Could health insurance be on the state chopping block?
By adamg - 5/7/09 - 8:18 am
With state revenues continuing to make like a drop of water at Niagara Falls, you're beginning to hear murmurs from political leaders about the costs of health-care reform. David Guarino - former PR person for former Speakah Sal DiMasi - discusses the possibility that this "sacred cow" might have to be led to the slaughterhouse:
... [I]f the trends continue and the choices are to raise taxes a lot more, lay off thousands more firefighters, teachers and cops or cut programs – even the ones that are working well, the sacred cows might just find themselves getting herded up.
Comments
The law wasn't really
The law wasn't really designed to cover the uninsured; it was designed to force younger workers, like me, to buy health plans that cover nothing and cost a fortune from private insurers.
This was never about state health insurance or making people healthier: this was about forcing an entire market which didn't want to pay, in some cases, a substantial chunk of their earnings for a health plan they don't want and wouldn't pay for anything if they really did have a medical emergency. I'm basically paying $140 a month for a product that's useless to me and that I don't want because otherwise I have to pay MORE in tax penalties. That's a crock, and against everything both sides of the aisle claim to stand for.
That is by design
Hi anon,
Agree with you 100% about the effects of this mandatory health insurance law - it's a tax on young people, men specifically.
However, it's important for us to understand that this was the ENTIRE POINT of the law. The reasoning behind this sort of tax is simple (and SwirleyGrrl, please help me out here if I miss a step here):
1. For insurance to be affordable, you need the widest possible subscriber pool
2. Groups that tend to need less medical care are less likely to pay for insurance
3. This drives up the cost of insurance for those who really need it
Now, this is not shocking, right? Pretty obvious. What might NOT have been obvious to you originally is that you are currently in group 2. So you get a little screwed, from your perspective. What is the prime demographic of group 2? It is populated mostly, so I understand, by young unmarried men. Men between the ages of 18-35, I believe, use the least medical resources. They also are least likely to pay for insurance in the absence of such a tax penalty.
Older people of both genders require more medical resources; and even young women, because they have children or are planning to have children, or are taking oral contraceptives to postpone having children, require on average more medical care than men of the same age. And, of course, children require a bunch of care.
Therefore, the entire point of this tax was to say "Hey, young man! You aren't paying enough to support the health care of everyone else! Pay up or get penalized!"
Now, upon reflection, you may decide that this is OK. Many people are not bothered by laws like this. After all, each young man will one day be an old man, requiring care himself. Many young men will be fortunate enough to one day have wives and children, who will require care.
On the other hand, you may be uncomfortable with this sort of law. You may decide that this is just a little too "from each according to his ability, to each according to his need" for your taste. How this strikes you will probably determine a lot about the evolution of your political and economic thinking and voting habits as you get older.
I'm not 100% sure how I feel about it, partially because I've had conventional employer-sponsored health insurance since I started working, so I was never directly taxed with this. But I am very curious what others think.
"Hey, young man! You aren't
"Hey, young man! You aren't paying enough to support the health care of everyone else! Pay up or get penalized!"
Which would make sense if we had a public health care system. We don't. We have a private health care system, that the state pays into while letting that private system exploit everyone by providing shoddy care at extortionate prices. Can you understand why that might bother me just a wee bit that I'm forced to participate in such a system? And that I'm supposed to be happy for the privilege?
Anybody could have told you what would have happened: the insurers will gladly accept the new customers...and then charge as much as they can get away with while giving them as little as possible, and refusing to lower rates for anyone else by pulling a bureaucratic shell game.
Which, by the way, is exactly what happened. Trust me, I spend a lot of my time dealing with health insurance, and nobody, and I mean NOBODY'S premium dropped because of this law. Nor did their care improve. Jesus Christ, just look at the story below this one.
Not a single dollar I pay goes towards the care of anybody who needs it, I guarantee you. It goes into the pockets of private companies, who turn around and deny care as much as possible. Our health insurance system is broken, and until we admit that and take it out of the free market, nothing is going to change.
Thoughts from inside the same boat
I've also been lucky enough to get insurance through work through this whole business, but I can sympathize with the first poster. I'd be pissed if I were forced to pay for something that I didn't want, couldn't afford, and doesn't really work well anyway.
Has this had any tangible benefit for anyone except insurance companies? Adam posted earlier the story about how we have to wait longer than anybody else for doctors, and I don't hear a lot of praises being sung about any aspect of this.
If only there were some way to manage health care in this country. If only there were dozens of first-world countries with models we could look to. If only.
Yeah, I would GLADLY pay
Yeah, I would GLADLY pay what I pay for insurance now in taxes if that meant that the money was going to the care of people who need it.
I blogged about this too
http://1smootshort.blogspot.com/2009/05/few-reasons-why-massachusetts-universal.html
Yes, it's a great idea in theory, but they totally don't know how to implement it.
Individuals aren't the only ones ...
David Guarino here ... I posted the original piece. Thanks Adam for promoting it on Universal Hub.
These are great comments and I completely get the frustration, particularly among young people who are totally healthy. I know I wouldn't have loved this much at first blush when I was young and healthy.
But to respond to some of the thoughts here, as I understand it, the point of the law was to get more people insured. The ranks of the uninsured cost all of us money, we all get that. People who aren't insured tend not to seek preventative care, they tend not to have primary care physicians and they tend to show up in the ER - where things cost the most - and then they can't pay the bills and the state "free care pool" (meaning me and you and every other taxpayer), pays the bills.
But as I understand it, the point wasn't just to put more on the uninsured themselves but ask for more from everyone in the system in order to lower the costly rate of uninsured in the state.
Yes, that meant the individual mandate that everyone must have health insurance - same as all drivers must be licensed and have car insurance. It lowers the risk and cost to all of us who are paying for it if the 22-year-old ski bum without insurance ends up with two broken legs and can't pay his hospital bills out of pocket.
But let's not forget that businesses have a huge part to play in this law too. Most businesses now have to provide coverage for employees (only the smallest businesses are exempt). You remember, they weren't real happy with that portion of the law...
Between individuals, employers and providers, this reform is a three-legged stool. Without shared responsibility among each side, it wouldn't work. With the shared responsibility each has taken, the ranks of the insured have gone way, way down.
Nobody understands what a
Nobody understands what a huge burden the Uncompensated Care Pool was for the State. They were spending MORE money than medicaid on mostly ER visits. Forcing people to buy insurance was the only way they could provide people care and not go broke. The only other option would have been to get rid of the Uncompensated Care Pool.