Health care: Simple needs, complex solutions

Posted: Monday, January 12, 2009 5:06 PM by Daily Nightly Editor

By Robert Bazell, NBC News Chief science correspondent

If the Obama Administration and Congress attempt to bring America closer to full health care coverage as promised, the conversation inevitably will focus on Massachusetts, the state that has made the boldest effort in the country toward that goal.

On Nightly News tonight we begin a two-part series on the Massachusetts experiment. And we must emphasize that it is indeed an experiment. No one can predict whether it will succeed. But according to a recent Harvard poll, the residents of the state are overwhelmingly satisfied.

As I noted in a report last week on the Obama plans, the details of health care reform can be mind-numbingly complex, but Americans want something simple: freedom from worry that they either lack good health coverage or might lose the coverage they have.

The Massachusetts program has already managed to lower the rate of uninsured in the state to 3.3 percent compared to the national average of 16 percent. Since it began two years ago, 440,000 formerly uninsured residents out of a total population of about 6.4 million have gained health care coverage.

The program managed to get passed in 2006 because then Republican Governor Mitt Romney and the Democratic legislature worked together to make it happen. It builds on the systems that were already in place, and rests on an concept of "shared responsibility." Employers with more than 10 workers must pay the state about $300 per worker if they don't offer health insurance and residents must pay a fine--up to $900 a year--if they don’t get some kind of health insurance.

To make it easier to buy private health insurance, Massachusetts expanded the Medicaid program, which in most places is available only to the poorest of the poor, and to those with low paying jobs on a sliding scale. Private insurance is easier to buy because of laws in the state standardizing health plans and prohibiting insurance companies from denying coverage because of preexisting conditions. Insurance companies are generally supportive of the law because it requires young, healthy people to buy health insurance along with everyone else. As a result, the companies are not just insuring the older, sicker population.

In my opinion, the main reason the Massachusetts experiment has succeeded as well as it has is that the Governor and the legislature hammered out the broad outline of the plan and its budget and then left the details to a board called the “Connector” (http://www.mahealthconnector.org/portal/site/connector/). The 10-member board has representatives from government, business, labor unions, insurance and other interests. Its job is to wade through the swamp of complicated decisions that are necessary to make the program function. If the Massachusetts government had tried to write every contingency into law, the plan would have failed. Interestingly President-elect Obama and future HHS Secretary Tom Daschle, who will head his health care reform effort, have both called for similar national boards to reform health care nationally. As I said, the details can be mind-numbingly complex. But the public’s need is very simple.

Click here to watch the related video report from NBC's Robert Bazell.

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Comments

Scott B says above:

"Some things that are not talked about is the fact that this is a huge burden on the state budget. Also that you are basically fined if you chose not to get insurance. So much for freedom.
Scott Benoit, MA"

Thanks Scott. Lets take a state that can't balance their budget, a tiny state population wise, that provides a health care system by force, that no one wants. Yes, lets use that as a national template. Fine idea.

Mike P (Sent Monday, January 12, 2009 9:45 PM)

This is an amazingly superficial article. The health connector in Massachusetts is running a HUGE deficit. The state has been borrowing FORWARD to cover the huge budget gaps. All of that is going to come due very soon and there is no money to cover the losses. All of this information is readily available if someone wants to actually look into it. Instead, people want to accept generalities, flowery prose and flat out BS. We should be able to come up with a national health care system, but this is NOT it.

Mike in Massachusetts (Sent Monday, January 12, 2009 9:47 PM)

I don't know who the TV Man talked to, but my family and friends in Mass. tell me that this plan has several flaws: First of all, you HAVE to buy insurance or pay a fine. Second, the insurance you have to buy if your employer (assuming you have an employer) doesn't provide it is not inexpensive. (Oh, it's inexpensive if you're Mitt Romney or a Mass. senator). Third, many doctors and facilities are not accepting the state insurance plan. I'm sure the plan is swell for the insurance companies. And if this becomes the template for the nation, god help us all and pray you don't get sick. It's a boondoggle.

D B, New York City (Sent Monday, January 12, 2009 9:48 PM)

All I will say is that NO GOVERNMENT will ever make me have halth insurance if I do not want it. That is ludicris! I can understand working with companies to make sure that their employees get care, but fineing them money will only hurt small companies in the long run. Horrible idea

Brad, Plano TX (Sent Monday, January 12, 2009 9:50 PM)

Health insurance works when everyone can get a group rate. Even without my employer's pay-in, it would be affordable for me. But the problem is I can't get a group rate should I lose it and so the cost would be prohibitive. If everyone were in the same pool, all citizens would be covered at a fair price, and employers could add their share to salary. It would be far cheaper for everyone. Also, each company would not have to negotiate separately, saving them more money.

People scream at socialized medicine and forget that's exactly what medicare is and to a certain degree similar to HMOs. Maybe it's more of a marketing problem than a health care problem.

If everyone is covered costs go down - more preventative care catches stuff early when it's cheaper and less emergency room treatment, another unnecessary cost.

It's a matter of getting everyone on board and selling it properly. Because everyone wants good health care coverage.

Kit (Sent Monday, January 12, 2009 9:50 PM)

"I certainly don't know the reimbursement rates for Medicaid in Massachusetts, but if it is anything like that of NJ then most physicians will either choose not to accept it or simply end up going out of business. My practice would essentially go bankrupt if I were forced to subsist on revenues earned from Medicaid payments. Frankly I couldn't afford to pay my employees and malpractice, never mind everything else.
Dan D'Auria, Tabernacle, NJ"

You're right Dan. GOOD BLOODY LUCK Finding a physician that take MassHealth. Its another subsidy for the health insurance companies, that provide worse and worse service every year. Massachusetts has solved *nothing*.

Just where DID you get all of those "satisfied customers"? It sounds like a rigged study to me.

Mike {P (Sent Monday, January 12, 2009 9:51 PM)

I am moving to another state after paying my income taxes. This state has become a totalitarian one.
Since the moment they forced us to get a private medical insurance , everything went wrong.
Wait until the economy colapse, what is our brilliant governor gonna do?

SOCIALISM IN MASSACHUSETTS (Sent Monday, January 12, 2009 9:51 PM)

SINGLE FATHER OF 6YR. OLD TWINS IN TEXAS....COST $870 MONTH SELF INSURED...BREAKING MY BANK WITH THE COST OF OTHER ESSENTIALS JUST TO LIVE...IT'S TO THE POINT I AM FIXING TO DROP COVERAGE ON MYSELF BUT I CAN'T DO IT UNTIL I HAVE A NECESSARY BACK OPERATION IN ORDER TO BE ABLE TO GO BACK TO WORK AND BE ABLE TO RAISE MY YOUNG GIRLS....IF I CAN FIND A JOB AGAIN!!!....WELFARE LOOKS TO BE THE ONLY FUTURE IN SITE!!

JERRY,PORT ARTHUR, TEXAS (Sent Monday, January 12, 2009 9:52 PM)

The reality of Massachusetts' socialized medical care is that the people who aren't participating in it are the ones who are satisfied. These people (in the rest of the U.S. they are called leftist Democrats) feel all warm and fuzzy inside at the thought of everyone being covered by Medicaid. Doctors in New York are turning more and more Medicaid patients away due to the lousy reimbursement they receive from the state. Same is also true in Massachusetts and other far left regions of the country. NBC News conveniently left this fact out of this puff piece. Yep, no agenda there. Hopefully Republicans will have the votes to block former Senate Plurality Leader Tom Daschle's universal socialized medicine from ever seeing the light of day.

Rob, New York, NY (Sent Monday, January 12, 2009 9:53 PM)

WHAT!?! who writes this stuff!?! Mass health care is very very unaffordable! I live in Rhode Island just because they have a high deductiable program (I never use my insurance) - I pay $172 a month! The LOWEST priced insurance in MA that I could find was $550!!!

Why wouldnt MA allow such a program? If someone wants a high deductiable... why not?

Get real...

Chris - Cumberland, RI (Sent Monday, January 12, 2009 9:54 PM)

Judging from the comments to this story from those who have actual knowledge of the system, especially those from residents of Massachusetts, it looks like Mr. Bazell is just making things up. But then again, what do you expect from the Old School media. They abandoned journalistic integrity some time ago.

By the way, our national health care plan for seniors,(Medicare for those who voted for Obama) is trillions of dollars in debt and getting worse each year. It seems that adding to a losing system is borderline insane. Not to mention that the non-partisan comptrolled general of the U.S. has stated that the U.S. is financially insolvent Let's add even more to the debt with unaffordable health care for all.

Brian Goettl (Sent Monday, January 12, 2009 9:55 PM)

"the residents of the state are overwhelmingly satisfied."

That is not true. 85% of my associates disagree.

Ben Carlton (Sent Monday, January 12, 2009 9:56 PM)

The Massachusetts system is simply a failure! Look closely at what it has done to the state budget. Also, carefully remember that being insured does not equate with being able to get care. Primary care is a disaster. When you insure people with an inadequate number of primary care physicians, it's a recipe for disaster.

Richard Armstrong (Sent Monday, January 12, 2009 9:56 PM)

It is apparent from the comments that the pay scale for medical practitioners is so low that many, if not most, don't accept it. When I saw how much it was costing, I realized that their costs were as high as ours were through our employer. When we compare the costs in the US to those of foreign countries, we quickly realize that the doctors are just having to pay too much for their malpractice insurance. If we want to lower the cost of insurance, we need to severely limit the size of medical judgements (and learn to accept that doctors are going to make human mistakes). Of course this won't happen, because the lobby from attorneys won't even let this be considered in the state legislatures around the country.

Neil Cagle (Sent Monday, January 12, 2009 9:58 PM)

I would find a way to opt out of the "establishment" if something like this came to my town. Fined for not having health insurance? This is absurd. Completely absurd.

Elizabeth (Sent Monday, January 12, 2009 9:59 PM)

How about working through the public health system? Put up good clinics in neighborhoods - run by nurse practioners on a sliding scale fee. Promote health rather than treat illness. Hold all citizens accountable for their health, no law suits when you drink too much alcohol, are overweight and underactive, smoke, take illegal drugs, are medically noncompliant. Reduce law suit settlements from the above population, reduce the cost of medicine by reducing defensive medicine. Encourage training family practice physicians rather than high paying specialties. Cut red tape and get to a simpler affordable plan. If someone wants upgrades and can afford them, let them be available. Cut the waste in the Emergency Rooms by re writing the EMTALA regulations. Overburdeoned medical offices tell their patients "go to the Emergency Room" the most expensive family practice clinic there is. Use common sense, preventive medicine, accountability, and structures already in place. Think practical and spare. Not everybody get to drive a lexus.

Linda Slover, Melbourne, FL (Sent Monday, January 12, 2009 9:59 PM)

Let's see how many african-americans, illegals from Mexicao and Cuba do they have? Whats the unemployment rate? Since it is arguable the most liberial state in the union, I doubt very seriously this is a good "example" state for state sponcered health care!!! Let's try say california, or Texas first.

Alan B. (Sent Monday, January 12, 2009 10:03 PM)

I would like honesty in the health care debate, whether it be about the Massachusetts program or other health care proposals. We want four things from the health care system: (1) choice of providers; (2) no rationing (either directly or through long delays for certain procedures); (3) excellent care; (4) affordability. Politicians of all stripes continue to falsely tell us that these are not mutually exclusive desires. Any system will deliver at least one of these, many systems can deliver two or three, but NONE can deliver all four. We need to admit that and make tough decisions as to how much of each of these we are willing to compromise. If any politican tells you we can have it all, they are lying. You cannot have excellent care from whomever you want, as much as you want, whenever you want, at an affordable cost. It's that simple. While Massachusetts will inevitably have to compromise on one or more of the above demands (and the TV series should make this clear, if it is to be honest and not merely propoganda), at least Mass. is making the effort to improve on what is admittedly a broken system.

Greg Travalio, Columbus OH (Sent Monday, January 12, 2009 10:04 PM)

How about the below which pretty much says this persons article is propaganda:

Lisa Poplaski - Pittsfield, Massachusetts

Mandatory Private Insurance Is Unaffordable

I think most people don't realize the consequences of this insurance mandate in Massachusetts because they have insurance at work or they're getting some other subsidy. They don't realize the full cost. But they could be in our situation someday.

Until this year we had health coverage through my husband's employer for about $300 a month with drug coverage. It was a good policy. But he lost that job and was out of work for 8 1/2 months. He finally got another IT job but with no benefits. We've been paying the doctor out of pocket when we need to and considering we are quite healthy that suits us just fine.

Now the state is forcing us to buy "health insurance" we don't need. The worst thing is they treat us like criminals. We always paid our taxes, our bills, and any other financial commitment, but this unjustified expense is not of our choosing.

We are in our late 40s. The only policy that would work for us - based on the state guidelines - costs about $720 a month, not including co-payments. That's far more than our total medical expenses have been up to now. There were slightly cheaper premiums but with high deductibles, so they wouldn't actually be cheaper.

Premiums are totally outrageous in this Ponzi scheme. Our income will be too high to get the subsidized coverage, but not enough to afford $720 a month. The state won't take into account our hardship or our loss of savings. You have to be practically homeless or in foreclosure before they'll give a waiver.

While my husband was out of work, we struggled but paid all of our bills by using our savings, breaking a CD and paying a penalty with each withdrawal.

Now we want to put a few hundred dollars back into savings every month. But if we had to pay for insurance, we'd have no savings, and we'd also have to deplete our CD.

We feel like we made reasonable choices and tried to save a little when we could. We are responsible, law-abiding citizens and we're being punished just as we're getting back on our feet.
First, if we don't buy the insurance before December 31, we'll lose our state tax deduction. Then, beginning January 2008 the state will bill us for up to half the cost, even though we'd be getting nothing for it. This feels like a scam to make money for the insurance companies and even the state.

What they call "health insurance" is in reality a walloping tax.

We are taking this one month at a time. Having lived in Massachusetts for 22 years, we have ties here, including family. We don't want to leave but we feel forced out.

Thomas Cresswell, Lakewood, CA (Sent Monday, January 12, 2009 10:04 PM)

This "experiment" does not address the illegal immigrant population and their continued cost to all taxpayers. The drain they place on the health care system, doctors and hospitals included. The "rates" that people are paying for health care have this "loss" built into it. Hospitals and doctors not unlike retail companies like WalMart must add losses into the cost of their goods and services thereby passing the cost onto those that do pay. Unfortunately the laws that govern hospitals "require" them to treat anyone presenting to the emergency room........whether it is an emergency or not. I work in a hospital and the amount of people using the emergency room for things like the common cold are amazing. The illegals know that they can not be turned away because of the law so they are treated........they don't pay and the cost goes on to you and me. There is no consequence for them to stop doing it because they don't have a social security number and due to that it doesn't affect their credit like the rest of us. They don't worry about being reported for being illegal because the hospital doesn't have the ability or the resources to deal with it. So until there are laws in place that only true emergencies must be accepted at emergency rooms and we quit passing out free services to those that are not legally here the people who are citizens will continue to suffer.

Dawn (Sent Monday, January 12, 2009 10:05 PM)

Thanks for caaying the spory. I do doubt such suceed can be copied because the are not enough primay care doctors, and with 47 million potenial consumers,the system will break down from over overload. The would advocate a National healh care assetment, to help break the problen to magemable segments. Acte contutios are not the same thing as a twent year older who is too lazy or cheap to buy coverage. Acute issue demand inneate attention.

Arlin Carlson,Minnepolis,Mn (Sent Monday, January 12, 2009 10:06 PM)

I live in Massachusetts, the plan is a collasal failure. Rates are too high, too many flaws in the
ointment.

And with the huge buget deficit I have to wonder if the plan will be killed off soon.

Dr. Welby, Boston, Ma (Sent Monday, January 12, 2009 10:06 PM)

MA only requires employers to provide insurance. Employees are left with poor expensive insurance that needs state asstance. The application process takes weeks& delays care Primary care MDs are in extremely short supply because of poor reimbursements. So those
appointments take 3 to 6 months to get. Then tests &
specialist appointments take weeks to move through.
This was what we were supposed to encounter with a Federal Health Care System. Well its here now!!!
Except this is expensive to state tax payers and employees
The current system of profiteering companies who blame patients demands for the costs of health care is insane. Its the greed of companies that raise costs.
A single payer system jointly suppoted by FED/STATE EMPLOYEES/EMPLOYERS IS MUCH FAIRER
This is too big a problem for any state to manage without asssistance

LOIS CROSS WILLIAMSBURG MA (Sent Monday, January 12, 2009 10:07 PM)

The only way to lower insurance costs is to reduce the amount the greedy doctor's, nurse's, drug manufactures, medical equipment suppliers, lawyers, and hospital owners are making! All insurance Underwriters do is try to figure out what outrageous charges they are going to have to pay these people for the following year. Dig deeper and you will see the real problem is the cost that these people earn on a yearly basis!

Danny, Kansas City, KS (Sent Monday, January 12, 2009 10:07 PM)

You want to help Doctors with malpractice insurance?
Pass tort reform so that lawyers don't keep suing doctors for millions of dollars over every slip up. I'm an insurance agent and I agree health insurance is a huge problem. Why not lower the Medicare eligble age to 55. This would leave the under 55 crowd left to purchase private insurance. Under 55 on average means less health problems and less premiums paid. This approach would also prevent people from being forced to keep working to 65 just so they have health coverage. Complete Universal health care only works in some very small nations in Europe. The U.S is to populated to pull this off.

Chad Downstate IL (Sent Monday, January 12, 2009 10:08 PM)

I often wonder why the policy makers never question where the high premiums come from in the first place. It certainly has been a shock to me that my insurance rates have quadrupled in the last twelve years or so. I know inflation and such have gone up but the proportions are way off. Where does MY premium go????

Dan Stevens, Bonney Lake, Washington (Sent Monday, January 12, 2009 10:09 PM)

None of these awful proposals, and the extremely bad one used here in Massachusetts, solves the core problems. Lets look at a few:
1) I made an appointment to see a doctor for stomach problems. I made the appointment in August 2008, and the *earliest* I could get to see a specialist was late November. And I have good insurance, at least now. Two weeks before the appointment, the doctors office called and pushed the appointment back another month. So, it took almost 4 months to see a stomach doctor. I saw the doctor for less than 10 minutes, I felt I got "the bums rush". The cost of that 9 or so minutes? $635.00. This amounts to about 5 million dollars a year income between the doctor and hospital. For *one* doctor. If I were forced to use the MassHealth plan, do you think Id have been able to see this doctor at all? I think not. And, how is the MassHealth "plan" solving the basic problem of of $6,500 dollars *an hour* for a fairly poor doctor? Where is the "solution"< I don't see it!!!
2) My brother has had dry skin problems his whole life. Recently, his doctor prescribed one of the "miracle" drugs we're seeing these days. The cost? $55,000.00 a YEAR for one pill a week. This is not a life saving drug, and it has awful side effects for immune system. How is the "plan" solving this problem?
3) When I was in college, a friend of my fathers had cosmetic surgery to remove fat around her stomach area. You've heard of "liposuction", this ws similar. It was *entirely* elective. After she recovered from the procedure, she discovered that her belly button was about 1/2" off center. She sued and recieved over a million dollars. This was in the late 1980's. FOR ELECTIVE SURGERY FOR FAT REMOVAL!!!

How are any of these "plans" solving any of the core problems of reducing cost internally and for frivilous lawsuits? I think they're not!

Mike P (Sent Monday, January 12, 2009 10:10 PM)

When I was in my 20's I CHOSE not to purchase health insurance with the intent to save money in order to purchase a house and have some money left in the bank so my wife would not have to work when we had kids. Once I turned 30 I began to purchase health insurance; now (pushing 40) we have a house and my wife is a stay at home Mom. If the state had mandated that I spend $11k plus for a decade I would not have been able to achieve what I have noted above. Maybe we should allow "the people" determine what is best for them and not teach our kids that the government knows best.

Fred S. Fishkill NY (Sent Monday, January 12, 2009 10:10 PM)

As a medical student, I am currently in $118,000 in debt and I have one more year left to go. Becoming a doctor may be one of the biggest mistakes we have done. Keep in mind that I am doing 4 years of college....4 years of medical school....3 years in Internal medicine...2-3 years in a subspecialty. Do the math...
4+4+3+2=13 years of becoming a doctor and now they want us to work for nothing. Thanks to Obama....hard work is not going to be rewarded...Its called personal responsibility something Americans don't really have. I can't tell how many times I have seen obese, hypertensive, & diabetic patients that eventually going into chronic renal failure. Maybe preventative medicine should get more funding b/c that will cut the costs significantly.

Chris (Sent Monday, January 12, 2009 10:11 PM)

Here in Alberta the gov just scrapped the monthly premium for healthcare altogether.

Robert, Edmonton, Canada (Sent Monday, January 12, 2009 10:13 PM)

I agree with other Mass residents that this article is misleading and the "experiment" is not all it's cracked up to be. For the countless readers, you really need to do more research. I am lucky in that I am in the healthcare field - doctors tend to view us as responsible patients, and out of professional courtesy, agree to accept us as patients. For the rest of the community, forget it. There is such an unbelievable shortage of primary care physicians in this state that many practices have closed themselves to new patients or provide suboptimal care. There is a long waiting list to see a doctor for routine health care maintenance. Solving the insurance puzzle is a very small piece of the experiment. The problem will not be fixed until, quite honestly, more people start taking more accountability for their own health, including diet, exercise, and lifestyle. I had better luck with healthcare in Ohio.

Pam, Boston, Mass. (Sent Monday, January 12, 2009 10:15 PM)

Bob, I just read all of the comments to date. Not one from Massachusetts had anything positive to say.

Augusto, Hartford, CT (Sent Monday, January 12, 2009 10:15 PM)

The solution will require wage and price controls for
all things medical, including pharmaceuticals, and
inhibition of patient overutilization. Any intermediaries inserted between providers and consumers must be specifically defined and monitored with a vengeance to avoid re-creation of the wasteful politcoparasitic mechanism currently in place.

Retired MD and former co-premed student with RBazell (Sent Monday, January 12, 2009 10:16 PM)

I'm not sure what the good folks of MA are complaining about, in terms of costs, anyway. Here in CA, my wife and baby daughter and I all have to be on separate plans because of my pre-existing condition, and the fact my wife is still interested in maternity coverage. Our three policies a month cost $1295, and two of the policies have $500 deductibles each. If you add up the out-of-pocket plus the monthly costs, we are spending about $18,000 for a family of three each year. I, too, would like to see universal coverage, low cost, wide physician acceptance, low government outlay, etc, etc... and I can tell you that the system as it exists currently in CA doesn't do a very good job of it.

George M, Half Moon Bay, CA (Sent Monday, January 12, 2009 10:21 PM)

Hmmm. I heard that they couldn't afford it at the level that they are at right now (the state that is) and that it is heading in the same direction as Hawaii (that is that it is bankrupt). I also know someone on the program that is waiting more than 6 months for a check up. This story is just propaganda, not reporting. Tell the truth and report the news and stop trying to sell the public on your agenda.

Tim, Milwuakee WI (Sent Monday, January 12, 2009 10:21 PM)

misleading...pure misleading!! and if others follow us in our states footsteps..people(except for the rich)are going to regret how awful it really is.

dd ma (Sent Monday, January 12, 2009 10:23 PM)

I have worked in health care for over 40 years. EMT, Paramedic, Medical Technician. I know the problems that are being faced by hospitals, doctors, and others in the health care field. Rising costs vs lower payments from Medicare/Medicaid. How can this help a low income individual to have healthe care if no one will accept it?

R Allen, Springdale, AR (Sent Monday, January 12, 2009 10:24 PM)

more media bias from slanted/uninformed repoters. the plan costs way too much and very restrictive/punitive. americans waste way too much money on health care by going to the doctor for every little thing. we want all the health care we can get for nothing. privatizing health care would force people to spend wisely. it would result in more competition from insurance companies to lower premiums by getting rid of prohibitive state laws that monopolize the industry. new innovative types of plans in regard to items covered and age groups would emerge.

another thing that must be addressed is end of life care expenses. of all the money one spends on health care, much of it is near death. money is wasted left and right on surgeries and treatments that are extremely costly yet only prolong life for extra months. insurance companies should not have to cover this unless individuals want to pay on their own or with a rider.

socialization kills innovation and choice and will eventually be too costly. privatiztion requires responsibilty but would succeed. of course most of this country's problems have to do with companies, government, and individuals being irresponsible by asking for and encouraging social welfare.

nate k (Sent Monday, January 12, 2009 10:24 PM)

Reading resident comments -- the jury is in and this is a failure -- predictably. Look folks, only 3% of people below age 65 have costs > $ 30K per year. Yet, these people create the greatest burden. If the government is going to get involved, doesn't it make sense to start there? You offer catastrophic insurance that splits the risk with the insurance companies to lower premiums. The impact on the existing system is minimal, sice re-insurance companies do this already, but the impact to premiums should be significant. Toss in insurance and tort reform to kick in another 10% reduction in costs, and you get affordable health insurance.

Brook (Sent Monday, January 12, 2009 10:24 PM)

I like it - higher cost of living, lower quality of life. Yes, I will move to Mass.

Joe Cola, SC (Sent Monday, January 12, 2009 10:25 PM)

This program is not perfect, to be sure. BUT.. where do we start? Where and when will America start to insure any and all?! Insurance is exceedingly complicated, as any MD will tell you. BUT, we MUST start somewhere. The Massachusetts plan is a very good start. This plan was drafted before this economy came crashing down, and when we return to a more favorable economy, we will see plans like this do even better than we could have guessed.
This is something that will benefit the Massachusetts economy in ways that we never dreamed of. All of the negatives that are being eliminated, are still doing so now, during an economic downturn. When the snowball starts rolling the other way, we will know that this is a good plan. Even if there are things that need to be fixed along the way. At least we started SOMEWHERE! This will work.

Bob, Saratoga Springs, N.Y. (Sent Monday, January 12, 2009 10:26 PM)

Why is it that the positive comments have come from those outside MA? Seems the citizens of MA are not so convinced they have a good deal.

In my opinion, the core issue is that the "consumer" of medical services is no longer directly connected to the "provider". Every month you send your money away to a big company whose primary goal is to increase dividends for its shareholders. And when you see your doctor, he/she must essentially beg your big company to send ever decreasing amounts of your money to reimburse him/her for the service provided. And many times the type of care you can receive is dictated by an anonymous worker bee at the big company who hasn't examined you, listened to your problems, and doesn't know anything about whether or not you actually need the care your physician recommends. Remember, their job is to protect the profit margin of the 'for profit' big company.

Perhaps the reason more and more physicians (not "healthcare providers") are deciding not to accept insurance or participate in these shell games is because we want to return to a time when we had a relationship with our patients (not "healthcare consumers") that was based on mutual respect and trust. Most people still value this type of a relationship.

I look forward to the day when the American public wakes up and realizes that they are directly responsible for their own health, that the insurance providers are interested only in large profits (no matter what they may say in their slick advertising brochures), and that the vast majority of young people who choose to become physicians do so because they generally love science and helping people.

Pray that the leaders of our great land are wise enough to listen to the public and not the healthcare lobbyists.

Joe M, Cardiologist, Jacksonville, FL (Sent Monday, January 12, 2009 10:26 PM)

Isnt this working over in the UK and other parts of the world?

Joa Azona (Sent Monday, January 12, 2009 10:26 PM)

Great start to something great and extremely necessary in the United States. As a registered nurse, I am excited about the promise of this plan and others like it designed to ENable Americans, and not DISable them.

Laurel Tyler, Memphis, TN (Sent Monday, January 12, 2009 10:27 PM)

I can't buy it -- this plan still pays insurance companies instead of doctors. How did anyone ever believe that the butting-into-the-medical-system of huge for-profit 3rd-party bureaucracies paying CEOs millions of dollars could possibly be a good idea or save anybody 5 cents? Like every other financial scam that ever existed, in "health insurance" and HMOs, a few elite insiders skim off the money and everybody else gets their money stolen. In the case of "medical care," buyers pay with their health and their lives. Only the complete eradication of the financial parasites can restore real health care and humanity.

Janet McLaren, Garland, TX (Sent Monday, January 12, 2009 10:27 PM)

I think that the poll must have took place in Boston, a city with no shortage of people who LOVE to live off of government resources. My "low" premium doubled after the first year of coverage, higher than it was before the state intruded on my health care.

This program most benefits those who contribute the least. The Robin Hood politics of MA is one of the main reasons I picked up my business and moved out of the state. We'll see how the plan does in a few years when other people like me who pull their own weight look for greener pastures. No one gets juice when there are no oranges left to squeeze.

John, Concord, NH (Sent Monday, January 12, 2009 10:28 PM)

As a self employed musician, this program has really helped me be able to afford health insurance. A little over a year ago I had a medical emeregency and without this insurance I would've been stuck with thousands of dollars of medical bills, probably would've lost my house and had to take my son out of college. Thank God for the Commonwealth Connector!

Luke, Massachusetts (Sent Monday, January 12, 2009 10:32 PM)

Does anyone else find it funny that this "journalist" who is not from Mass. is trying so hard to sell this plan? It seems that the residents of Mass on this blog are not actually "overwhelmingly satisfied"...hmmmm?

Jason, Acworth Ga (Sent Monday, January 12, 2009 10:33 PM)

Just a reality check here, but when I did a paper on this last fall the State of Massachusetts had already spent $400 million more than was budgeted for this experiment, after only 2 years.

John, Ohio (Sent Monday, January 12, 2009 10:34 PM)

Seems like many from MA that have blogged on here believe it is another rip-off. With the highest level of insurance type companies in the states located in MA, short of Bermuda ,its a wonder.

Another Barney Franks joke..

Dave Williamson (Sent Monday, January 12, 2009 10:37 PM)

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