Health Reform in Massachusetts – How is it working?

The Massachusetts Health Care Reform Law, also known as the Massachusetts mandatory health insurance law, was passed in 2006 and offers an opportunity for the rest of us to learn what works and doesn’t work (at least in Massachusetts!) In implementing this law, the state of Massachusetts has tried to coordinate systems, such as Medicare, that are already in place. The law seems also to have preserved some choices for people.     It provides subsidized health care for residents earning up to 100% of the Federal poverty level (around $21,000 for a family of 4), and partially subsidized care for those earning up to 300% of the Federal poverty level. Residents and small businesses are assisted to purchase appropriate health insurance plans through Commonwealth Health Insurance Connector Authority or “Health Connector.” Those who do participate in an insurance plan are given a $219 tax rebate; those who do not participate are not eligible for the rebate.   The law was passed to address the need of the estimated 6% of the Massachusetts population that was uninsured. It was not easy getting lawmakers and other stakeholders to agree on what was needed and what would work. One broad concept agreed upon was the principle of shared responsibility. Another principle in the law is that of providing “credible” coverage, or coverage that was both affordable and adequate for lower income residents. Besides creating The Connector, the law also required employer participation, non-discrimination rules, and mandatory coverage for all. Mechanisms were put in place to control costs while improving quality of health care.    What the law did –* continued and expanded upon employer sponsored health insurance as the primary source of coverage for Mass. residents workers.* encouraged pre-tax treatment of health insurance premiums for employees * made it easier for individuals and employers to participate in health care coverage and also introduces financial penalties for not participating * creates standards of adequacy and affordability of new, state-endorsed insurance plans. It expands public programs for people without access to employer sponsored health insurance* moved uninsured people form uncompensated care to insured care * maintains the health care safety net for uninsured people who cannot afford, or who are ineligible for, health insurance.    Within its first year, 122,000, or about one-third of Massachusetts’ uninsured gained health insurance coverage  Commonwealth Choice plans became available for small businesses (up to 50 employees) October 1, 2007    The Kaiser Family Foundation has an “uninsured” webpage which includes a fact sheet on the progress of the Massachusetts law. http://www.kff.org/uninsured/7494.cfm     For more information, you can Google “Massachusetts Health Care Reform Law” or look at a one-year report at http://masshealthpolicyforum.brandeis.edu/publications/pdfs/31-May07/MassHealthCareReformProgess%20Report.pdf


Health Education in the Community

      I believe that today’s school districts are not providing adequate education about personal health and overall wellbeing in class. There is only one certified nurse that is responsible to cover several schools within any given town. The lack of a person capable of teaching students about healthcare is leaving students, especially the younger generations, with a knowledge deficit of self-care and personal hygiene. Due to this issue, many children are not taught the simple prevention methods such as the proper way to wash their hands. In turn, this leads me to believe that their parents are lacking the knowledge to teach their children the importance of preventing the spread of multiple infections and illnesses. This problem could be resolved if there was an educational class added to the curriculum. I believe a possible solution could be to hire certified nurses to educate students at all grade levels about public health issues in a mandatory class. Also, these issues could be covered in the physical education classes. Again, without discussing this issue, the community will continue to be burdened with increasing numbers of multiple drug resistant infections and other preventable diseases such as Diabetes Mellitus Type 2.  Submitted by Susie, Student Nurse at University of Northern Colorado 


CNA Continuing Ed. Day

As an organization for Professional Nurses, the Colorado Nurses Association has been involved in Health Care Reform/Health Care for All for a number of years. The CNA-HCA Committee meets on a regular basis – new members are always welcome!

 

You are encouraged to attend the November 7, 2008 Colorado Nurses Association Continuing Education Day for more information on Health Care Reform. Out Keynote Speaker, Leading Journalist and Author, David Sirota will address The future of Health Care and Reform Issues. This will be followed by a Panel Discussion on Health Care Reform. This panel will present views from not only Mr. Sirota, but also the Colorado Hospital Association , the Colorado Nurses Association and the National Federation of Independent Business State Director.

 

For additional information, please visit the Colorado Nurses Association website www.nurses-co.org

CE and Convention information is available.

 

Eve Hoygaard, President

Colorado Nurses Association

 

http://www.championnursing.org/uploads/NursingCenterFactsheet20080620.pdf

 


Mayors join those lined up behind national health care

Northern Colorado Business Report
By Steve Porter
July 18, 2008 –

Another major group recently endorsed a federal bill that would expand the nation’s Medicare system to include everyone in America in a universal health-care plan.The U.S. Mayors Conference, meeting in Miami in late June, voted for a resolution in support of HR676, also known as the United States National Health Insurance Act.The resolution noted that 47 million Americans are currently without health insurance and that millions of others have coverage so inadequate that one major illness could lead to financial ruin.The resolution also noted that:
• Managed care systems like HMOs and other so-called market reforms have failed to contain health-care costs, a situation that now threatens the international competitiveness of U.S. manufacturers;
• Administrative costs of private insurers consume one-third of private health-care spending while Medicare has administrative costs of less than 5 percent;
• U.S. hospitals spend 24.3 percent of their budgets on billing and administration while hospitals in Canada - which has a single-payer system - spend only 12.9 percent;
• Harvard researchers estimate that more than $300 billion could be saved annually by replacing private insurance companies with a single public-payer system;
The United States remains the only advanced nation in the world without universal health coverage while premiums for workers who get their health insurance through their employer - the vast majority - continue to rise by 10 percent, 12 percent or more every year.And at the same time, private insurance companies continue to reap record profits. In 2006, the nation’s six biggest health insurers earned almost $11 billion in profits, according to ConsumerReports.org.It’s a situation that can’t continue much longer, universal health-care advocates say. And it’s a system that business can’t carry much longer, according to Nathan Wilkes, a co-founder of the Business Coalition for Single-Payer Healthcare.

“Basically, everybody in the group - we all have different backgrounds in business and political leanings - but we all recognize the current health-care system is crushing business and it’s making us not competitive globally,” said Wilkes, an Englewood resident who helped form the group in 2007.

Wilkes said his group helped formulate the message sent to the mayors that changing to a single-payer system would benefit them through cost savings to their respective cities by no longer dealing with multiple insurance companies, each taking their own profits, and by buying drugs and medical supplies in bulk.

“It doesn’t take a rocket scientist to figure that part out,” Wilkes said.

HR676, sponsored by Rep. John Conyers, D-Mich., and co-sponsored by 70 other representatives, would basically expand the Medicare program - an existing single-payer plan now restricted to those 65 and over - to include every citizen. The bill has been endorsed by numerous medical organizations, including the National Medical Association and the American Nurses Association.

Others lining up behind it include several faith-based organizations, the Kentucky and New Hampshire houses of representatives, 20 cities and counties, the League of Women Voters, AFL-CIO organizations in 33 states and more than 400 labor groups across America, including the Boulder Area Labor Council and the Southern Colorado Labor Council in Pueblo.

Opposed by industry
So with all these groups coming together behind HR676, what’s keeping it from being enacted?

Wilkes says any real change in the current system is strongly opposed by the private insurance industry, big pharmaceutical companies and manufacturers of medical devices. “Anybody that’s making big profits today is against it,” he said.

Last year, Colorado tried to take a step toward insuring all of its residents - about 800,000 aren’t insured - through the 2008 Blue Ribbon Commission on Health Care Reform. Five proposals were forwarded to the Legislature in January, including a proposal from Health Care for All Colorado that would have provided coverage for all through a single-payer plan.

Eliza Carney, chair of the Northern Colorado chapter’s steering committee, said she was “disappointed but not surprised” by the legislature’s failure to adopt any of the proposals.

Carney said financial constraints were part of the inaction but also a lack of political will.

“I think some of the (Democratic) legislative leaders were swayed by pundits who said it was a controversial issue and they would be hammered by the Republicans at election time,” she said.

Both Carney and Wilkes strongly support HR676 but say getting momentum behind a national health-care plan probably won’t happen without successful state-level programs. Both said they would like to see Colorado develop a pilot program that could serve as a possible prototype for a national health care program.

“It’s not going to happen without a lot of grassroots action,” Carney said.

Asked whether a change in the White House this year might increase HR676’s chances of passing in Congress, Wilkes said he holds out hope under a Barack Obama presidency.

“I’m always hopeful,” he said. “It’s definitely getting better for something like that to happen. I would love to see a situation where Barack Obama is president with a filibuster-proof Congress to finally pass a universal health-care plan.

“That would be phenomenal.”