Since its inception, the flaws in the system that has been incorrectly called the Massachusetts "universal" health care have been clear to me. On the other hand, as a pragmatist, I knew that we would probably to take some baby steps, or failed starts, to get to where we need to be. As it has been described to me, changing a system like this is just like trying to turn a supertanker--it cannot be done instantly.
As a small business person responsible for my own insurance, the pain of the current system has been acute to me. I know that it isn't easy to get, and exactly how much it costs. I know that it is a massive drain on my resources to take the time to hunt down plans and programs that might work. That time should be spent on my business, on what I do best.
Another problem is hiring, of course. I have been told flat-out by talented people that they can't leave their corporate jobs because they carry the insurance for their family, and can't take the chance on a venture like mine. I completely understand this.
That said, I was willing to look at the MA system and give it a shot. I know a lot of people are opposed to the mandate that requires everyone to carry insurance, and I see the problems associated with that. The definition of "affordable" lacks much understanding of individual circumstances that includes student loans, or needing a car to get to work, and a whole lot of other scenarios of our lives.
However, it would be hard to do much worse from my perspective. My existing coverage was tricky to get, I was never sure it would be available on an ongoing basis, and it was expensive. Full disclosure: I am now on one of the state plans. It costs less in premiums, but I have a much higher deductible. I will have to say I got more choices from the system than I used to have. But the overall costs would be about the same if I needed to actually use the insurance.
As the deadline looms that requires everyone to have insurance, we will be seeing more and more consequences of the faux-universal health in MA. Here I will present a couple, but as it plays out I know there will be others.
An early indication of the failures can be tied directly to Governor Willard Mitt Romney. How's that business mandate--the requires businesses with more than 11+ full-time or full-time equivalent staff to offer insurance? Here's a piece of the problem:
About 500 companies will pay for not insuring workers
....State officials and business leaders called the small number of penalty payers a positive sign for the state's effort to ensure that every resident has coverage. But healthcare advocates said it reflects the weak requirement for business participation set by the administration of former Governor Mitt Romney.
Either way, the state will collect only about $5 million in penalties, far less than the $24 million budgeted, which could result in another budget shortfall for healthcare reform....
Today I saw another consequence:
Firms find ways around state health law
To comply with the new state insurance law, a Burger King franchisee in Boston expanded coverage from just his salaried staff to all full-timers. To control his costs, he halved the share he pays. Only three of the 27 newly eligible employees took the insurance; others say they can't afford it....
So here we see an employer offers insurance to people who didn't have it before (nice), and gets around paying the low-balled state penalty of the Mittster. At the same time the employer pushes the cost to his staff (oh, brother...).
Another strategy:
Another employer split his firm into separate corporations, each with fewer than 11 full-time employees, according to his insurance broker. That way he does not have to offer insurance, nor pay a fine.
A pattern emerges:
Other employers said they are seeing the same pattern - expanded eligibility that does not lead to many more insured individuals.
More people end up needing to use the state plan. And for some people that might work. For others it may not.
If you want to see what the MA state insurance means, you can try out this searchable tool and understand the coverage and costs. To just quickly get to some pricing, I'll give you a zip code and job code number. I have a plan for a single person, I don't know much about how it compares for families--but if anyone wanted to check and offer the data as it compares to their existing coverage I'll be happy to update this.
Try your hand at the MA coverage, and see how it would work for you.
CommonweathConnector
Zip code: 02144
Industry code: 3721 (this is scientific R & D, fairly common here--but you can hunt for your industry code if you like)
You will be offered various plans, but keep in mind that we are required to carry prescription coverage now--so the lowest cost ones would require you to pay the uninsured penalty.
I suspect in the end we are going to see that businesses will get out of their obligations. On the other hand, I don't think insurance should be tied to businesses, either. I hope we can move to solutions that work for everyone, everywhere in the US. Band-aids are not cutting it.