The Ontario Health Insurance Plan (OHIP), which covers about 12 million residents of that Canadian province, employs roughly 1500 people. The Connector has 35.6 FTEs. It helps arrange coverage for the 30,000 people with private insurance purchased through the Commonwealth Choice program; 23,000 who get partially subsidized coverage under Commonwealth Care; and 92,000 low income individuals signed up for free insurance. That’s a total of 145,000 people. In other words, the Connector employs twice as many (2.5) people per 10,000 enrollees as OHIP (1.2).
That comparison doesn’t sound too bad, until you realize that OHIP actually pays all of the bills for care in Ontario and administers virtually the entire health care financing system. The Connector merely serves as a glorified insurance broker, signing people up for coverage with plans like Blue Cross and Harvard Pilgrim. So on top of the 4% to 5% cut of every premium dollar that the Connector takes, Blue Cross and Harvard Pilgrim take their 15%. (I can’t tell you what Tufts’ share is – their annual report for 2006 left out the figures – though it does let slip that its net worth rose by $96 million even as enrollment fell).
In total we paid more than $800 million for health insurance companies’ overhead last year – $20 million to the Connector (about $145 per person they helped find coverage) $251 million to Blue Cross, $332 million to Harvard Pilgrim, and (my estimate) about $200 million to Tufts. And this figure doesn’t include the overhead of the dozens of smaller insurance plans in our state. If OHIP had been on the job the cost would have been about $75 million – less than one tenth as much.
A few other figures to remember on this first birthday of health reform. According to the U.S. Census Bureau, in 2006 there were 469,733 uninsured residents of Massachusetts with family incomes above $150% of poverty. The Connector says that it now covers 23,083 of them under Commonwealth Care and has enrolled another 30,000 private plans. That’s 11% of the total.
David Himmelstein
Associate professor of medicine at Harvard Medical School and
Co-founder of Physicians for a National Health Program
Thank You Doctor Himmelstein for posting the TRUTH about this bogus Healthcare reform law. I cannot believe the lawmakers on Beacon Hill don’t think someone can figure out that this is a rip-off to the uninsured and the taxpayers. Where is the outrage? the Big Dig was not a wake up call to the citizens of this State that we need to clean house!
Dr. Himmelstein,
Thanks for continuing to point out how wasteful and ineffective this bogus “reform” actually is. I’m certain that when their terms on the board expire all of the Connector members will either return to executive positions in a newly fattened insurance industry or move on to lucrative lobbyist jobs. In the meantime, the middle class continues to struggle and vanish.
Before health reform was implemented, during the first six months of 2006 the relatively small, non-profit health care program for the uninsured that I direct in north Berkshire County interviewed 678 low-income uninsured individuals to determine public health insurance eligibility; we found that 64% were eligible for health coverage, but 36% remained uninsured. But after health reform was implemented, during the same six-month period in 2007, we interviewed 1,183 uninsured individuals and we found 95% were eligible for health coverage; only 5% remained uninsured.
While we should not lose sight of the larger goal of achieving universal and comprehensive health coverage, I suggest that we not let the perfect be the enemy of the good. I can’t tell these previously uninsured individuals that we are going to deny them health coverage, because we have not yet found the supposedly-perfect health care delivery system yet.
In regard to Mr. Norton’s last comment, I was a member of the Connector Board of Directors from May 2006 to August 2007. For the record, I am a social worker, not an “executive in a newly fattened insurance industry”. Since my term expired, I have not been offered a “lucrative lobbyist job” and I don’t expect that will happen. I can only dream!
I must say Mr. Halpern I am an “uninsured” citizen who is being treated really badly! My own State lawmakers and Governor have thrown me to the wolves. When they say “Universal” that means all not just a select few. The truth of the matter is most that on free or almost free are not complaining but when the rest of us are over charged that is not fair and for the State to be so proud of this is even worst. They have decided who gets what and for how much and either you pay up or be penalized. The uninsured who are not wealthy are not criminals. I have never been this upset and living with this stress that the State is causing me will make me sick!
Mr. Joffe-Halpern,
William Shakespeare wrote: “The evil men do lives after them; the good is oft interred with their bones.”
I am glad that you were able to provide insurance to your clients. My concerns are:
a.) Will they be able to maintain that insurance?
b.) Will they be able to obtain care under that insurance?
Social work is a noble calling, and it is not particularly profitable in the monetary sense. I laud the fact that you may have done some good. However, what you and the current members of the Connector Board need to acknowledge, is that many thousands of people will be hurt by this ill-considered and punitive law. People like Norma, and to a lesser degree, myself. You might argue that waivers are available to those who can not afford insurance, but these are issued at the whim of the Connector, and in the realest possible sense, they accomplish nothing. Are you saying that we can do no better than this?
My thanks to you, Dr. Himmelstein for speaking out. The Connector has a way of fudging the figures depending on who they are speaking to.
I attended a presentation by Jon Kingsdale in early August at which he stated that there were 175,000 newly insured in MA as of July 1; 105,000 in Commonwealth Care and 70,000 in Commonwealth Choice. I asked him how many of the 105,000 were paying customers. Response: 20 percent. That leaves 80 percent paying nothing. Since then, I have found out that all 80 percent are not NEWLY insured; some were auto-enrolled from other programs.
According to figures from the MA Budget & Policy Center, on August 28, 2007, the Census Bureau estimated that 653,000 person in MA were without health insurance during the 2004-2006 period which is 10.3 percent of the population.
Whether one goes by these numbers or those in your letter, the Connector is not exceeding their expectations for this sham reform as they like to tell the public in their victory propaganda.
To Chip Joffe-Hapern:
Congratulations on the fine work you have done insuring previously uninsured people. However, the majority of MA residents who are uninsured will be badly hurt by this law. The premiums are not affordable and the coverage is inadequate, nevermind adding in the copays.
Furthermore, it is a crime to steal our hard-earned money in the form of penalties to subsidize the plans because we need that money to pay our heat and utility bills, real estate taxes, food, etc.
You refer to this as shared responsibility but who is doing the sharing? The low-to-middle income residents who can least afford it plus we are subsidizing through our taxes per usual. It’s a double whammy and cui bono?. Your fifteen seconds are up. Not us.
The subsidized plans also contain an estate recovery program and our confidential medical records are to be handed over to the Connector, a group of appointed bureaucrats with no checks and balances.
Massachusetts should be ashamed. It is time the rest of the ctiizens of this great nation understand what is truly going on here.