“Row harder.” That’s what some are saying to poor and sick consumers who they want to hit with large co-pay and premium increases, intended to cover financial gaps faced by the Connector due to successful enrollment efforts.
Locally and nationally, rough fiscal waters are ahead for healthcare. Threats by the federal government to further decimate funding for children’s healthcare and Medicaid loom like a black cloud over our state’s noble first-in-the-country healthcare experiment.
The time is now for new, big ideas about how Massachusetts keeps healthcare reform on course. Consumers, taxpayers, and the state are doing their share of the rowing. It’s time for businesses, insurers, and hospitals to grab an oar.
A recent Boston Globe editorial asked, “If people on limited incomes must pay more, why not employers?” It’s an important question at the right time. It should also be applied to insurers and hospitals. The $295 fee employers who fail to offer affordable insurance must pay is a paltry sum, in light of what is now being asked of Connector insurance enrollees, the state, and taxpayers. If consumer rates go up, so should assessments for negligent businesses. The state should also revise the anemic regulations that determine which employers are obligated to pay assessments.
Right now, only 33% of employees at a business must purchase the employer-provided healthcare for that business to avoid paying special assessments fees to the Connector program. It’s time to raise that bar, so there is a real incentive for employers to offer affordable plans which at least half of their staff will choose to purchase. The Romney administration predicted $55 million in revenue would be generated from negligent employer assessments to offset healthcare costs for consumers and taxpayers. Due to the weak 33% standard, only $6.2 million has been collected through these employer assessments to date. That’s a big hole in an even bigger bucket – one that no amount of cost-shifting to consumer or individual taxpayers will ever fill.
In contrast to proposed co-pay and premium increases for consumers, hospital and insurer contributions to state-subsidized healthcare have remained flat since 2005. In fact, large hospital systems and insurers continue to reap financial gains from the system. Over three years, healthcare reform will bring in over $540 million in new taxpayer-funded reimbursements for hospitals. Meanwhile, the amount of charity care hospitals provide the community is declining rapidly, because more of their patients are coming through the doors with insurance. It’s evidence that healthcare reform is working, but it’s also evidence that the powerful Boston teaching hospitals are in a position to contribute more towards the future success of reform.
In 2007, major Boston teaching hospitals held nearly $9 billion in unrestricted net assets, an increase of $2 billion, or 30%, from the previous year. Major Boston teaching hospitals hold $16 billion total in assets. If hospital assessments were simply increased at the rate of healthcare inflation, it would be a significant step towards filling the current fiscal gap facing reform, while alleviating mounting pressure on consumers and taxpayers.
There’s plenty of opportunity for insurers to row harder, too. According to recent reports, Blue-Cross and Blue Shield chairman William C. Van Faasen was paid $16.4 million in retirement benefits in January 2006. That’s more than double what the proposed premium increases for thousands of Massachusetts consumers would yield the state this year, if the proposed Connector insurance fee hikes are accepted in their current form.
The proposed course of dramatic cost-shifting to consumers, the state, and taxpayers is neither a short-term nor a long-term solution for funding healthcare reform. Why must working families and taxpayers shoulder the burden alone? Clearly, new revenue sources from hospitals, insurers, and from businesses who fail to provide affordable coverage to their employees, must be considered.
A sense of shared responsibility is what has made reform a success thus far. That sense of shared responsibility must not be allowed to erode. With rough waters ahead, simply asking consumers, the state, and taxpayers to row harder won’t cut it. Hospitals, insurers, and businesses must embrace an “all hands on deck” approach and pay their fair share to keep this honorable first-in-the-nation experiment on course.
Celia Wcislo
Assistant Division Director, 1199SEIU
and Connector Board member
I have read on this blog there is a Senate bill 705 called Mass health care trust and it states that Steve Tolman,Frank Hynes,Jamie Eldridge,Patricia Jehlen and others are on board.I know the State legislators can start over and do the right thing for all the citizens.Please look into this.Thank You.
RE: “A sense of shared responsibility is what has made reform a success thus far. That sense of shared responsibility must not be allowed to erode. With rough waters ahead, simply asking consumers, the state, and taxpayers to row harder won’t cut it.”
With all due respect, “rough waters ahead” disregards the reality that the health care crisis rough waters have been swirling all around us (drowning some) for a long time now, and that much of the Chapter 58 law and its fake reform is making things worse. The shared responsibility is an illusion; all but the poorest among us continue to get a raw deal and for many it has made things worse (tax penalty fines but still uninsured).
What do union members have to say about propping up the current flawed health care system, particularly when a contract comes up for bargaining and hard workers are faced with giving away wage increases to hold health care costs down, or to protect retiree health benefits?
The health care system is corrupted by the profit motive and we need organized labor to help us change that, not to build on it. Thank you for considering this sincere request.
“The definition of insanity is doing the same thing over and over and expecting different results.”
Benjamin Franklin
Also, we know that Ch.58 says, “Six members of the board shall constitute a quorum, and the affirmative vote of 6 members of the board shall be necessary and sufficient for any action taken by the board.”
and ” Any action of the connector may take effect immediately and need not be published or posted unless otherwise provided by law. Meetings of the connector shall be subject to section 11A½ of chapter 30A; but, said section 11A½ shall not apply to any meeting of members of the connector serving ex officio in the exercise of their duties as officers of the commonwealth if no matters relating to the official business of the connector are discussed and decided at the meeting. The connector shall be subject to all other provisions of said chapter 30A, and records pertaining to the administration of the connector shall be subject to section 42 of chapter 30 and section 10 of chapter 66. All moneys of the connector shall be considered to be public funds for purposes of chapter 12A. The operations of the connector shall be subject to chapter 268A and chapter 268B.”
But, where are the miuutes of the Feb. 14, 2007 meeting? The public has a right to know the public’s business.
[...] of universal coverage, we have to keep it affordable for it to be a success and everybody has to ROW HARDER. Under Chapter 58 we have witnessed a corporate take over of our health care system … and we need [...]
Who will be devoted to stopping all the profit motive from the provider, medical device and pharma world?
From Health Care for all blog:
“Four makers of artificial hips and knees paid doctors more than $800 million in royalties and fees in four years to influence their choice of implants, a U.S. investigator told Congress. The unidentified companies control about three-quarters of the $9.4 billion worldwide market for hips and knees, said Gregory E. Demske, an assistant inspector general at the Health and Human Services Department, at a hearing yesterday of the Senate Special Committee on Aging.
“Illegitimate” payments, the extent of which is unknown, influence orthopedic surgeons’ medical judgment and are so common that it will be difficult to eliminate the practice, Demske and other witnesses said. The fees have enriched doctors and distorted the market by bolstering sales of lower-quality devices, they said. “Industry and physicians are equally culpable,” said Sen. Herb Kohl (D-Wis.), chairman of the panel. “Some physicians make it known to the companies that they will be loyal to the highest bidder. Where does the patient’s well-being fit into the equation?”
And how about this stat from their blog:
“Many prominent health thought leaders, such as Dr. Don Berwick at the Institute for Healthcare Improvement, have asserted for years that as much as one third of health spending is clinical waste.”
Doctors and hospitals are overtreating, bilking the system and oh yeah, receiving millions of dollars in payments from pharma and medical device markers and none of them want their gravy train taken away.
“black cloud over our state’s noble first-in-the-country healthcare experiment.”
THis is an experiment? Are we monkeys or pigs?
“A sense of shared responsibility is what has made reform a success thus far.”
Is the success you refer to the 300,000 (at least) paying penalties to support those who get the insurance for free while the penalty-payers can’t afford to pay their bills and still have no insurance?
Or is it enforced poverty? (The way the affordability schedule is set up, people don’t dare earn a dollar over their current income bracket or their premium, copays or penalties will double. Even if they were to earn $300 over, they wouldn’t be able to pay those increases. In fact, someone might end up in Commonwealth Choice and then they will really be up a creek. Better to quit one of the part-time jobs or not take that raise even though the extra money is needed to pay the skyrocketing cost of living and property taxes, etc.)
Is it a success because residents are not only penalized for being uninsured but also for getting a good job? (The 2008 penalties are based on gross income so if a resident is uninsured for 4 months and owes a $35 per month penalty, and in month 5, said resident gets a great $50,000 per year job with insurance, the 4-month penalty will be much higher instead of being based on their low income during the 4 months.)
Is it a success to cause such stress to people who are trying to survive this unfair law? Stress is extremely unhealthy and until this law falls apart, many residents will have little to no sense of well-being which is also highly unproductive.
“. . . to keep this honorable first-in-the-nation experiment on course.”
Is it honorable to steal hard-earned money from low-to-middle income people because they can’t afford to purchase a specific product? Extortion and collusion are both crimes.
Is it honorable to use people as unwilling test subjects in an experiment that hurts them? When a law is passed that adversely affects a large population of people and has as many holes in it as Chapter 58, the legislature has not exercised due diligence.
Added to that, we have the Connector flying by the seat of their pants while hard-working residents continue to be left in limbo – unable to get any answers or never the same answer twice because one hand doesn’t know what the other is doing.
It’s time to end the charade and stop hurting people.
Celia, thanks for the blog entry. I know the current statistics seem to show that fewer people are using the emergency Sounds like good news.
I’m sorry you’re stuck trying to make this thing work, when, in my opinion, the problems we all face when it comes to medical care are so much more numerous and bigger than that.
To the ‘definition of insanity’ offered by Beth, above, I add my own saying, “If you find yourself saying ‘things just can’t continue this way much longer,’ then you’re probably right, they won’t.”
We face making massive changes to our entire cultural attitudes toward health, illness, medical care and financing. The old models on which we have based our current system of doctor fee for service compensation, employer benefits, etc. has been stretched to the breaking point by swelling population, changing technology, economic turmoil, and other factors. The result is that we’re all helping to pay for medical care that is not needed and is actually damaging our health (see the book “Overtreated”, just out)! The money is coming out of the pockets of the middle and limited income citizen and going to benefit the “Medical Industrial Complex.” As much as this law attempts to provide “universal health care,” it actually compels participation in this vast transfer of wealth from poor to rich, leaving most of us with more stress and poorer health overall.
Clearly, those benefiting from this will not relinquish their ‘entitlement’ to our money easily. In the past, when significant government policy changes were proposed, the industry responded with fear mongering, rather than constructive proposals and a spirit of cooperation.
Sadly, for massive cultural change, there will probably have to be massive cultural crisis, first. At some point, almost everything will have to stop (massive strikes, institutions shut down, people die), and we’ll have to start over from scratch. I have had a difficult time envisioning any alternative. Well, I haven’t finished the book “Overtreated” yet, so I’ll let you know. In the mean time, increasing scarcity of fossil fuel energy will probably come along and force these changes upon us. Looks like that’s a trend that’s already started. I think of that scene in the movie “Titanic.” The ship has just hit the iceberg and at a hasty meeting on the bridge, the engineer who designed the thing points out that with five holds breached it’s a certainty tha the ship will sink. At that chilling moment, they all realize that a significant number of passengers will die and there is absolutely nothing they can do to prevent it. There are simply not enough lifeboats. The thing is, the passengers don’t know this yet. There is no easy way to go out and say, “Look, a good third of you are going to die tonight.” That’s where we stand right now, in a way. Sorry, but that’s what I see.
Sorry, a line got dropped at the beginning. I meant to say “emergency room as their source of ‘primary care.’”
You cannot believe how long ive been looking for something like this. Browsed through 8 pages of Google results couldn’t find diddly squat. First page of Bing. There this is… Really have to start using it more often!