Today is the first day that an individual in Massachusetts can purchase a new Connector approved health plan. It is a date that came quickly. The bottom line to the successful implementation of health care reform is education. An understanding of health care reform and its implications needs to be fostered as there are individual consequences.
Educating the public about a major change in public policy is not an easy feat. While Nancy Turnbull made me laugh with her suggestions for “seals of approval,” she is on to something. Many reports and my own conversations confirm that many are unaware of the individual mandate to purchase insurance. While the issue of affordability has prevented some from accessing coverage, persuading those that make a deliberate choice not to purchase coverage presents an additional challenge beyond simple education. We – meaning all of us in health care – need to engage the public and ensure that the individuals and families who will now be able to purchase health insurance understand their coverage options, the benefits and the costs of that coverage.
Our history in the United States of providing social safety nets, which dates from colonial times, has shown that these programs evolve as times change and start with a massive need for information. In 1938, the Woolworth Company used a sample social security card to demonstrate how a card would fit in one of their wallets. More than 40,000 people reported that sample number as their personal number with 12 people reporting the sample number as their number as late as 1977. The public had to learn that Social Security numbers are individual.
What do residents of the Commonwealth need to know right now?
They must be enrolled in a health insurance plan by July 1, 2007 or face financial consequences.
Their health coverage, whether provided by an employer or purchased individually, must meet requirements for a minimum level of coverage as established by the Commonwealth’s Connector agency.
This massive and welcome expansion of public policy to provide health care coverage for all has a price tag that is financed by all purchasers and taxpayers.
The first point is easy to understand and should be the groundswell message that spreads across this state. Every resident must be enrolled in a health care coverage plan by July 1 or lose a tax deduction in 2007. In 2008, they will pay a greater penalty for not being enrolled. By my estimation, that could amount to an annual payment of $1500 or more.
The goal of health care reform is to ensure that all residents of the Commonwealth have protection in the form of health insurance. They have a wide variety of options and should investigate the benefits, cost and quality of their health care. I am hopeful that the state will adopt standard measures of health care quality so that individuals can more easily evaluate their health care options.
Health care reform legislation does not address the fundamental issue of increasing health care costs. Therefore, providers as well as health plans must be creative in delivering solutions. Doctors and health plans must use evidence-based medicine, the latest science available, to standardize care. This will help improve quality and eliminate unexplained variations in who receives which treatment and when. Individuals must know their medical history, their treatment options and where they can receive high quality care with the greatest efficiency. The art and science of medicine must be called upon in full measure so that the habit of using the most expensive treatments as the first line of care does not cripple this grand, historic effort.
This week, the Commonwealth’s Connector will begin a campaign to inform the public about the options and obligation for health care coverage. I challenge us all to learn, and to communicate throughout this process. The success of this reform depends on it.
James Roosevelt, Jr. is President and CEO of Tufts Health Plan
What everyone REALLY needs to know is what James Roosevelt, Jr is calling “Health Care reform” is *not* health care reform.
Simply requiring people to buy Mr. Roosevelt’s product or a similar product is not Health Care reform. It’s more like extortion.
Nothing in what Massachusetts is doing changes our almost $2 to $1 spending ratio when compared to other OECD countries with no evidence that the extra spending results in better health outcomes.
Nothing in the law addresses bureaucratic waste in the Massachusetts’ pricey health care system.
Nothing in the law addresses the unfair tax subsidyafforded to employer ensured tax payers vs. those that must buy insurance outside of an employer based system.
Real health care reform would eliminate parasitic middle feeding “health insurers” and implement a real single payer plan that didn’t require healthy non smoking 57 year olds to pay $500 per month while offering obese chain smoking 37 year old alcoholics $175 per month low priced plans.
Mr. Roosevelt is 1 for 3 on his list of “what residents of the commonwealth need to know now.”
He writes:
“They must be enrolled in a health insurance plan by July 1, 2007 or face financial consequences.”
No – not true at all. The financial penalties for being uninsured take effect if an adult is uninsured on December 31, 2007. Not July 1. Also, some people will be exempt from the requirement due to the affordability standards. And others can get a waiver from the requirement based on individual circumstances. The process will be fairly easy, they say.
2. He also writes:
“Their health coverage, whether provided by an employer or purchased individually, must meet requirements for a minimum level of coverage as established by the Commonwealth’s Connector agency.”
Not really. The Connector has not established any substantive minimum creditable coverage requirements yet. The requirements don’t take effect until January 2009. So for now, any insurance plan one buys is fine.
Here’s a bit more on “What the public needs to know…”, addressed to all readers and to hcmgowan who posted a Commonhealth blog Comment (included below, at end) on April 27th, 2007 at 9:41 am
Much more far-reaching health system reform efforts designed to comprehensively address issues of access, cost and quality of care have been underway in MA for well over a decade. The MA Health Care Turst bill, filed each session sisnce 1998, Ballot Question 5 in 2000, and the Health Care Constitutional Amendment that was ongoing from 2003 to 2007.
The citizen activists and 130 organizations supporting the healthcare constitutional amendment did not “stop short”. Our work continues to this day. It is of relevance to note that the group “Health Care For All”, most disappointingly, did unendorse the amendment effort after the seriously flawed Chapter 58 health reform law was passed last April.
Equally important to point out is that NONE OF THE OTHER 130 orgnizations who have endorsed the amendment campaign across the state have pulled their endorsement.
Activists are still working for the amendment to be placed before the voters despite the legislature’s refusal to grant it its second required vote in Constitutional Convention. Most unfortunately, the media’s refusal to cover the health care amendment campaign and the legislature’s actions has contributed to misunderstanding about what happened and where things stand now.
I’ll try to briefly bring you up to date on it, plus you can learn more at the campaign website http://www.HealthCareForMass.org and use this link to read the one newspaper article that did cover what happened at the 1/2/07 “Con Con” http://www.metrowestdailynews.com/opinion/8999026738272927743
Currently, there is legal case pending before the MA State Supreme Court asking for a court-ordered remedy to the travesty of justice that occurred on 1/2/07 when 101 members of the MA legislature denied the citizens hc amendment its second required vote, a up-or-down on its merits so it would have a chance to be placed on the statewide ballot in 2008.
This travesty of justice — truly a crushing blow to health justice citizen activists, many of whom gave large parts of our lives to this effort over the past 4 years — took place at 6pm on 1/2/07. This occured with nary a peep from the media; that in itself is another disgrace, IMHO. Campaign leaders and supporting organizations vow to continue good faith efforts to secure the health reform goals set out in the Amendment. Hence the legal action being pursued.
The citizen activists who launched the MA healthcare constitutional amendment initiative four years ago (I myself am one of the original 10 signers) most certainly NEVER “stopped short” of working for a second required vote on that amendment. We welcome all those interested to join this effort. You can learn more and sign on for email updates at http://www.DefendHealth.org
prior Commonhealth blog comment from hcmgowan:
“I read all the comments and still wonder why non-profits that have got all of their “soldiers” on board with petitions to go for Universal Health Care for All and a constiutional admendmentent stop short when the legislature “cave in” again to the greedy insurance companies who back their efforts with grants and only Support their efforts until they get what benefits their Corporate interests without regard to the cost to us taxpayers and how it comes up short in accomplishing what gives a “fair shake” to Seniors.