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The Independent Investor: Is Massachusetts Health Care Reform Working?By Bill Schmick
iBerkshires Columnist
08:36PM / Thursday, August 06, 2009
 | | Bill Schmick |
As the Obama health-care initiative occupies the nation's center stage, Massachusetts' landmark, employer-paid Medical Security Program continues to be touted as a model for national reform. This week's news that the program will run out of money by January, thanks to the high rate of the state's unemployment and ballooning medical costs, makes one wonder if the model is working.
Clearly the state's claim to fame is the decline in the rate of the medically uninsured to 2.6 percent. That feat should be applauded since the national average is closer to 15 percent. The Connector Board, an independent state agency, steers consumers to six private insurers that offer four different levels of coverage.
Coverage is mandatory ($1,000 penalty per year for noncompliance). The state subsidizes individuals earning $32,500 or less ($66,000 for a family of four) and no one can be denied insurance or charged higher rates because of their health or pre-existing conditions. Residents who cannot afford even the lowest-priced plan can apply to the board for a penalty waiver.
Today, rising medical costs are threatening the viability of the program. A Payment Reform Commission has been created to address this issue. In July, the commission released a report making a first stab at moderating costs through pursuing a "global payments" system. How such a system would be implemented or the time period required was not clearly delineated. Still, don't blame the state for going slow since even the best minds in the nation have yet to come up with a solution to medical cost containment. It's one of the issues that have stalled progress on the national level.
Another unanticipated problem with the Massachusetts reform is the lack of affordability among many individuals and families earning above the subsidized income level, especially for residents aged 50 to 64. Quite a few residents have been able to prove that the plan choices are simply not affordable at their income level while others opted to pay the penalty because it was cheaper than paying the insurance premiums.
In addition, the law allows insurers to raise premiums as people get older. In some cases, older folks can be paying twice the rate as a younger person. That makes sense on an economic basis since generally the older one gets the more health care one requires, but what if you can't afford it? This can be a very real problem here in the Berkshires where the population is generally older than the state's average. Given the current recession and the high rate of unemployment, being forced by the government to buy insurance that you can't afford is the stuff of which nightmares are made.
Speaking of unemployment, the bill was passed in boom times (2006) when the state was enjoying full employment, so linking your job and insurance coverage seemed sensible. Today, an increasing number of our citizens are out of work and out of insurance without applying for state subsidies. That raises the costs of the program, thus the recent warning that the program will run out of money by the first of the year. To date, spending for the program has doubled from $630 million in 2007 to estimates of as much as $1.3 billion this year.
Dr. Susanne King, a child psychologist based in Lenox, is an outspoken advocate for a single-payer system of health care and has written frequently on the problems of the Massachusetts health-care system. Single-payer is a system whereby a single organization (the government, for example) would collect all health-care fees and pay out all health-care costs.
"We could save $8 billion to 10 billion if we moved to a single-payer system. You see it's not the distribution system — the doctors, hospitals, treatment — that needs fixing, it's the administration of this system that needs to be rethought," argues Dr. King.
Given the mounting fiscal troubles Massachusetts is facing, will the taxpayer be asked to make up the difference or will it be levied on the business sector? One thing is for sure, health-care reform is here to stay in Massachusetts but that doesn't mean it can't be remodeled to answer the challenges we face.
Bill Schmick is a registered investment adviser and portfolio manager with Berkshire Money Management (BMM), managing over $180 million for Americans in the Berkshires. Bill’s forecasts and opinions are purely his own and do not necessarily represent the views of BMM. None of his commentary is or should be considered investment advice. Direct your inquiries to Bill at 1-888-232-6072 (toll free) or at wschmick@berkshiremm.com. Visit www.afewdollarsmore.com for more of Bill’s insights.
Anyone seeking individualized investment advice should contact a qualified investment adviser. None of the information presented in this article is intended to be and should not be construed as an endorsement of BMM or a solicitation to become a client of BMM. The reader should not assume that any strategies, or specific investments discussed are employed, bought, sold or held by BMM. |
Your Comments
iBerkshires.com welcomes critical, respectful dialogue. Name-calling, personal attacks, libel, slander or foul language is not allowed. All comments are reviewed before posting and will be deleted or edited as necessary. Comments are closed for this article. If you would like to contribute information on this article, e-mail us at info@iBerkshires.com |
| when you elect cadillac duval and stupid cops obama, we will be paying more taxes for medical care | | from: taxpayer | on: 08-06-2009 12:00AM
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| This is a well thought and written article, but the first sentence that describes the Medical Security Program as a national model is innacurate. That program has actually been around long before Massachusetts healthcare reform and was not part of the 2006 landmark legislation. | | from: Phil Hunt | on: 08-07-2009 12:00AM
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| It is a great article, however, it does beg the question: why the reason for all that unemployment in Massachusetts, and Nationally, for that matter? Unfortunately, I believe that, in terms of ideas of how to improve our healthcare system, Massachusetts is, in fact, a model. The problem centers on the massive train wreck for a Presidential Administration that took office in 2000, was re-elected (somehow) in 2004, and ran our government, based on non-factual, ideological theories and fear-based politics, off a financial cliff of historic proportions. That is what happened. It has nothing to do with the leading-edge healthcare reform that Massachusetts has been so bold to attempt. Also---- I'd bet ANYONE $100 that Massachusetts is STILL in a much better healthcare situation that in the other 49 states, where most others not only lack JOBS, but ALSO lack ANY healthcare coverage. Great. Thanks, George W. We can thank HIM for all of those jobs in Iraq that he single-handedly created, I guess. | | from: Burton | on: 09-04-2009 12:00AM
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I enjoyed this article. I was wondering how it was working. i have read many articles from good to bad, I think the bad is overtaking the good and it may only be the beginning. I am interested to see what happens in the next couple years.
As for you mr burton, please get off your liberal high horse. I for one never voted for bush, and didn't agree with most he did, but he is not the only one to blame. If i remember correctly the democrats had power in congress his last two years and never stopped the spending and helped put forth a stimulus that failed and up our decifit. Stop pointing fingers and let's solve stuff. | | from: | on: 09-18-2009 12:00AM
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