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July 28, 2005
Lawmakers mulling health care reform
Jeremy Schwab
With high health insurance costs plaguing state
residents and businesses, Massachusetts lawmakers are considering
four competing proposals to revamp the health insurance system.
The four plans have similar goals — increasing the number
of insured residents while minimizing costs — but would
achieve those goals in vastly different ways.
Supporters of a single-payer health care system that would eliminate
most private insurance and give all Massachusetts residents government-funded
health plans testified at the State House last week.
They said a single-payer system would be cost effective because
it would have much lower administrative costs than HMO plans and
would eliminate the need for the costly free care pool that funds
care for the uninsured.
“Currently, 39 cents out of every dollar goes to overhead,”
Sandy Eaton, chairman of the Mass-Care Coalition which supports
the bill, told the Banner. “If we could cut back by, say,
10 percent, we would have billions more to cover everyone.”
In addition to saving administrative costs by streamlining and
reducing paperwork such as means testing forms, the plan would
create a statewide pool to negotiate with pharmaceutical companies
for lower drug prices.
The plan would need federal approval, as federal Medicare money
would be rolled into the health care trust established under the
plan.
Gov. Mitt Romney’s plan, meanwhile, would put little pressure
on the insurance industry. Under his plan, insurers could create
cheaper insurance products that cut back on some services while
maintaining core coverage such as doctor visits, emergency care
and prescription coverage.
The state would eliminate the free care pool and use the money
instead to subsidize insurance for lower-income people not covered
by Medicaid. If state residents refused to purchase health insurance,
they could lose their personal exemption on their income tax under
Romney’s plan.
“Affordable insurance can be available to all citizens without
a government takeover of the health care system,” said Romney
in a press release.
Romney’s poke at advocates who support an expanded government
role in providing health care was matched last week with rhetoric
from the other side.
“The market-based proposals which are so popular right now
simply violate ideas of social justice,” Arnold Relman,
former editor of the New England Journal of Medicine, told the
Joint Committee on Health Care Financing.
A third proposal, supported by a coalition including the Greater
Boston Interfaith Coalition, Health Care for All and the Service
Employees International Union, would also offer health coverage
to all residents, say supporters.
Dubbed the Health Access and Affordability Act, it would expand
access to MassHealth, allow individuals to join large group coverage
plans and force more employers to cover their workers.
A fourth plan, offered by Senate President Robert Travaglini,
would cover half of the 532,000 uninsured state residents over
the next two years, according to a press release.
Travaglini’s plan would loosen restrictions on health care
companies as an incentive to cover more low-income people and
force insurers to offer plans for individuals under 25 years old.
The plan would also seek to expand Medicaid enrollment for those
who are eligible but un-enrolled and force large employers that
do not offer insurance to pay for the free care costs incurred
by their employees.
Observers familiar with the workings of the State House expect
the Legislature to ultimately adopt a plan incorporating elements
of the different proposals.
The wave of new proposals to reform the medical insurance system
was spurred in part by the increasing cost of health coverage.
Soaring costs are hurting state residents and businesses and overburdening
the free care pool.
A drive to put on the ballot a constitutional amendment giving
every resident a right to health care has also helped spur lawmakers
to act.
“Every politician to look real has to come up with something,
because it looks like the movement to amend the constitution is
unstoppable,” said Eaton of Mass-Care.
Supporters collected over 70,000 signatures in 2003 to move the
proposal to the Legislature, which passed the proposal at its
constitutional convention last year. Assuming legislators pass
it again at the constitutional convention tentatively scheduled
for next month, the question will appear on the ballot in 2006.
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