Thanks to Workforce Magazine for
publishing an excellent piece on the great cover up on healthcare affordability under the "insurance"-centric (and troubled) Massachusetts program that the Obama administration has made the model for our "to be troubled in four years" national insurer mandate/bailout.
They also again bring up a number of very important points that are rarely brought up here (and which are being completely ignored in the mainstream media.) They are important ones that will effect hundreds of millions of Americans by forcing them to buy intentionally bad "insurance".
Resulting in their not being able to afford adequate healthcare - instead workers are forced to buy such terribly inadequate health care that they often receive inadequate medical care, should they become sick. And even then, they (or the government) often has to pay huge extra costs. The system wastes probably 50% of each dollar taken in!
The issues discussed are extremely important because they effect a group of people far more likely to be injured or already ill than the lobbyists or their politicians in Washington.
Massachusetts' "insurance" mandate has resulted in more workers relying on insurance provided through their employers but has left many low-wage earners in a financial quandary-- because even if they are "offered" insurance, they often have rarely enough money to pay their basic expenses, and the cost of insurance is so high that the state has not been able to extend subsidies to those employed - they make too much, instead it has relied on small penalties for employers and small fines for wrkers (relative to the cost of insurance) of around $1000.
So it hasn't put a dent in rising health care costs and has left many uninsured, and often, exempted from paying a fine because the system failed them, not the other way around.
Each healthy worker who opts for the fine rather than buy "insurance" costs the insurers money but the net result is to make the insurance for those who remain more expensive.
The large number of people who were not covered, and the premium hikes of as much as 45% in Massachusetts, which are often passed on at least in part to workers, in the form of benefit cuts, higher premiums and co pays, should should show us clearly that the system is already in crisis.
Massachusetts law has resulted in more people buying health insurance, but many prices have risen substantially because the state cannot do anything to reduce healthcare costs substantially under the wasteful "insurance" and private purchasing system.
Low wage workers are finding that they cannot afford anything. In particular, sick workers, (and those over 40, who must pay TWICE what younger workers pay, in addition to higher medical costs caused by aging)- Many are finding that they cannot afford the add-on costs -they cannot afford to buy "insurance" of high enough quality so they could ALSO afford to go to the doctor.
Medical premiums hikes and other costs like co-pays and deductibles - often huge amounts for already struggling families, are also rapidly crowding out all other spending, causing a "great recession" and many businesses to lay off workers or close.
The article reports that since the Massachusetts law forces many low-wage workers, to buy the increasingly unaffordable but still, low quality health "insurance" from their employers. This employer supplied "insurance" is their only alternative, even for those who cannot afford to because of health issues that take precedence. Some doctors in the state have also instituted a one problem per visit policy with prescription refill visits counting as one problem, that makes it next to impossible for people with multiple health issues to find real, affordable care, especially if a new problem crops up. Even if they have the money to pay for one or two visits a month, thats often not enough. And items such as blood tests that would cost $10 or $20 in Mexicali or Tiajuana, simple tests can add hundreds or even thousands of dollars to their bills.
Subsidies are constantly being reduced in scope, because of the huge cost increases, and many any poor families also make too much. Massachusetts premium subsidy is basically, like the Federal subsidy will be, is in essence for the very poor, and given the high cost of living in Massachusetts, many who qualify are in an impossible situation, because they can barely afford money to pay rent.
"Mike Trigilio, president of Associated Home Care, told Smerd that his employees "are barely able to muster enough money together for rent or food, let alone health insurance. In the past a lot of employees would go without it. Now they are forced to take it, and it puts a strain on them and on our company."
And they STILL often cannot afford to go to the doctor or fill prescriptions!
Trudy Lieberman offers this in her commentary on the article at CJR.
"If a Massachusetts business with more than fifty full-time workers offers insurance and pays at least one-third of the premium, its employees are no longer eligible for state-subsidized coverage. As Smerd reported, these employees can decline the health insurance--but they will pay a fine for doing so, unless the state determines the premiums they would have to pay are not affordable. If they want insurance, though, they must take what their employer offers them, even if it busts the family budget. It's the same old affordability question that has dogged people in Massachusetts and lawmakers in Washington as they struggle to replicate the Bay State's law on a national scale.
Campaign Desk has pointed out that the state's employers, and small business owners in particular, are facing huge rate increases this year--20 to 45 percent. Some are paying even more. This is a cautionary tale for the pols trying to craft some kind of bill that will please both Democrats and Republicans. "
"Trigilio is all for providing health insurance, "but companies like ours can only offer so much," he says.
Politicians like to please their campaign donors by telling their constituents that they can still afford their donors products- like insurance, when they really cannot afford that level of waste any longer.
"Americans wonder whether they will be able to afford health insurance if it is required by law. The same question worries employers as they consider their own financial viability."
...
"In Massachusetts, policymakers decided to put most of the burden on workers rather than employers. Federal reform could provide subsidies to low-income workers, but unless it also can bring down health care costs, reform will amount to cost-shifting to businesses and the federal government."
(and neither wants to pay- so the net result is care in name only- of huge uncovered costs, totally unexpected for many people when they go to the doctor or hospital-
"For low-wage workers, especially for home health care aides like Desrosiers and the businesses that hire them, national health reform represents a major test of the employer-based health care system. Desrosiers says she would measure the success of national reform by the size of her savings account. By that measure, reform in Massachusetts has fallen short.
"I thought it was going to help me," Desrosiers says. "I thought it was a great opportunity for families like mine to have health insurance. We could pay less money for health insurance and have more money for savings. I have a checking and savings account and the savings has nothing. You can't really save, my friend. You can't really save."
With single payer, we would save around half of the money people and busineses spend on healthcare simply by eliminating a huge source of waste that adds no value.
We can't afford to waste another decade while a million more Americans, or probably, more, die.