Are universal healthcare programs working?
February 3, 2009 by Bill MeltzerPosted in: Healthcare costs, In this week's e-newsletter, Latest News & Views
When Massachussets passed its mandatory health coverage law, employers nationwide were concerned.
The law affects employers of all sizes, requiring employees to either have company-paid coverage or for an employer to contribute to a state plan.
So how’s it working so far? The results have been mixed.
On the bright side, few firms have dropped their own insurance plans because of the cost (as critics of the program originally predicted). The biggest positive change is that many more low-income employees have received regular checkups and preventive visits.
On the negative side, the plan has already cost the state $869,000,000 more than estimated. The burden may fall on employers and full-time employees via tax hikes.
Roughly 100,000 state residents have been fined for not having health insurance. About 2% of residents get off the hook because they fall below required income levels.
February 5th, 2009 at 2:57 pm
The nanny state marches on – at the expense of us working folks.
February 6th, 2009 at 8:31 am
100,000 state residents have been FINED for NOT having health insurance. REALLY? REALLY!!
February 6th, 2009 at 9:03 am
Are you serious? Almost a trillion dollars?? Doesn’t sound like it’s working to me!
February 6th, 2009 at 11:13 am
OK – are we going to learn anything from this or not? Socialist programs do not work!
February 6th, 2009 at 1:50 pm
What we don’t know from this article is how much it was costing the state before this program was put into place. When there is no affordable coverage, the working poor (yes, and some who can’t or don’t work, too) use the ER as their primary care physician because they have no other choice. This, of course, causes huge waits and compromised access to care for everyone – insured or not. Plus, the hospitals don’t get paid adequately or at all when folks are uninsured. We’ve had numerous trauma centers and ER’s close in California because of this imbalance. So, you can call them “Socialist” or “nanny” programs and say they don’t work. But where is the “free market” in this? If there is not great profit to make, the market isn’t going to solve this problem – or they would have done so by now. Those in it have no incentive (financially) to do so. People are going to try to survive – they are not going to just go away. Problems like this are so much more complex than people seem to think. For years we’ve heard inflation was 3% – but our health premiums have increased far more than 3%. Every year it’s a doublt digit increase. Something needs to be done.
February 10th, 2009 at 3:31 pm
Almost a billion dollars and tons of aggravation for employers and penalties to individuals without healthcare. There are still long lines at the emergency rooms across Massachusetts, what a colossal mess. This will be much worse in the near furture and the State will look for someone to fund this mistake, THANKS ROMNEY, for leaving a lasting impression on your way out.
February 12th, 2009 at 3:51 pm
Kudos to Judy for giving more than just a 30-second knee-jerk reaction. To add to her discussion there is nothing in the article to indicate the cost savings realized or to be realized from the fact that the previously uninsured will now be given access to preventive health care, rather than waiting until something minor becomes something major and taking it to the ER. The increased medical cost and the lost productivity from lack of access to health care is a huge expense. Perhaps it is not a full success story yet, but with some constructive criticism it may work better than the nay-sayers think. Doing nothing was not working.
February 12th, 2009 at 4:05 pm
Insurance was originally meant to be for catestrophic situations, not day-to-day or minor problems. I could see the state paying for preemptive or preventative and catestrophic medical care. For example, a lot of insurance companies will pay for a colonoscopy but only if nothing is found. If the doctor finds a ployp, it becomes a surgical issue and the original colonoscopy is then no longer covered regardless of whether the surgery is ever done. I still think it’s less expensive (also read: less profitable) for people to be given free exams and preemptive care. I would more easliy consider paying a doctor to keep me well and not paying him/her if I get sick.
February 12th, 2009 at 4:07 pm
“OK – are we going to learn anything from this or not? Socialist programs do not work!”
I kind of confuses to me when people make statements like this. What some don’t realize is that the program designed and used in Massachusetts is not really a socialist program because it is not directly funded by the government alone. However many programs we do take advantage of like our school system, police force’s and fire departments are all socialist systems, I am sure none of the individuals that rail against universal health care would want to abolish. You may think that universal health care won’t work but the system we have isn’t working either. Also, France which does use a socialist health care program is #1 when it comes to taking care of their citizen’s health care needs.
What I did take out of the article was that “many more low-income employees have received regular checkups and preventive visits”. This will in the end, save everyone money. The more health issues we prevent, the less people go to the ER, or get on long term disability. I just don’t believe that there are many positives to our health care system when compared with a universal one.
February 12th, 2009 at 4:26 pm
The free market hasn’t been in health care for decades. The free market can’t operate when the government starts dictating how physicians, hospitals and suppliers are to paid. Free market solutions often have profit but because of profit they also have charity. You don’t work at a company that aims to never make a profit because they would cease to exist in a very short time. The Obama administration has hinted that with universal coverage there will be, in essence, rationing and cost controls (if you are old gee you are going to die anyway so we’ll just give your portion of the pie to someone younger). Free markets benefit everyone because they find more effective and innovative ways to work. Have you ever seen any really effective or innovative in any government program? No. Health care is not a right.
February 12th, 2009 at 4:56 pm
Judy and Frances, the free market would work if left to its own. So many states (and the Feds) have placed mandates on healthcare programs which destroy profitability. And when hospitals are forced to accept indigent (and illegal aliens) the profits are gone and WE end up subsidizing the rest. Then the hospital closes and the indigent go to another and the cycle repeats.
Don’t get me started on socialized medicine, it won’t work. Why are we messing with the best medical care system by throwing the government into the equation. I say get the government OUT of it completely.
February 12th, 2009 at 4:59 pm
There are definitely pluses and minuses. I have seen medical bills cause bankruptcy for those who do not have health insurance. However, I truly believed that the standard of care will greatly decrease. I say this because my best friend and I were both high risk pregnancies at the same time and we knew this at the start. I received regular care with visits to specialist to monitor myself and the baby. My friend saw her doctor 3 times during her pregnancy, she almost died during delivery and the baby suffered also. If she would have had better care with closer monitoring, the complications would not have occurred. My baby cost me $4,000, with insurance, while she paid nothing for hers. I would rather pay a portion of the cost and receive better care, especially when it is life and death. By the way, I live in the US and my friend lives in Canada. I can also site multiple cases of the substandard care or the waiting times for seeing a doctor or having a necessary surgery in Canada as my family lives there.
February 12th, 2009 at 5:43 pm
That would be $1 billion not $1 trillion. I see no solutions offered only criticisms of the solutions proposed. How much of the $1 billion is funded by employers vs. tax payers.
February 12th, 2009 at 7:48 pm
Keith: Isn’t this crazy, not covering the colonoscopy if polyps are found and operated on? Hadn’t heard that before. How else would one know he had a pre-cancerous condition without that procedure? Talk about arbitrary! (On the dental side, I once had a root canal which the insurance said they’d cover, but wouldn’t cover the necessary post that stablizes the tooth. I argued it was needed and part of the treatment, so they agreed to pay it. Do we have to argue everything? Strange.) Frances, you believe health care is not a right. Well, I guess it isn’t listed in the Bill of Rights, but most of us do believe we need it and therefore should have it. Even poor people want to treat problems. Lee, I guess people’s experiences in Canada vary – my friend always said her mother got excellent care there. But another family member, whose mom lived in Wales, didn’t like the government healthcare system at all. Generally, as to the free market, I’m not against it if competition really works to give more choices and reasonable rates. But, human greed often rears its ugly head – big, bigger, biggest pay for the top people, profits being the driving force, not the mission of healthcare, at least in some companies, so we need to find some balance between all government and no government.
February 13th, 2009 at 8:16 am
If you really think socialized medicine will work, talk to someone in Canada and see how they like it. They are taxed to the hilt. and the programs are a joke. Visit a hospital in Canada if you get a chance. Try waiting for 10 to 12 hours to see a doctor. You think it’s bad here? HA HA HA.
February 15th, 2009 at 5:12 am
Can you provide more information on this? Excellent post though… Highly recommended.
February 16th, 2009 at 7:40 am
Can you provide more information on this? Excellent post though… Highly recommended.
February 16th, 2009 at 8:17 am
If the government wants universal health care, then have the government open hospitals, have the government pay the doctors and nurses. Do not force it on the private sector, do not make it a mandatory thing. If I do not want health insurance then why should I be forced to take it? Regardless of if it works or not, it will result in the specialized doctors moving away from the area to places that are less restrictive toward their profit margin and will result in longer lines.
And before anyone on either side say something…for every good story about heathcare (universal or private), there is a bad story. The solution is not to force healthcare on everyone, but educate them on how to take better care of themselves. Let the people decide if they want to be part of this system. And if you want to help pay for it, do not increase income taxes, increase sales taxes. This way everyone will be helping pay for the healthcare and will lessen the impact of lobbyist on it.
February 18th, 2009 at 5:08 pm
I can see that many employer who are forced to contribute to this plan will probably compensate by paying their employee’s less. The real answer would be to take the employer out of the system, that’s what causes the free market system to not work. Why should employers have anything to do with a person’s healtcare? Every individual should have their own health insurance and like car insurance, the free market would keep costs regulated. And, when you leave a job you wouldn’t have to wait to get a new health plan, you would have your own.
March 5th, 2009 at 2:25 pm
Jenny, the free market HAS spoken and said that employers need to provide healthcare. We provide because it will be hard to retain /recruit the best employees if we don’t.
Judy Buckley, you say “it isn’t listed in the Bill of Rights, but most of us do believe we need it and therefore should have it.” [I can't tell if you agree this statement or not.] Well, most of us believe we “need” a car or believe we “need” to own a home. However, that belief does NOT make it a right. By definition, being in the constitution/BoR/later legislation DOES make it a right.
March 5th, 2009 at 2:28 pm
By the way, my mother-in-law is under the Canadian health care system. She waited a year for her first cancer surgery, and a year for the second one a decade later.
Our system isn’t perfect, but moving toward that kind of system is definitely not progress.
March 6th, 2009 at 5:31 pm
Mike: I do think it’s a right – a moral one, at least. Are you the Mike who said in an earlier post on wellness programs (about people getting fired for lying about smoking) that we are morally required to take care of employees? Then, later in the post, that employer insurance plans are a part of socialism? My impression is that socialism (and communism, it’s more evil brother) are God-less systems and wouldn’t be calling on morality to solve social issues. I’d think the “common good” would be their rallying cry. (Their leaders would, of course, define “common good.” Seems the leaders of those systems do all right for themselves.) As to the free market we were also discussing, it is profit driven and the decisions are made by humans and it’s hard not to think that greed does play a big part in those decisions. Profit is good – more profit is better. That’s human nature, I think. In any case, maybe Americans can come up with an improved version of universal healthcare. We need to think outside the box and see how to fix or avoid flaws.