the legislation, 18 will benefit.  That's great news and an impressive ratio.  But it also means businesses will still suffer, and that publicity is much too easy to capitalize on.  Stories from across the state of mom and pop establishments going under will leave a stark impression that this legislation is unfair. 

These anecdotes, though existing in a 1:18 ratio, will act like the frivolous lawsuits everyone reads about, and assume that tort reform is a mighty fix indeed.  But in health care, myth is hard to fight. 

Now, thankfully, Massachussets is a liberal state that recognizes some sacrifice is needed to get everyone covered.  The rest of the country, however, does not look at small businesses closing so kindly.  But between this and the Walmart bill, these renegade states might be able to tear a hole in our myths.  Especially in contrast to Bush's won't-fix-a-thing-solution: HSAs.   

Sebelius is the awesomest

Now for some local news. Kansas Governor Kathleen Sebelius (see here for more on the governor) introduced a new program to help low-income Kansans afford prescription drugs:

CommunityRx Kansas was approved and funded by the state Legislature in 2005. According to Sebelius, it will offer discounts between 15% and 80% on most generic drugs for uninsured residents with annual incomes up to 200% of the federal poverty level who do not qualify for public health insurance programs. An estimated 150,000 Kansas residents are eligible for the program, according to Sebelius. Right Choice Pharmacy and Prescription Network of Kansas will administer CommunityRx, which will cost participants $10 annually. The state will pay about $200,000 to process the program, and the 286 participating pharmacies will absorb the actual cost of offering the discounted drugs, the Eagle reports.

This is another great plan implemented by the states to help people out. It's inexpensive and will help 150,000 people afford the drugs they need.

That, coupled with the plan to give extra assistance with Medicare Part D enrollment, and Kansas just ain't looking as red as it used to.