By Susanne L. King

Massachusetts Has been lauded for its healthcare reform, but the program is a failure. Created solely to achieve universal insurance coverage, the plan does not even begin to address the other essential components of a successful healthcare system.

What would such a system provide? The prestigious Institute of Medicine, part of the National Academy of Sciences, has defined five criteria for healthcare reform. Coverage should be: universal, not tied to a job, affordable for individuals and families, affordable for society, and it should provide access to high-quality care for everyone.

The state’s plan flunks on all counts.

First, it has not achieved universal healthcare, although the reform has been a boon to the private insurance industry. The state has more than 200,000 without coverage, and the count can only go up with rising unemployment.

Second, the reform does not address the problem of insurance being connected to jobs. For individuals, this means their insurance is not continuous if they change or lose jobs. For employers, especially small businesses, health insurance is an expense they can ill afford.

Third, the program is not affordable for many individuals and families. For middle-income people not qualifying for state-subsidized health insurance, costs are too high for even skimpy coverage. For an individual earning $31,213, the cheapest plan can cost $9,872 in premiums and out-of-pocket payments. Low-income residents, previously eligible for free care, have insurance policies requiring unaffordable copayments for office visits and medications.

Fourth, the costs of the reform for the state have been formidable. Spending for the Commonwealth Care subsidized program has doubled, from $630 million in 2007 to an estimated $1.3 billion for 2009, which is not sustainable.

Fifth, reform does not assure access to care. High-deductible plans that have additional out-of-pocket expenses can result in many people not using their insurance when they are sick. In my practice of child and adolescent psychiatry, a parent told me last week that she had a decrease in her job hours, could not afford the $30 copayment for treatment sessions for her adolescent, and decided to meet much less frequently.

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1 Comment

  1. maxine gilliam on January 18, 2010 at 11:10 am

    Seems to me that Mass. did not think this through before passing the universal health care bill. Apparently the bill was passed, insurance companies continued to get filthy rich; after recognizing the flaws in this bill no one tried to amend it for corrections so that the people (all the people)could benefit. I believe this could work if done properly. The universal health care plan can work under the Obama administration if each one of the failed issues in Mass. is looked at and corrected on a national level. but of course this is not the real issue here. The real issue is to fight anything that this administration tries to do because, after all, all democrats are inherently evil and wicked. Makes you go Hmmmmmm!! I adminit that everything this administration is doing may not necessarily be what’s right; but I do believe that if we do what we’re suppose to do as a nation (pray for those that are in authority over us) that we will see a great move of God in this nation. From the White House to our house.