A report last week indicated the number of non-emergency visits to Massachusetts emergency rooms hasn't really dropped since the state began requiring everybody to have health insurance.

Anya Rader Wallack, whose Blue Cross Blue Shield of Massachusetts Foundation helped fund the report explains some of the reasons why - most notably, people seeking medical care after their normal practitioners have gone home for the day:

... suggests that one way to significantly reduce ED visits in Massachusetts for non-emergency conditions is simply by offering care during evening and early morning hours as well as on weekends, or by managing more primary care needs over the phone (something for which physicians seldom receive reimbursement). ...

Insure the people who actually apply for health insurance. Mike Mennonno provides the latest chapter in his saga to get coverage through MassHealth:

... It's a hassle. But the worst that can happen is I will be uninsured and assessed a penalty at tax time. The penalty in 2007 was a measly $219/year, which, frankly, is worth paying to avoid dealing with the clowns at MassHealth in Revere (I can only imagine the drab cubicles, stained carpets, antiquated computers, and the sad, angry race of cube-dwellers paying for their sins in this bureaucratic hell). In 2008 the penalties have increased as well. For me, it would come out to $420.

Still a bargain, in a way, when you think about it.

ChezNiki describes what it's like to actually be covered by one of the plans set up for people who don't have work-provided health insurance:

... This so-called Universal Healthcare takes a law degree and three or four agencies to decipher, and will be a nightmare for anyone with a language barrier, a temp job or seasonal work. The State will have a very difficult time collecting the tax penalties from people who couldn’t afford the healthcare in the first place. People whose taxes are ultimately taken may even form a class and sue. And the uninsured, underinsured and folk with misplaced paperwork will wind up where we always do for our health care, in an eight to twelve hour wait in Emergency. ...

Mike Mennonno on the news that the state now thinks a lot of people who already have health insurance will have to buy even more under the state's new health-coverage law: Mass. "Universal Health Coverage" is the new Big Dig.

Which probably represents the first time ever that Mennonno and the Margolis Boys agree on something.

Looks like you might get to vote this fall on whether to add health care as a right guaranteed by the state constitution.

UPDATE: No, you won't.

Sushiesque posts photos of protesters outside today's legislative Constitutional Convention.

Bay Windows liveblogging of the convention.

John Keith is soooo upset that the anti-gay-marriage air force has been grounded for the day because of the rain:

... Or, maybe they crashed into each other.

Either way, a win-win.

Although not before they buzzed Spatch enough to make him wish he could move to an island and set up his own benevolent dictatorship.

The Enzi bill, which would have stripped the rights of states to require coverage for specific conditions (everything from infertility to diabetes) was defeated in the U.S. Senate.

Via Blue Mass. Group.

Eliot Gelwan, a psychiatrist, reads about problems people in Britain have getting affordable dental care and says he feels their pain:

... None of my MassHealth (the version of Medicaid here) patients have any dental benefits, and it is getting more and more difficult to find even emergency services for them. From time to time, the underlying reason why someone presents to me with a mental health problem such as despondency or suicidality (which MassHealth still pays for) is agonizing dental disease. ...

Sen. Mike Enzi, R-Wyoming, came up with the bill that would let insurance companies offer health insurance that doesn't provide the coverage mandated by Massachusetts (indeed, would let companies sue if the state tried to tell them otherwise). Christopher Davis discovers that Enzi once opposed federal overrides of state insurance laws - before the insurance industry started giving him money.

John McDonough, who helped gain passage of our recent health-care reforms, calls Enzi's bill one of the most alarming and far-reaching health care bills to move through Congress in years.

Earlier:
Federal bill could strip many of us of key health-insurance coverage.

S.1955, a bill now in the U.S. Senate, could gut Massachusetts laws that require coverage of everything from alcoholism and infertility treatment to mammograms and maternity care.

The law, officially titled the Health Insurance Marketplace Modernization and Affordability Act of 2005, is ostensibly aimed at giving small businesses a way to afford health insurance. Of course, given who runs the Senate, the law would do this in part by allowing insurers to offer low-cost plans that do not have to comply with existing state health-insurance coverage law (insurers could sue states that try to keep enforcing current mandates).

More:
Background links
State-by-state list of potentially at-risk programs
MetaFilter discussion

John McDonough has the word from the late-night session.