What about the individual who is repeatedly told by their physician that they need to improve their diet in order to lose weight. In this example, losing weight would lead to lower blood pressure, lower cholesterol, and the lessening of a diabetic condition. Wouldn’t that also be a choice?

Let’s use lipitor as an example. Non discounted lipitor costs about $110 per month. So if you have 1000 people in the commonwealth whose high cholesterol are diet driven and not hereditary, then someone, the state, the taxpayers, the insurance company, but not the individual, is paying $1,320,000 to cover that medication alone.

Now do you think that Mass only has 1000 people in that situation. The number is probably more like 600,000 given the obesity rates in the country. Now using that number, the premium surcharge to cover lipitor is $792 million every year in Mass. alone.

Are you saying the people who have Multiple Sclerosis, Lymphoma, Rheumatoid Arthritis, accidental injury, mental disorders or even Strep throat and the general spectum of diseases of the aging. etc., should be judged and punished for their misfortune?

Of course, they have no choice in their diseases. It seems quite oversymplistic to assert that most ill health is caused by not making “healthy decisions”. Some more circumspect souls might even see it as condescening.

In fact, blaming the victim is no way to fix the atrociously dysfunctional medical care non-system that exists in Massachusetts or this country. The MANDATE FAD that pervades current thinking is equally condescening and will prove to be as ineffective and detructive as Prohibition or McCarthyism.

Just as we pay for our police, fire departments, schools, national security and myriad public services, medical services should be provided and the expense broadly shared for the common good. There is no justification for profit in the health related misfortunes of others.

Medical CARE and health INSURANCE are not synonymous and they never will be. Yes, life is a crap-shoot, but we are not willing gamblers in this table’s stake.

Answer: No.

Insurance companies and their products do very little – if anything at all – that is of benefit to the American people and to our health care system.

In fact, many well-informed individuals would argue that these corporate profit-seeking entities and their bosses are the direct cause of many – if not most – of the negative and destructive influences on healthcare access, affordability and quality.

Health insurance as a commercial product is the infamous centerpiece of our perverse approach to healthcare in Massachusetts and the U.S..

Treating healthcare as a commodity, a thing to be bought and sold in the “marketplace”, instead of treating healthcare as a social good to be guaranteed for all (and paid for by all in equitable fashion) lays the foundation for most of the other ills that plague our non-system of care.

The world-renowned New England Journal of Medicine contains an excellent article making just this point:

“Market-Based Failure — A Second Opinion on U.S. Health Care Costs” by Robert Kuttner, Feb. 7, 2008

click here to read:
http://content.nejm.org/cgi/content/full/358/6/549?query=TOC

However, when we start talking about the rating mechanism for health insurance, most other states operate on the basis of health underwriting, with consumer protections found through the creation of a high risk pool for those with high cost medical conditions. In MA we basically operate a high risk pool for everyone and we have been doing so since guarantee issue health insurance became law in the 90’s. Our state’s latest efforts at health care reform were aimed at making insurance affordable, but neglected to deal with the fact that the guarantee issue market has driven out competition and driven up costs in MA over the past several years, and the last reform builds on a flawed system. The healthy people who can’t afford or don’t see the value in purchasing health insurance will continue to opt out if we can’t deliver affordable options to them. And we can’t deliver affordable options without re-examining the impact of our guarantee issue market.