“An informed populace makes wise decisions”

President Thomas Jefferson

First I would like to say thank you to WBUR for establishing this blog. Everyone has an interest in how the Health Care Reform Law is implemented: individuals, the self-employed, businesses of every size both in the for profit and non profit sector, and the public sector. No matter if one is currently insured, uninsured or if one is underinsured, this law will clearly impact all of us.

The Artists Foundation has a 34 year history of involvement in artists health care issues and has been one of the leading organizations statewide and nationally on artists’ health care issues. Artists are included as chief planners in our programs, services, and policies. Several of our current board members and advisory board members are experts in health care policy and are actively working on the current health care issues facing artists in the Commonwealth.

As of my last count I am on, as the AF representative, 2 statewide coalitions (www.artshealthcarecoalition.org and http://www.hcfama.org/ACT/), 6 working groups and 2 task forces. Members of our board and advisory board are also on duty with monitoring this law. One of our board members is a key and active member of the Greater Boston Interfaith Organization that is working on affordability issues. Other board members are monitoring how this law will impact small businesses and employers. The AF has been working with artists to gather written testimony and to help them present their spoken testimony at public hearings to help to ensure that artists are not hurt by the Health Care Reform Law.

Many artists are self-employed and many have multiple-part time jobs. Often these jobs or situations do not offer access to affordable and adequate health insurance. If insurance is available, it is usually economically out of reach and/or the insurance offered is sub par in that it is not comprehensive and underinsures the policy holder leaving them open to huge potential medical debt.

The Artists Foundation has created a new on-line free resource for Massachusetts artists working in all disciplines to aid them navigating the Massachusetts Health Care Reform Law and its requirements. It is also a site to help health care providers enroll artists into health care reform options:

http://www.healthcareforartists.org

This site has useful information also for individuals who are not artists and we will, in the coming weeks, will be building out the section to help small businesses navigate the requirements of the Health care Reform Law.

We ask you to bookmark this site and spread the word of it to as many artists working of all disciplines across the state. Please pass web site on to any arts organization, school, health care provider, or anyone else you might think this site could help and could help spread the word of this site.

The AF has been heartened to see how welcoming and helpful the Connector Authority, our elected officials, other key state agencies, and the members of the coalitions, task forces, and working groups, have been to our organization and by extension to the Artists of the Commonwealth. Everyone is clearly working together to make the Commonwealth the best it can be. The AF is proud to be part of this effort.

Kathleen Bitetti
Artist
Executive Director
http://www.artistsfoundation.org

Bravo to WBUR for this great public service! And thanks to the remarkable “stable” of people who have agreed to contribute. This is a terrific idea.

(And thanks, too, for getting ridding of the registration requirement to post comments. That will prompt much more discussion for sure.)

P.S. I’ve linked you to my blog. I hope it brings in traffic.

Good idea; the more public discussion the better.

I must acknowledge being more than a little dismayed to see in the list of 24 planned blog contributors, 19 are men and only 5 are women. Need I say more? Add to this the related concern that while you include the Mass. Medical Society you do not include the Mass. Nurses Association (MNA) as a contributor. MNA is a professional organization with over 24,000 members. And nurses are the most numerous front-line healthcare providers in the state who have a lot to contribute to this discussion. I urge you to contact the MNA with a request to participate with regular blog contributions. (disclimer, I’ve been a member of the MNA for 15 years). Someone from NASW (Social Workers’ Association) would be a fine addition too.

I offer these thoughts in a constructive spirit.

Perhaps one of the nurses or other attendees who were at the Feb. 27th Legislative Briefing convened by MassCare on health reform and untapped opportunities for cost control would be willing to write up a post on the event; it was very good and very well attended.

MassCare’s website is http://www.MassCare.org and their Executive Director is Benjamin Day.

Welcome to the blogosphere!

David Harlow
http://healthblawg.typepad.com

I am so glad to see this effort. I am the curator of Gallery 1581, housed in the Boston Graduate School of Psychoanalysis in Brookline. We are in the process of trying to get the word out to the art community that we offer affordable psychotherapy and psychoanalysis through our therapy center on Beacon St. We will be launching a series of discussion and analytic groups specifically for artists at our next gallery opening, Friday May 4. I look forward to more participation with this excellent-sounding community thinking about health care for artists.

I agree with Ann. The absense of a sizable female presense on your blog is inexcusable. For women it’s still an uphill battle to be heard.

Everyday in our Emergency Room we see tens of hardworking people who just cannot make ends meet and pay for health insurance. In addition, as you all know, without insurance there is no place to go but the Emergency Room. It is about time for the state to work on providing health care for all. I hope that applying for the new state insurance program will be an easy process for people and not let anybody fall through the cracks. We are paying for this care anyway, not only through the free care pool, but through our auto insurance rates which are astronmical as are workpersons compensation rates. Plus, by having so many people use the ER unnecessarily the actual cost of health care for this population is greater than it should be. I hope there is a way to look at all of these areas and come up with a more global approach to the problem, and some creative financing, that looks at the bigger/interconnected picture. Maybe auto insurance rates would go down a bit for everyone if everyone in the state was insured? That might help sell the program.

Anne Chiriboga wrote:
“Everyday in our Emergency Room we see tens of hardworking people who just cannot make ends meet and pay for health insurance.”

So our rent-a-lawmakers’ answer is to make it illegal to live in the state without health insurance. And, the news media, especially NPR applauds. I guess the goal is to finally drive as many of those non-ends-meet makers leave the state and raise the average income.

“In addition, as you all know, without insurance there is no place to go but the Emergency Room.”

Gee I wonder if that’s because most docs in the last 50 years have become high priced specialists while eschewing family practice and now hide inside of high cost institutions such as HMOs and hospitals where they feed at the medical insurance revenue trough.

I’m curious. Just how many of the above list of do-gooding deciders for us buy their health insurance without help from the taxpayers or their employer. I won’t suffocate myself while waiting for answers.

Ann Eldridge Malone lamented:

“I must acknowledge being more than a little dismayed to see in the list of 24 planned blog contributors, 19 are men and only 5 are women. Need I say more?”

The focus of your lamentation seems a bit displayed. What if it were 19 women and 5 men. The problem I see is that it’s 24 members of the high paid affluent elite who will be shielded from any negative affects of what they impose on moderate wage earners without medical insurance.

Eight represent organizations that directly benefit from the newly extorted revenue stream. One of them is a law maker whose contempt for uninsured workers, I believe Mr. Dimasi was fond of calling us “free riders”, is on record. The only board member that hints at representing the insuranceless taxpayer is Mr. Widmer.

Hey, Rick, I appreciate your reflections on my gender rep concerns. Point well taken. I have a few more thoughts on the larger reform issue so here goes:

“Shame on us” is a big part of my reaction to this reform info as it is “rolled out”.

Is anyone else bothered by the discrimination that screams out in this approach? Look at each “option” and its 3 categories of age discrimination. I find that grostesque. Just as different classes of care for different classes of people on the macro policy level is a grotesquue moral outrage in our supposed caring, civilized (and wealthy) society. (This should clear up any uncertainties about my positions on basic health policy distinctions…

I guess it really comes down to a few basic human and social values and what health policy those values lead one to, be you a nurse, a stock broker, maid, or a Governor. One set of values lead to treating health insurance as a commodity in the “marketplace”-a major facet of the approach here at present). Another set of values lead to treating it as a social good with both individual and shared responsibilities.

My values combined with my understanding of healthcare clinical and policy issues gained through working in in the field for 30 years, and personal experiences (having a sister with schizophrenia), have led to a passionate embrace of health insurance & healthcare as a social good.

By the way this is what EVERY OTHER industrialized country and its People have also embraced and they enjoy much better care at much lower costs. OECD data show that France has the best quality and value in their HC system and they spend ~$273 per person per month for it!!

I want to give a hearty thanks to a poster on http://www.BlueMassGroup.co, a blog where this topic gets a lot of solid discussion. He said:

“It’s time we started thinking about healthcare as a public good, not as a commoditiy available only to those who can afford it. I think we are moving in the right direction, but I worry that the entire system will collapse before we get where we need to be.”

To be clear, as much as the current reform approach dismays me, I also hope it will serve to get us on track toward a smarter, more caring, civilized and cost-effective approach to sustainable universal healhtcare where everyone has the duty to contribute in a equitable manner and everyone has the right to benefit from universal health insurance. There are many folks across the state who will keep taking action in concert with others who share this vision. Learn more and get involved at http://www.MassCare.org/about.

And by the way I support a private delivery system.

Hellokbk – this is just a testing, don’t worry about it

I lost my health care insurnace (Tufts)on January 1st of this year. I currently work three part-time jobs, six days a week. None of those companies are required to offer health insurance as they are all small companies with less than 10 employees. As a 53 year old, divorced male, I know the importance of having health insurance, espicially in the case of a severe illness. My elderly mother was in a severe auto accident two years ago and the cost of one month in the ICU was close to $200,000.00. Luckily, she had insurnace coverage. Such a cost would have bankrupted me. I am on of the ones that Ann Chiriboga mentioned who falls through the health insurance “cracks”. I make more than $9000.00 so I am not eligable for free care. By working three jobs, I make more than $29,000.00 so I am not eligable to particiapte in any of the Mass Health programs. I do not belong to any “group insurance plans”. I am not a small business owner. I do not own a hoouse or any proptery. When I contacted Tufts about enrollment plans, I was told that my monthly premium would be $1000.00 per month. When I contacted Blue Cross and Blue Shield, I was told that my monthly premiums would be $750.00 per month. I make $3000.00 to $4000.00 per month, which isn’t bad for part time work. But if I wish to continue to live in this state and NOT be fined for not having health insurance, than I am better being a quiting two of my jobs and plead poverty. Or better yet, maybe I just just rob a bank and go to jail. At least there I would get free rent, free food, free membership to a gym and free health care.

Thank you for letting vent my fustrations because I relly do not where to turn for help with this situation.

The attempts at healthcare reform were all the buzz at recent “Healthcare access” meeting in San Diego and at The Society of Teachers of Family Medicine meeting in Chicago. There is widespread concensus at those venues that reform will proceed, or the wheels will come off the “staus quo healthcare” bus. There is also broad agreemenr\t that meaningful reform will not happen while insurors are at the table as serious players. Single-payor appears to me to be the most effective mechanism to proceed with the messy business of dismantling the expensive, technology driven, insurance profiting non-system that has grown up over the oast 50 years.

I vote for single payor and for diverting 20% of our healthcare dollars from overhead to medical care.

Can anyone tell me if my husband, who has his health insurance through the Netherlands is required to have a MA company coverage? He is covered for any emergency while he is here. He visits the Netherlands regularly and has his physicals there. He also gets his medication there. The cost of his coverage is about 25% of the cost of a similar policy here. It seems that he meets the requirements of the law but I don’t know for sure. I also don’t know how we would provide the form that was mentioned that is given by the insurance company and must be filed with our income tax. I would appreciate any information and or suggestions about where I can get my questions answered. Thanks

Hi Amy – as I understand it, the insurance mandate only applies to Massachusetts residents. I’m not sure from your comments whether your family is here on a permanent or temporary basis. If you are here permanently, I suggest you paste this question in an e-mail to the Connector (the state board charged with implementing the law) to see what kind of verification you could provide about your health insurance(connector@state.ma.us. One note of caution, between now and 1/1/09 any kind of insurance meets the requirements of the mandate. After 1/1/09, there will be stricter rules about what qualifies as insurance.

Good Luck Amy.

Thank you so much. i will try the connector site. I have MA coverage as I am a U.S. citizen. My husband is a citizen of the Netherlands and has a green card. He resides in both places and pays taxes in US and Holland. Thank you again for your help. Amy

Hi Amy,

So long as your Husband’s health insurance meets Minimum Credible Coverage standards (prescription coverage, $2000 deductible, etc) by 2009 he should be considered in compliance with the law. Though he probably will need to sign an Employee HIRD form stating to his employer that he is rejecting MA employer health coverage and already has insurance.

Hope that helps!

Thank you WBUR for making this blog available to have public dialogue. While I am for everyone receiving healthcare coverage I do not agree that making everyone pay is the solution to the healthcare issue in America. In my humble opinion the unspoken message you are sending everyone is it doesn’t matter what health choices you make if you smoke, eat poorly, do extreme sports, everyone will be covered because everyone has to pay. There is no incentive to stay healthy because everyone is required to pay. Assuming two indiviudals are of the same age and same income bracket, why should the individual who chooses not to smoke have to pay the same premium as a person who chooses to smoke when we’ve been informed that smoking is clearly not healthy. There should be an incentive for the person who smokes to quit smoking by lowering their permiums if they stop smoking. Why isn’t there a strong voice that speaks about making it mandatory to have physical education in all schools so that young people develop the habit of exercise, making it mandatory that all students have take a course in nutrition to develop good eating habits. Obesity is now the third largest health issue in America. How did that
happen? Who allowed soda machines in schools? They were there when I was going to school. Can anyone project how much health care premiums will cost for an individual in 2015? Will the average person be able to afford it? Forcing everyone to pay, in my humble opinion did not take a lot of thinking. Coming up with a national healthcare program that educates people on how to be healthy, provides incentive for staying healthy and making healthy choices requires more thinking and a vision of creating a country of the healthiest people.

Thanks to WBUR for this blog, which I discovered by reading Martha Bebiner’s profile in Airwaves.
I agree with Sara Ting that there are many societal changes that should be made to make us all healthier and they need to begin with children. Many of them are, with more physical education and taking the soda machines (which were originally put in schools to help with revenue) out of schools. Nutrition classes are a good idea, but how to eat is better taught by example, what is served in the lunch room, what is served at home.
My heart goes out the the people like John Kulig who work hard to make ends meet, but cannot afford health insurance. CommonHealth needs to find a way to help these people too.
My concern now is the projected increase in premiums for next year. All the major payors, except Tufts, lost money in the first 2 quarters, so now the premiums go up. One of the anticipatable costs of manditory health insurance is that people who didn’t have it before would use it, which would create a big, expensive blip in the system while they got their physicials and follow ups. In the meantime, the insurers will have their big premium increases. How can the State help control those increases, before more and more of us are priced out of the market?

For preparation of a PBS/NewsHour piece on the progress of the Massachusetts health reforms, were looking for interesting case histories of people whove become newly insured through either Commonwealth Care or Commonwealth Choice since the implementation of these programs. Ideally these would be people for whom having health coverage has been an important new benefit – e.g., they suffered from chronic illness and were previously unable to obtain coverage and now have it, etc.

We also are interested in stories of individuals who are newly subject to the health insurance individual mandate and are either shopping now to purchase insurance, or have strong opinions pro or con the mandate, or both.

If you are a person in any of these categories, or if you know a person like this who would be willing to speak with us – and possibly to be featured in a NewsHour television segment – please contact us. Susan Dentzer, NewsHour health correspondent, sdentzer@newshour.org and David Stephen, producer, at dstephen@ newshour.org. Thank you.

The recent health insurance fee schedules have failed to take in consideration those who have supplemental insurance and are compliant with the state Minimum Creditable Coverage. I am self-employed and have had Tufts Plan “No Rx” for four years. I am a Viet Nam War Widow and have documented pharmaceutical coverage through CHAMPVA of which I pay less than $100 per year for deductible and co-pays. This plan has helped to keep my health insurance costs down. I am compliant with the new state law. However, the Health Insurance industry in the Commonwealth no longer offers a “No Rx” plan, although this is not State mandated. My only option is to pay an additional $100 per month for the unnecessary RX coverage; I will also loose my VA pharmaceutical benefit because I will have an RX plan . The additional cost to me will be $200 or more per month.