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July 28, 2005 The Bay State Banner – Vol. 40, No. 50
Lawmakers mulling health care reform
Jeremy Schwab

With high health insurance costs plaguing state residents and businesses, Massachusetts lawmakers are considering four competing proposals to revamp the health insurance system.

The four plans have similar goals “increasing the number of insured residents while minimizing costs “but would achieve those goals in vastly different ways.

Supporters of a single-payer health care system that would eliminate most private insurance and give all Massachusetts residents government-funded health plans testified at the State House last week.

They said a single-payer system would be cost effective because it would have much lower administrative costs than HMO plans and would eliminate the need for the costly free care pool that funds care for the uninsured.

Currently, 39 cents out of every dollar goes to overhead, Sandy Eaton, chairman of the Mass-Care Coalition which supports the bill, told the Banner.

If we could cut back by, say, 10 percent, we would have billions more to cover everyone.

In addition to saving administrative costs by streamlining and reducing paperwork such as means testing forms, the plan would create a statewide pool to negotiate with pharmaceutical companies for lower drug prices.

The plan would need federal approval, as federal Medicare money would be rolled into the health care trust established under the plan.

Gov. Mitt Romney’s plan, meanwhile, would put little pressure on the insurance industry. Under his plan, insurers could create cheaper insurance products that cut back on some services while maintaining core coverage such as doctor visits, emergency care and prescription coverage.

The state would eliminate the free care pool and use the money instead to subsidize insurance for lower-income people not covered by Medicaid. If state residents refused to purchase health insurance, they could lose their personal exemption on their income tax under Romney’s plan.

Affordable insurance can be available to all citizens without a government takeover of the health care system, said Romney in a press release.

Romney’s poke at advocates who support an expanded government role in providing health care was matched last week with rhetoric from the other side.

The market-based proposals which are so popular right now simply violate ideas of social justice, Arnold Relman, former editor of the New England Journal of Medicine, told the Joint Committee on Health Care Financing.

A third proposal, supported by a coalition including the Greater Boston Interfaith Coalition, Health Care for All and the Service Employees International Union, would also offer health coverage to all residents, say supporters.

Dubbed the Health Access and Affordability Act, it would expand access to MassHealth, allow individuals to join large group coverage plans and force more employers to cover their workers.

A fourth plan, offered by Senate President Robert Travaglini, would cover half of the 532,000 uninsured state residents over the next two years, according to a press release.

Travaglini’s plan would loosen restrictions on health care companies as an incentive to cover more low-income people and force insurers to offer plans for individuals under 25 years old.

The plan would also seek to expand Medicaid enrollment for those who are eligible but un-enrolled and force large employers that do not offer insurance to pay for the free care costs incurred by their employees.

Observers familiar with the workings of the State House expect the Legislature to ultimately adopt a plan incorporating elements of the different proposals.

The wave of new proposals to reform the medical insurance system was spurred in part by the increasing cost of health coverage. Soaring costs are hurting state residents and businesses and overburdening the free care pool.

A drive to put on the ballot a constitutional amendment giving every resident a right to health care has also helped spur lawmakers to act.

Every politician to look real has to come up with something, because it looks like the movement to amend the constitution is unstoppable, said Eaton of Mass-Care.

Supporters collected over 70,000 signatures in 2003 to move the proposal to the Legislature, which passed the proposal at its constitutional convention last year. Assuming legislators pass it again at the constitutional convention tentatively scheduled for next month, the question will appear on the ballot in 2006.

Former Massachusetts Senior Action Coalition Secretary Catherine Perez, 92, testifies before legislators last week on the need to create a universal, government-run health care system. The hearing was on one of four markedly different plans offered by legislators to dramatically increase the number of state residents with health insurance.

© Banner Publications Inc

  

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