One day after Governor Patrick filed his state budget proposal for fiscal year 2009, the Boston Globe ran a front page story highlighting the size and nature of the additional investments in health care reform included in the budget.
Following that story, there were a number of efforts to highlight information needed to understand the significance of these budget increases. I appreciate those efforts and want to reiterate some of them:
• In evaluating the costs of health reform, we should be mindful that the costs are borne not only by the state but also by the federal government.
• Anticipated Pool spending is down from pre-health care reform levels and continues to fall. It is true that this decline in Pool costs is not alone sufficient to pay for subsidized health insurance for those who previously could not afford coverage – but it does make a real and important contribution.
• Health reform is larger than Commonwealth Care. It includes expanded coverage and restored benefits through MassHealth, increased payments to providers to reduce cost-shifting, and other initiatives. We are paying more – but are also getting much in return.
• In evaluating the costs of health care reform, I find it helps to hear some of the stories of the hundreds of thousands who are newly enrolled in coverage – how it has improved their health and transformed their lives. This completes the picture of what our dollars are purchasing.
At the same time, even with caveats and context, there is no question that health care reform is expensive, and its costs are growing. The magnitude of these expenses poses an increasing challenge to those who care about our state’s capacity to sustain health care reform and our ability to invest in other priorities. Indeed, even if the better perspective is over $150 million in additional net expenses for health reform (as opposed to $400 million in gross) in fiscal year 2009, that is a substantial amount of new resources in a budget anticipating slow revenue growth. With needs for new initiatives in a range of policy areas and an uncertain economic environment, no one should be completely sanguine about this picture.
And so I consider this a pivotal year for health care reform. Health reform was enacted into law because of visionary leadership, courage and compassion on the part of the Legislature (above all), providers, insurers, business leaders, advocates and so many others. This year, I believe that same spirit can and will guide us through the challenge of sustaining health reform. The conversation has begun. Let’s get to work. The cost of inaction is too high.
Leslie Kirwan
Secretary for Administration and Finance for Governor Deval Patrick
and Connector board chairwoman
Ms. Kirwin, are you for real? “…visionary leadership, courage and compassion on the part of the Legislature (above all)…needs for new initiatives in a range of policy areas…uncertain economic environment, no one should be completely sanguine about this picture.” Where’s the shovel.
This state fake reform law is bankrupting us all and will never be sustainable. Plus it DOES NOT DO A THING TO HELP most residents in the state, those who are getting killed by high health insurance costs. Yeah, we want everybody to have healthcare but we gotta do it in a way that’ll actually work.
That means outing the greed-meisters running the insurance and drug companies and the gigantic hospital systems (or are you and/or your circle of chums on their “non-profit” board of directors perpetuating this mess?).
We DO NOT need to throw more of our hard earned good money after bad and put more public funds into the coffers of the private insurance companies. But that is EXACTLY what this law forces us to do. Plus it forces thousands of uninsured individuals and families to feed the private insurance beast again in order to “comply with the individual mandate.”
Too bad these people won’t have any money left after paying the monthly premiums to pay for the co-pays and deductibles, so they won’t be able to actually get health care.
You said “We are paying more – but are also getting much in return.” Baloney. This fake reform law has us paying through the nose just as bad as usual. Get real.
Ms Kirwin, re “getting much in return” why don’t you give us an update on Attorney General Coakley’s “investigation” into the $20Mil CEO payout to the “non profit” Blue Cross Blue Shield executive? Is that part of what we’ll get in return? Is he going to give it back? After all, the public heavily subsidizes BCBS as a “non profit”, don’t we???
Who do you and Deval Patrick and the “visionary courageous Legislature” think you are fooling?
If you still don’t get it take a look at the video link below and I think you’ll catch on – make sure you watch it towards the end when the California Senator tells it like it is. We desperately need leaders like her here in Massachusetts.
Medical Students Stand Up For Real Health Care Reform at http://youtube.com/watch?v=pYoe6hJAXaw
Get real.
Thank You so much Get Real that protest made my day! The insurance companies are ruining the Nation and that must stop.Where are our Senators?Where is the Governor?Why aren’t they on our side?Money is their agenda.We are fined for not being wealthy and they think that’s okay.They could end this mandate today and start over with a fair deal for ALL! “EVERYBODY IN”
Leslie Kirwan,
If a resident cannot afford the insurance and is fined but cannot afford to pay the fine,won’t they be jailed for nonpayment of taxes?That is a jailable offense.Please answer this question,I do not want to go to jail because I am not wealthy enough.
Norma,
If you go to jail, you’ll get free health insurance. I’m sure that’s the way the connector will spin the issue.
Mandatory Health Insurance is a tax,
your response is very funny I certainly need to laugh but I am serious.I want an answer to my question.Because nonpayment for taxes is a jailable offense.The fact is DOR should have nothing to do with insurance unless they want to put us in jail.I want an answer,do I ask the governor’s office?who is in charge of enforcing the fines if you can’t pay them?
Get real, Get Real. You too, Norma.
I can only imagine that you both want MRIs and CAT scans when you want them and at the first sign of something scary will run to MGH — even when you can get the same care at a less expensive hospital. A single-payer health system? My friend’s mother in Ottawa was diagnosed w/lung cancer 6 months ago and is STILL waiting for a scan. Big government is never going to catch on in the US. Better to find a way where everyone has a part of it…and maybe Mass. isn’t all right, but at least we’ve got the guts to try it.
LThompson
Sorry to hear about your friend’s Mother and her problems getting a test. It sounds frustrating and upsetting. Maybe that is what makes you be so mean to me and Norma. Please don’t take it out on me and my neighbors. We are hard working people who do not go to MGH or whatever when we are sick. We usually wait to see if it will go away on its own and if it doesn’t we try to see a doctor for help or ask at the drug store.
You say “Better to find a way where everyone has a part of it…”. I agree. But that is not what the new state law is doing or is even trying to do. It is a cash cow for the insurance companies and hospitals at the expense of all taxpayers and especially lower income people who are uninsured and are not helped in any way by the new law. Instead they are fined for being uninsured.
Improved American Medicare For All is a way for all of us to “have a part of it” – both to help pay for it and to have equal benefit for it. That is what me and Norma and so many others are talking about.
to LThompson,
please realize that with a $4000.00 dedutable I will have to pay for that scan out of pocket.I do not have that kind of money.You say “we’v got the guts to try it”try what exactly?Don’t all the citizens count?Why is okay for some to be in and others out?Do you think by paying for insurance but not having it is ok?Maybe your wealthy and in a position to pay out $4000.00 a year plus the monthly payment,I cannot afford to do that.