Free Republic
Browse · Search
News/Activism
Topics · Post Article

Skip to comments.

In Massachusetts, Universal Coverage Strains Care
New York Times ^ | April 5, 2008 | KEVIN SACK

Posted on 04/05/2008 7:32:48 AM PDT by socialismisinsidious

Once they discover that she is Dr. Kate, the supplicants line up to approach at dinner parties and ballet recitals. Surely, they suggest to Dr. Katherine J. Atkinson, a family physician here, she might find a way to move them up her lengthy waiting list for new patients.

Those fortunate enough to make it soon learn they face another long wait: Dr. Atkinson’s next opening for a physical is not until early May — of 2009.



Now in Massachusetts, in an unintended consequence of universal coverage, the imbalance is being exacerbated by the state’s new law requiring residents to have health insurance.



“It’s a recipe for disaster,” Dr. Sereno said. “It’s great that people have access to health care, but now we’ve got to find a way to give them access to preventive services. The point of this legislation was not to get people episodic care.”



Here in Massachusetts, legislative leaders have proposed bills to forgive medical school debt for those willing to practice primary care in underserved areas; a similar law, worth $15.6 million, passed in New York this week. Massachusetts also recently authorized the opening of clinics in drug stores, hoping to relieve the pressure.



Dr. Atkinson, 45, said she paid herself a salary of $110,000 last year. Her insurance reimbursements often do not cover her costs, she said.

“I calculated that every time I have a Medicare patient it’s like handing them a $20 bill when they leave,” she said. “I never went into medicine to get rich, but I never expected to feel as disrespected as I feel. Where is the incentive for a practice like ours?”

(Excerpt) Read more at nytimes.com ...


TOPICS: Business/Economy; Government; News/Current Events; US: Massachusetts
KEYWORDS: bluestates; control; government; healthcare; hillarycare; meddling; romneylegacy; socialism; socializedmedicine; universal; universalhealthcare
Navigation: use the links below to view more comments.
first 1-5051-55 next last
I attended a health care debate and the Liberal solution to primary care doctor shortages was: "tell medical students what kind of doctors they can be. Oh yeah, and tell them where they can practice."

The scary part: the med students attending this debate were still for "one payer coverage" after hearing this!
1 posted on 04/05/2008 7:32:49 AM PDT by socialismisinsidious
[ Post Reply | Private Reply | View Replies]

To: long hard slogger; FormerACLUmember; Harrius Magnus; Lynne; hocndoc; parousia; Hydroshock; ...
Socialized Medicine aka Universal Health Care PING LIST

FReepmail me if you want to be added to or removed from this ping list.
2 posted on 04/05/2008 7:33:22 AM PDT by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
[ Post Reply | Private Reply | To 1 | View Replies]

To: socialismisinsidious

Mitt Romney wrote and signed the Mass. healthcare boondoggle.


3 posted on 04/05/2008 7:37:16 AM PDT by Greg F (Do you want a guy named Hussein to fix your soul? Michelle Obama thinks you do.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: socialismisinsidious

I have a good buddy who is a doc, and who is a Dem despite all that. It just makes no sense to me whatsoever.


4 posted on 04/05/2008 7:37:37 AM PDT by FreedomPoster (<===Typical White American)
[ Post Reply | Private Reply | To 1 | View Replies]

To: socialismisinsidious

But hey! Look at the bright side! Under RomneyCare you can get your offspring killed for only fifty bucks!

/s


5 posted on 04/05/2008 7:39:13 AM PDT by EternalVigilance (With "Republicans" like these, who needs Democrats?)
[ Post Reply | Private Reply | To 1 | View Replies]

To: socialismisinsidious

6 posted on 04/05/2008 7:43:38 AM PDT by HangnJudge
[ Post Reply | Private Reply | To 1 | View Replies]

To: Greg F
Mitt Romney wrote and signed the Mass. healthcare boondoggle.

Among many other liberal causes he supported all his political life - until he decided to run for pres. and yet some here want him as McCain's V.P. pick.. I suppose some want to see two liberals on the Republican ticket.

7 posted on 04/05/2008 7:52:00 AM PDT by Graybeard58
[ Post Reply | Private Reply | To 3 | View Replies]

To: Graybeard58
People that live in that Socialist hell-hole need to vote... ...with their feet.
8 posted on 04/05/2008 7:55:51 AM PDT by Frobenius
[ Post Reply | Private Reply | To 7 | View Replies]

To: socialismisinsidious

In Massachusetts, Universal Coverage Strains Care...

a strain this year...bankrupt next year .... more taxes to follow....great socialist system!!!


9 posted on 04/05/2008 7:57:20 AM PDT by nyyankeefan
[ Post Reply | Private Reply | To 1 | View Replies]

To: Greg F
Health Care Reform in Massachusetts — A Work in Progress  [http://content.nejm.org/cgi/content/full/354/20/2095]
Volume 354:2095-2098  May 18, 2006  Number 20
The New England Journal of Medicine

In April 2006, Massachusetts enacted far-reaching health care reforms (see box).1,2 Starting in July 2007, all state residents must carry a minimum level of health insurance, a requirement that will be enforced through the state tax return. Coverage may be through an employer, Medicaid, Medicare, or new programs that will facilitate the purchase of private coverage. In many instances, failure to comply with the new law will lead to financial penalties. By 2009, the proportion of state residents who are insured should markedly increase.

Key Components of the Massachusetts Plan [http://content.nejm.org/cgi/content-nw/full/354/20/2095/T1]

The reforms follow months of intense discussions and have bipartisan support (see the article by Altman and Doonan in this issue). Many of the measures are creative and novel. For example, assistance in the payment of premiums will be provided for low-income persons and families who are not eligible for other public insurance. This assistance will aid in the purchase of insurance by people with incomes under 300 percent of the federal poverty guidelines, which in 2006 are $29,400 for an individual and $60,000 for a family of four living in the contiguous United States. For those who are ineligible for subsidies, the merger of the health insurance markets for small groups and individuals should reduce premiums, perhaps by 25 percent for individuals, according to state officials. A broader ability to purchase insurance on a pretax basis should reduce the net cost of insurance for those who cannot already do so.

Funding includes federal and state spending, as well as assessments on hospitals, insurers, and employers. Supplemental revenue to support the reforms is projected at $201 million in fiscal year 2008 and $173 million in fiscal year 2009, according to legislative analysts. This includes $125 million each year from general state revenues; the rest is from employers. When fully implemented, the reforms should represent a meaningful advance against the problem of the medically uninsured, even though only Massachusetts residents will benefit.3

The overall effect is harder to predict. The requirement is for a minimum level of health insurance, not an optimal level. Improving access to medical care for previously uninsured persons may increase the demand for needed services, such as surgery, thus improving health but increasing costs. The reforms may make little difference in many factors that contribute to spending, including the costs of prescription drugs and health care administration. There will be new roles for the state and federal government, individuals, employers, and health insurers and some new cost-control measures. Nonetheless, the overall structure of private health insurance and the payment and delivery of medical care will remain intact, and costs will relentlessly increase.

In 2004, the health expenditure per capita in the United States was $6,280, or more than $500 a month, and accounted for 16 percent of the gross domestic product. Spending grew by 7.9 percent from the previous year. In 2005, the average monthly cost of coverage through job-based health insurance was $335 for an individual and $907 for a family, according to the annual survey conducted by the Kaiser Family Foundation and the Health Research and Educational Trust. In Massachusetts, the average cost of policies is higher. Massachusetts has a long history of health care reform, including a controversial 1988 universal care law that was enacted but never implemented and that was eventually repealed. In the mid-1990s, the state expanded Medicaid and created a subsidized drug program for seniors.4 As compared with the nation as a whole, Massachusetts has a higher percentage of residents who have health insurance through their employers and a lower percentage of people without insurance (see Figure 1). Massachusetts already spends a considerable sum each year to compensate community health centers and hospitals that treat the uninsured, using state and federal funds, as well as payments from insurers and employers who are self-insured. Some of these existing funds will be redirected to improve insurance coverage. Although such favorable conditions suggest that the reforms have a greater chance of success in Massachusetts than they would elsewhere, officials still have to implement the measures and address the diverse situations of the uninsured (see Figure 2).

Funding includes federal and state spending, as well as assessments on hospitals, insurers, and employers.

Figure 1. Health Insurance Coverage in Massachusetts and the United States. [http://content.nejm.org/cgi/content-nw/full/354/20/2095/F1]

Figure 2. Characteristics of Uninsured Persons in the United States in 2004. [http://content.nejm.org/cgi/content-nw/full/354/20/2095/F2]

When Mitt Romney, the state's Republican governor, signed the health insurance reform bill, he vetoed some provisions, including an annual charge of $295 per employee to businesses with 11 or more full-time employees that do not provide health insurance or contribute to it. By early May, the legislature, which is overwhelmingly Democratic, had overriden this veto. The $295 charge is dwarfed by the annual cost of health insurance, and the anticipated revenues are only about $50 million a year. Although the so-called "fair share contribution" is not a substantial financial incentive for employers to provide insurance, it does symbolize the logic of the reforms — that employers and employees share responsibility for health insurance.

Implementation depends on new regulations and insurance plans, as well as on the accuracy of many assumptions. One assumption is that the Centers for Medicare and Medicaid Services will approve the aspects that require its assent. These include the use of Medicaid funds to provide assistance to lower-income persons and families in the payment of premiums, expansion of Medicaid to include children of families whose income is up to 300 percent of the federal poverty guidelines, and continued support to Boston Medical Center and the Cambridge Health Alliance to care for people who remain uninsured. The waiver agreement under section 1115 of the Social Security Act allows the state to operate part of its Medicaid program under rules that are different from those that usually apply. Although approval is expected this summer, the federal government has not signaled its intentions. In any event, the waiver will expire in 2008 and will have to be renegotiated.

The estimated number of people without health insurance in Massachusetts ranges from 550,000, which is based on an annual state survey, to 715,000, which is the number provided by the Census Bureau for 2003–2004; state officials consider the higher number less reliable. The Massachusetts plan assumes that about 515,000 residents would gain coverage, leaving perhaps 35,000 without insurance. However, there is no certainty about the number who will gain coverage. In addition, if the actual number is considerably higher, the funding will fall short.

A new state authority, the Commonwealth Health Insurance Connector, will administer many of the insurance aspects of the reform and will have to approve the new policies before they can be sold. The target price of policies for low-income persons — before premium-payment assistance is applied — is $300 a month, which would be paid mostly by the state. These policies will have Medicaid-like benefits. They will not have deductibles, and there will be no premiums for persons who earn less than 100 percent of the federal poverty guidelines, or $9,800 a year. Otherwise, such items as the actual cost of insurance, the premiums after assistance is applied, out-of-pocket payments, and the extent of coverage will not be known until policies become available later this year.

A related assumption involves the availability of "affordable" insurance for people with incomes that make them ineligible for subsidized premiums. The individual mandate to have insurance is contingent on the availability of affordable plans. Although the term has yet to be defined, an "affordability scale" is to be set annually, by the connector. It is uncertain, however, whether the policies will truly be "affordable."

The insurance products are expected to offer coverage that is similar to the subsidized policies but may have important differences, such as deductibles, high-deductible plans tied to health savings accounts, substantial out-of-pocket payments, or more limited choices of doctors and hospitals. Although the Romney administration has set a target price of $200 a month for "comprehensive insurance" for an individual, state legislative leaders contend that the actual price will be about $320 a month. The features and prices will not be known until policies become available in 2007.

The Massachusetts health care reforms are ambitious and complex. State officials anticipate that adjustments will be needed along the way. Perhaps their most important assumption, however, is that the costs and economic burden will be acceptable in the long term. When the economy slows, state tax revenues decline. Simultaneously, Medicaid spending accelerates and the number of people who are either enrolled in Medicaid or uninsured increases.5 For the reforms to succeed, Massachusetts will have to sustain them through the economic hard times, when they will be needed most.


Source Information

Dr. Steinbrook (rsteinbrook@attglobal.net) is a national correspondent for the Journal.

References

  1. The 184th General Court of the Commonwealth of Massachusetts. Chapter 58 of the Acts of 2006, an act providing access to affordable, quality, accountable health care. (Accessed May 2, 2006, at http://www.mass.gov/legis/laws/seslaw06/sl060058.htm.) 
  2. Idem. Health care access and affordability conference committee report. May 2, 2006. (Accessed April 24, 2006, at http://www.mass.gov/legis/summary.pdf.)
  3. Schroeder SA. The medically uninsured -- will they always be with us? N Engl J Med 1996;334:1130-1133. [Free Full Text]
  4. McDonough JE, Hager CL, Rosman B. Health care reform stages a comeback in Massachusetts. N Engl J Med 1997;336:148-151. [CrossRef][Medline]
  5. Kaiser Commission on Medicaid and the Uninsured. State fiscal conditions and Medicaid. November 16, 2005. (Accessed May 2, 2006, at http://www.kff.org/medicaid/4087-04.cfm.)

 

10 posted on 04/05/2008 7:57:39 AM PDT by K-oneTexas (I'm not a judge and there ain't enough of me to be a jury. (Zell Miller, A National Party No More))
[ Post Reply | Private Reply | To 3 | View Replies]

To: Greg F

Seems a big part of the problem is an independent State Agency (the Commonwealth Health Insurance Connector Authority and its Connector Board) which caves to pressure and rewrites the rules on the fly. Like any ‘good’ State Agency.

Boston Globe

SALLY C. PIPES
At one year, Mass. healthcare plan falls short

By Sally C. Pipes | May 15, 2007

MASSACHUSETTS’S UNIVERSAL healthcare law turned one in April. To survive, its guardians have had to make many changes, each of which has increased current and future government spending, increased the government’s role in regulating the healthcare market, decreased individual responsibility to purchase insurance, and made certain that the plan will fall far short of achieving universal coverage.

The promise of the law was simple and seductive: Require people to purchase health insurance, make the insurance affordable, or at least tax-deductible, and then fine those who don’t comply. Subsidies could come from the current money devoted to the Uncompensated Care Pool and the federal taxpayers. Universal coverage, then, would be achieved with little new spending.

Numerous problems existed with this plan, but the fairy tale quality appealed to politicians and the national media, so it passed to much fanfare.

Interestingly, the Commonwealth Health Insurance Connector Authority, the bureaucrats in charge of implementing the plan, decided that the universal individual mandate does not apply to everyone, but rather only those who can afford the premiums. Therefore, nearly one in five of the currently uninsured will be exempt from the law.

The Connector Board also bowed to pressure and reduced the monthly premiums on the subsidized-but-not-entirely-free healthcare plans. This will increase the program’s costs by $13 million.

Even at these reduced rates, the plans will still not be attractive to many. People earning between 151 percent and 300 percent of the federal poverty limit — $25,000 to $110,000 for families and $15,316 to $50,000 for individuals — are expected to pay up to 9.6 percent of their income on insurance premiums, or pay fines. (This 9.6 percent is before any co pays and cost sharing.) Meanwhile, taxpayers are still subsidizing them by as much as 94 percent of total costs.

The structure is a gourmet recipe for runaway spending. With this level of premium, those who don’t value insurance enough to make financial sacrifice to purchase it will neglect to do so. The fine — set at $216 — will be more attractive than the premium. Politicians will be under strong pressure to not enforce the mandate once the fines increase to meaningful levels. Indeed, they have already shown their willingness to back away from it for the 20 percent of people, and have set up a waiver process to exempt others on a case-by-case basis.

At the same time, the massive premium subsidy will make these plans extremely attractive to individuals who expect to use large quantities of healthcare. The population paying the premiums will be older and sicker than the general population. Spending will explode. It will come from somewhere, most likely the taxpayer.

Early data already provide evidence of this dynamic. As of April 1, 62,979 individuals had signed up for Commonwealth Care, the subsidized plans. Of these, 52,500 were enrolled in the totally free option. Give something for nothing, and people sign up. The plans in which people have to pay are a different story. Sign-ups have been slow, and the people who have enrolled are older and sicker than those signing up for the free plan.

The average age of a person in the free plan is 36, while the average age in the paid plans is 47. Of the free plans, there have been 214 specialty referrals per 1,000 enrollees. Of the paid plans, there have been 416 specialty referrals per 1,000 enrollees.

The system is set up to tax the young and healthy — who typically have both less income and less wealth — to subsidize those who are older and less healthy. One goal, according to the organization Health Care For All, is “to create a statewide credible risk pool, so healthy people ‘prepay’ toward their medical care.”

The problem with this is that the young and healthy, who are already prepaying for Medicare out of every paycheck, may object to this new form of taxation. According to the state’s own data, it’s not the young and healthy who use the Uncompensated Care Pool or who abuse emergency rooms, so the real point is the prepay or taxation and subsidization of a so-called risk pool.

So one year in, we have a plan that, even if no more concessions to liberal advocates are made, falls 20 percent short of its stated goal. Its costs have already increased by at least $13 million and are on track to skyrocket by some multiple of this once the doctors’ bills start coming in. Happy Birthday.

Sally C. Pipes is president and CEO of the Pacific Research Institute.


11 posted on 04/05/2008 8:00:39 AM PDT by K-oneTexas (I'm not a judge and there ain't enough of me to be a jury. (Zell Miller, A National Party No More))
[ Post Reply | Private Reply | To 3 | View Replies]

To: socialismisinsidious
The point of this legislation was not to get people episodic care.”

The point of the legislation was to establish a more socialist government. Whether people got better health care was irrelevant and not important.

12 posted on 04/05/2008 8:02:29 AM PDT by Moonman62 (The issue of whether cheap labor makes America great should have been settled by the Civil War.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: K-oneTexas

In the intervening two years since that article costs have gone up radically from what was estimated for Romney care and we have stories of health care rationing by inability to get service (as the story for this thread shows). It is not a surprise that universal insurance has led to inability to get care . . . that’s the function of a market . . . to make supply and demand equal through the mechanisms of price. When you remove that and require insurance, you get these results. Rationing of service through lack of supply (since demand has no cost — insurance is required regardless of whether you use the service or not) and higher costs for the socialist government who pays for the care since more people demand more care regardless of actual price of the care.


13 posted on 04/05/2008 8:05:57 AM PDT by Greg F (Do you want a guy named Hussein to fix your soul? Michelle Obama thinks you do.)
[ Post Reply | Private Reply | To 10 | View Replies]

To: Frobenius
People that live in that Socialist hell-hole need to vote... ...with their feet.

I did - after living there for 14 years - I lived in the Beautiful Berkshires - but the writing was on the wall - and that was 39 years ago.

where does the time go?

14 posted on 04/05/2008 8:08:01 AM PDT by maine-iac7 ("...but you can't fool all of the people all of the time" LINCOLN)
[ Post Reply | Private Reply | To 8 | View Replies]

To: Greg F

Due to State Agency interpretations and rulings to implement the statute. None of which have been challenged in a court. Maybe, someone running the program making the daily decisions would share the blame for its cost. Reading the second article I posted, possibly the Health Connector Board is the problem.


15 posted on 04/05/2008 8:13:29 AM PDT by K-oneTexas (I'm not a judge and there ain't enough of me to be a jury. (Zell Miller, A National Party No More))
[ Post Reply | Private Reply | To 13 | View Replies]

To: socialismisinsidious

Conservative “Hero” Mitt Romney, and the Heritage Foundation begat this!?

I guess socialism is conservative these days, huh?


16 posted on 04/05/2008 8:13:56 AM PDT by JSDude1 (Tis only a “protest” vote if your political worldview is Republican 1st, conservative 2nd. -pissant.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: K-oneTexas

Government mandated, universal, compulsory healthcare . . . what could go wrong? /sarc


17 posted on 04/05/2008 8:16:37 AM PDT by Greg F (Do you want a guy named Hussein to fix your soul? Michelle Obama thinks you do.)
[ Post Reply | Private Reply | To 15 | View Replies]

To: Greg F
Read about the people who make the decisions:

Commonwealth Health Insurance connector Authority Board

 

 

18 posted on 04/05/2008 8:22:26 AM PDT by K-oneTexas (I'm not a judge and there ain't enough of me to be a jury. (Zell Miller, A National Party No More))
[ Post Reply | Private Reply | To 17 | View Replies]

To: K-oneTexas

It’s a sort of corporatist vision. Health care unions, insurance companies, government, universities all represented on the board. Mussolini would approve!


19 posted on 04/05/2008 8:25:55 AM PDT by Greg F (Do you want a guy named Hussein to fix your soul? Michelle Obama thinks you do.)
[ Post Reply | Private Reply | To 18 | View Replies]

To: socialismisinsidious

And, which Massachusetts governor signed universal care into law? The same one certain conservatives were hailing as the conservative savior during the primaries.


20 posted on 04/05/2008 8:27:30 AM PDT by Ol' Sparky (Liberal Republicans are the greater of two evils)
[ Post Reply | Private Reply | To 1 | View Replies]

To: socialismisinsidious

Medicare=Government Provided Healthcare.

Note that the provider feels “disrespected” by Medicare, not just under paid.

There are lots of sensible reforms that could be made to out insurance and healthcare systems, but expansion of government systems really should not be one of them. Government systems leave everyone feeling disrespected, to say the least.


21 posted on 04/05/2008 8:29:36 AM PDT by Wiseghy ("You want to break this army? Then break your word to it.")
[ Post Reply | Private Reply | To 1 | View Replies]

To: Frobenius
People that live in that Socialist hell-hole need to vote... ...with their feet.

They may be... I saw an article the other day that said north Texas is the fastest growing region in the country. They have to be coming from somewhere.

22 posted on 04/05/2008 8:31:51 AM PDT by r-q-tek86 (If you're not taking flak, you're not over the target.)
[ Post Reply | Private Reply | To 8 | View Replies]

To: Frobenius

I saw this coming thanks to FReepers in Tenn and their experience with Hillary Care, I fled and got, see my tag line.


23 posted on 04/05/2008 8:38:19 AM PDT by Little Bill (Welcome to the Newly Socialist State of New Hampshire)
[ Post Reply | Private Reply | To 8 | View Replies]

To: Greg F
Maybe, the problem lies not so much with the law that was passed ... but rather the interpretation and implementation of it by those individuals chosen to the administer it. Don't get me wrong, most laws do have their flaws and blemishes, however how they are administered is where "the rubber mets the road."

I'm not from Massachusetts but I remember when this legislation was proposed by Governor Romney, he presented 'his' plan and then the Legislature made their changes and passed 'their' plan. The differences being slight or great I'm not sure, although Gov. Romney vetoed portions of the legislation (Line Item Veto). Then the Legislature over-rode his vetos.

The people put in place to administer a statute have far reaching effects, especially when they are appointed but also if they are elected to be sure. In this case the Board appears to be appointed by the Governor. I'm guessing these members were not the ones appointed by Romney when he was in office.

Does the Dem State Legislature have to fix it, yes ... do they want to change anything other than the deficit it created, unknown.
24 posted on 04/05/2008 8:45:03 AM PDT by K-oneTexas (I'm not a judge and there ain't enough of me to be a jury. (Zell Miller, A National Party No More))
[ Post Reply | Private Reply | To 19 | View Replies]

To: socialismisinsidious; weegee; Coleus; wagglebee; blam; SunkenCiv; neverdem; Clemenza

Hey folks—isn’t ANYONE going to mention how strange it is that the avatars of socialized medicine (The New York Times) published an article pointing out problems with the system?? Has hell frozen over??


25 posted on 04/05/2008 8:57:39 AM PDT by Pharmboy (Democrats lie because they must.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Greg F

And many people here on FR as well as on other websites are presently pushing for Mitt Romney to become McCain’s final VP choice! Here’s truly one reason to not have Mitt as McCain’s VP choice (Although it probably doesn’t really matter who McCain does pick for his final VP choice, IMHO. Too many people in general don’t like McCain for many legitimate reasons, and McCain will continue to be disliked no matter who he chooses for VP.)


26 posted on 04/05/2008 9:03:57 AM PDT by johnthebaptistmoore (Vote for conservatives AT ALL POLITICAL LEVELS! Encourage all others to do the same on November 4!)
[ Post Reply | Private Reply | To 3 | View Replies]

To: K-oneTexas
Maybe, the problem lies not so much with the law that was passed ... but rather the interpretation and implementation of it by those individuals chosen to the administer it.

I don't see how the administrator of the program can have any effect on the fact that there's a shortage of medical providers.

Your statement sounds like that old tired argument for communism...you just need the right people to make it work.

News flash - a bad idea is a bad idea...no matter who is in charge of it. Communism, universal healthcare, etc.

27 posted on 04/05/2008 9:06:31 AM PDT by vrwc1
[ Post Reply | Private Reply | To 24 | View Replies]

To: socialismisinsidious

During a stay at a recent top hospital in Boston, I harrumphed about Universal Health Care in front of a young intern. He chimed in that he was all for it. They seem to think it will bail out the hospitals that are struggling to treat all the non-insured. Apparently no one teaches basic economics in med school.


28 posted on 04/05/2008 9:14:04 AM PDT by Melinda
[ Post Reply | Private Reply | To 1 | View Replies]

To: socialismisinsidious
18 to 35 year old men tend to avoid seeing doctors. As such, many of them don't bother getting health insurance.

It looks like Massachusetts had planned for them to pay for health care but continue to avoid seeing doctors.

Why is anyone surprised that if you force someone to pay for a service, they might actually want to use it?

29 posted on 04/05/2008 9:15:31 AM PDT by Drew68
[ Post Reply | Private Reply | To 1 | View Replies]

To: FreedomPoster
Good morning.
“It just makes no sense to me whatsoever.’

Look at the black community which has been severely damaged by DemocRAT policies yet continues to vote overwhelmingly for RATs. It's mind boggling.

Michael Frazier

30 posted on 04/05/2008 9:50:32 AM PDT by brazzaville (No surrender, no retreat. Well, maybe retreat's ok)
[ Post Reply | Private Reply | To 4 | View Replies]

To: socialismisinsidious

Is Kevin Johnny’s brother?


31 posted on 04/05/2008 9:59:23 AM PDT by MIchaelTArchangel
[ Post Reply | Private Reply | To 1 | View Replies]

To: socialismisinsidious

From the anti-yuppie blog, ‘Stuff White People Like’

#94 Free Healthcare

In spite of having access to the best health insurance and fanciest hospitals, white people are passionate about the idea of socialized medicine. So much so that they have memorized statistics and examples of how for-profit medicine has destroyed the United States.

But before you can exploit this information for personal gain, it’s important that you understand why white people are so in love with free health care.

The first and most obvious reason is “they have it Europe.” White people love all things European, this especially true of things that are unavailable in the United States (Rare Beers, Absinthe, legal marijuana, prostitution, soccer). The fact that it’s available in Canada isn’t really that impressive, but it does contribute to their willingness to threaten to move there.

These desires were only heightened in 2007 when Michael Moore released “Sicko,” a documentary that contrasts the health care industry in the United States with that of Canada, France and Cuba. As a general rule of thumb, white people are always extra passionate about issues that have been the subject of a Moore documentary. As a test, ask them about 9/11, Gun Control, or Health Care and then say “where did you get that information?” You will not be surprised at the results.

But the secret reason why all white people love socialized medicine is that they all love the idea of receiving health care without having a full-time job. This would allow them to work as a freelance designer/consultant/copywriter/photographer/blogger, open their own bookstore, stay at home with their kids, or be a part of an Internet start-up without having to worry about a benefits package. Though many of them would never follow this path, they appreciate having the option.

If you need to impress a white person, merely mention how you got hurt on a recent trip Canada/England/Sweden and though you were a foreigner you received excellent and free health care. They will be very impressed and likely tell you about how powerful drug and health care lobbies are destroying everything.

Though their passion for national health care runs deep, it is important to remember that white people are most in favor of it when they are healthy. They love the idea of everyone have equal access to the resources that will keep them alive, that is until they have to wait in line for an MRI.

This is very similar to the way that white people express their support for public schools when they don’t have children.


32 posted on 04/05/2008 10:19:34 AM PDT by Leisler
[ Post Reply | Private Reply | To 1 | View Replies]

To: vrwc1
You totally misinterpret or misunderstood what I was saying.

I have spent 27 in State government (Texas Comptrollers Office) before retiring. The Legislature's give much authority to the State Agencies and Commissions they create to interpret and implement the statutes they pass. The court reviews when law suits are brought (but doesn't always over rule the State Agency). Then again the Legislature doesn't revisit what they've done all the time and straighten out State Agencies decisions, unless a big donor or sufficient constituents claims they were harmed. Many of these Agencies wield great power with little or no Legislative oversight, ongoing Legislative oversight.

You might be right that there is a shortage of providers but here in Austin I really don't see that. The Yellow Pages has dozens of pages of MD's of all stripe and kind. Many are GP's and PCP's in administered health care programs (insurance companies and State mandated) or clinics. Some sections of the country may have shortages, I would not contest that ... and law suits have caused doctors to leave the medical field. How many were GP's I do not know rather than specialists or surgeons.

Many people just don't get health insurance, for a variety of reasons. [See Five Myths of Health Care (Number (1) specifically)]. Or they go into a hospital, clinic or emergency rooms and get the government to pay for it under care for the poor and indigent. City, County and State budgets have funds for this specific purpose.

The right people would be nice to have ... but this isn't a perfect world. My point is the State have a bureaucracy to manage health care and invariably appointing those who believe in social programs, for health care, running it. Never a conservative or libertarian ... that is a problem in government at every level in this country. The State's also have and a variety of other areas in which Agencies oversee the day-to-day working of them for the State. Politicians (the bulk of them, not all of them) believe they are elected to control and to keep the job for life getting rich and well-known in the process.

A better system is to have the patient and the doctor in charge, with government and lawyers out. Insurance companies must be involved, since not everyone is independently wealth and can afford to pay cash. The insurance companies must surely weigh the risks if they are to provide coverage but should not be the final arbiter (medical professionals here) on what coverage is included or excluded, especially life saving surgeries or treatments.

But we do have a problem in general because many of the lawyers involved are government lawyers ... a double whammy. Couple them with tort lawyers and they have negotiated not only your health care but your future.
33 posted on 04/05/2008 10:20:44 AM PDT by K-oneTexas (I'm not a judge and there ain't enough of me to be a jury. (Zell Miller, A National Party No More))
[ Post Reply | Private Reply | To 27 | View Replies]

To: socialismisinsidious

“but I never expected to feel as disrespected as I feel.”

I have a tough time feeling sympathy for a doctor who makes over $ 100,000 and still speaks in ebonics.


34 posted on 04/05/2008 10:24:58 AM PDT by shaft29 (Just your typical white woman.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Ol' Sparky
"And, which Massachusetts governor signed universal care into law? The same one certain conservatives were hailing as the conservative savior during the primaries"


The text translates: "Health, child protection, fighting poverty, aiding travellers, community, helping mothers: These are the tasks of the National Socialist People's Charity. Become a member!"

There is a lot of socialistic sentiments in Mormonism, so it isn't surprising that a leading Mormon would desire many of the same social outcomes.

35 posted on 04/05/2008 10:26:00 AM PDT by Leisler
[ Post Reply | Private Reply | To 20 | View Replies]

To: Melinda
Apparently no one teaches basic economics in med school

Yeah, they teach other stuff...

36 posted on 04/05/2008 10:30:48 AM PDT by Jim Noble (I've got a home in Glory Land that outshines the sun)
[ Post Reply | Private Reply | To 28 | View Replies]

To: socialismisinsidious
The scary part: the med students attending this debate were still for "one payer coverage" after hearing this!

Of course - - that's the way socialist liberal Democrats think; only those OTHER medical students will be told what their practice will be and where they shall be stationed. Remember, Democrats walk into their polling places on election day and vote for big government confiscation of more tax money - - from their neighbors.

It is difficult to imagine anything more rude and selfish than being a Democrat.

37 posted on 04/05/2008 10:38:01 AM PDT by Lancey Howard
[ Post Reply | Private Reply | To 1 | View Replies]

To: K-oneTexas
I don't think I misunderstood at all what you were saying...I think you misunderstood the main point of the article. Look at the first four sentences:

Once they discover that she is Dr. Kate, the supplicants line up to approach at dinner parties and ballet recitals. Surely, they suggest to Dr. Katherine J. Atkinson, a family physician here, she might find a way to move them up her lengthy waiting list for new patients.

Those fortunate enough to make it soon learn they face another long wait: Dr. Atkinson’s next opening for a physical is not until early May — of 2009.

Now in Massachusetts, in an unintended consequence of universal coverage, the imbalance is being exacerbated by the state’s new law requiring residents to have health insurance.

Clearly the problem is NOT that the right person isn't administering the plan, the problem is that there are too many people requesting healthcare services and not enough healthcare providers to provide those services. We're talking about Massachusetts, not Texas, so your Austin Yellow Pages statistics don't have any bearing on the situation.

Many people just don't get health insurance, for a variety of reasons.

We're talking about Massachusetts...remember? It is mandated that every resident have health insurance - they can't choose not to get it, so I really don't see what point you're trying to make. Your statement isn't relevant to the topic under discussion.

My point is the State have a bureaucracy to manage health care and invariably appointing those who believe in social programs, for health care, running it. Never a conservative or libertarian ... that is a problem in government at every level in this country.

To my original point, IT DOESN'T MATTER WHO'S IN CHARGE IN MASSACHUSETTS! If there aren't enough healthcare providers, there will be a healthcare shortage - period!

A better system is to have the patient and the doctor in charge, with government and lawyers out.

A better system? Once again, we're discussing the law in Massachusetts. Why are you talking about "a better system"? That is not relevant to the discussion.

I'll say it again, given Massachusetts healthcare laws, it doesn't matter who's in charge. It's a bad idea, and anyone with half a brain could have foreseen the shortage they are now experiencing, since it seems to happen everywhere universal coverage is tried.

38 posted on 04/05/2008 10:54:43 AM PDT by vrwc1
[ Post Reply | Private Reply | To 33 | View Replies]

To: Pharmboy
I did wonder about that. The point of the article isn't that government, top down medical management doesn't work but rather that there is a shortage of Primary Care Docs in MA (and those evil specialist get paid way too much). Maybe they are laying the ground work for (just as the lib at the debate said) top down government which not only controls medicine but ALSO what type of doctors are needed and in what regions? “You will go into Family Practice!”

To keep this horrible shortage from happening country wide they can justify forcing the new med school grad to enter a primary care residency rather than surgery or orthopedics. (hey it's for your own good!)
39 posted on 04/05/2008 11:26:25 AM PDT by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
[ Post Reply | Private Reply | To 25 | View Replies]

To: Melinda
And apparently common sense isn't required to get into Medical School either.
40 posted on 04/05/2008 11:28:14 AM PDT by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
[ Post Reply | Private Reply | To 28 | View Replies]

To: Leisler

Too true. Should change “White People” to “Liberals”


41 posted on 04/05/2008 11:32:23 AM PDT by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
[ Post Reply | Private Reply | To 32 | View Replies]

To: vrwc1
I did read the article as well as several others (my Posts #10 and #11). This article does not exist in a vacuum to determine what did and is happening.

In Massachusetts that shortage of doctors and health care providers exists - you said it does and that will be a granted. However, in another the article states; "Nonetheless, the overall structure of private health insurance and the payment and delivery of medical care will remain intact, and costs will relentlessly increase" (in Post #11). Reading "...delivery remains in tact ...", makes me wonder ... was the shortage of doctors and health care providers the case in Massachusetts prior to the Legislature passing this health care reform? I don't know.

Also, in Massachusetts the 'Connector Board' opened up the statute language by their interpretation of it: "The Connector Board also bowed to pressure and reduced the monthly premiums on the subsidized-but-not-entirely-free healthcare plans. This will increase the program’s costs by $13 million"(in Post #11). Also cited rising cost, without this tampering, in paragraph above with the article (from Post #10).

Many people not getting health care is as true for any State in the Union, that includes Massachusetts. People in Massachusetts's "must carry a minimum level of health insurance, a requirement that will be enforced through the state tax return. Coverage may be through an employer, Medicaid, Medicare." (see Post #10) Is it a check box on your state tax return?

Coverage through and employer for the employee, in many plans has no cost to the employee, it is a cost of doing business for an employer and not an employee choice. Choice comes in when there is a cost to the employee in covering a spouse or family. So if you employer gives you coverage - you got it. Same with Medicare - you got it. Do these people get more through other means or only the minimum required by the statute? If they do they do, do have to report it, with additional check boxes on state tax return? Choices for some, yes. Any way, the main point is who is left without coverage as defined by the statute? Only those the law was intended to cover. Question, who is being covered?

The shortage of doctors, if existing before the passage of the law, definetly complected its implementation. Would not matter if have a person is covered or not covered. Doctor shortage would affect everyone. However, couple this shortage with the Connector Board opening up the pool of people covered and lowering the cost is exactly what placed in into a deficit position. I don't believe the Legislature passed the law if the Revenue Impact statement (if Massachusetts has such a thing) showed that it would cost the State exorbitantly in their tax revenues which actually fund State government. In this instance, in Massachusetts, it did matter who was in charge and those policy decision they made. In this case the statute was not the culprit, the sole culprit, rather those placed into positions of responsibility to see to the implementation and administration of some very complected problem(s). As well as the fact that any complications existing were not alleviated (by the Legislature or some State Agency) before it was passed.

This same health care environment exists in every State in that it is legislatively controlled or mandated in one way form or another. Massachusetts is peculiar in how the mandate is made by the Legislature. The form or vehicle the Legislature creates makes a difference ... but I don't believe it makes Massachusetts so unique that it must be treated in a void from other States. High costs and deficits are a result of Legislative mandate in all States and the those made by the Feds in providing health care. If policy costs are higher in one State than another, that is a different problem.

Shortages of doctors do exist in many places, I do not deny that. As I said I haven't seen that in Austin ... or the hue and cry isn't on the news coverage.

For you in Massachusetts maybe you need a 'new' Legislature with 'new' ideas to write a 'new' statute to replace the current one. Maybe the Legislature needs to get 'new' Connector Board Administrator and members, but I believe that's the Governors prerogatives. Will that happen, I don't know. Short of that Massachusetts citizens will continue to pay the deficits.

Massachusetts isn't unique. You can not address one issue and only one issue. The interrelationships with other issues must also be handled as they impact each other. I.E., the shortage of doctors/health care professionals, number of patients with own coverage, number of patents without coverage or mandated coverage, cost (premium) of insurance, benefits of insurance plan (purchased or mandated), State and Federal mandates ... and the list goes on. As for doctors, I don't believe Henry Ford's assembly line philosophy for making cars is valid for medical care ... but its gotten that way.
42 posted on 04/05/2008 12:08:46 PM PDT by K-oneTexas (I'm not a judge and there ain't enough of me to be a jury. (Zell Miller, A National Party No More))
[ Post Reply | Private Reply | To 38 | View Replies]

To: socialismisinsidious
...in an unintended consequence of universal coverage...

Morons.
43 posted on 04/05/2008 12:11:49 PM PDT by Vision ("If God so clothes the grass of the field...will He not much more clothe you...?" -Matthew 6:30)
[ Post Reply | Private Reply | To 1 | View Replies]

To: johnthebaptistmoore

Yah the idea of a 2 RINO ticket in McCain/Romney is dispiriting.


44 posted on 04/05/2008 1:16:55 PM PDT by Greg F (Do you want a guy named Hussein to fix your soul? Michelle Obama thinks you do.)
[ Post Reply | Private Reply | To 26 | View Replies]

To: socialismisinsidious

“tell medical students what kind of doctors they can be. Oh yeah, and tell them where they can practice.”


That was in Hillary’s H.R. 3600 Health Care, 1364 page plan. I’ve still got a copy of the thing.


45 posted on 04/05/2008 1:27:06 PM PDT by IM2MAD
[ Post Reply | Private Reply | To 1 | View Replies]

To: K-oneTexas
In Massachusetts that shortage of doctors and health care providers exists - you said it does and that will be a granted.

I didn't say that - the article did. I even posted the pertinent excerpt from the article. It wasn't me that said there was a shortage - it was the New York Times.

makes me wonder ... was the shortage of doctors and health care providers the case in Massachusetts prior to the Legislature passing this health care reform? I don't know.

The article answers your question...

The state ranks well above the national average in the per capita supply of all doctors and of primary care physicians.

You said:

However, couple this shortage with the Connector Board opening up the pool of people covered and lowering the cost is exactly what placed in into a deficit position...In this instance, in Massachusetts, it did matter who was in charge and those policy decision they made. In this case the statute was not the culprit, the sole culprit, rather those placed into positions of responsibility to see to the implementation and administration of some very complected problem(s).

First of all, you are using the word "complected" when I think you intend to say "complicated". "Complected" refers to a persons facial complexion, whereas "complicated" refers to something that is difficult to understand.

Secondly, the 'Connector Board' did not "open up the pool of people covered" as you say. From your post 11:

Interestingly, the Commonwealth Health Insurance Connector Authority, the bureaucrats in charge of implementing the plan, decided that the universal individual mandate does not apply to everyone, but rather only those who can afford the premiums. Therefore, nearly one in five of the currently uninsured will be exempt from the law.

As you can see, they exempted many people from the insurance requirement. If the law were fully implemented, things would be even worse. So it is the statute itself that is the causing the problem, not the administrators or their policy decisions. There was no doctor shortage before the law was passed - the Massachusetts law is fully to blame for the shortage. It doesn't matter who the administrators in charge are in this case.

46 posted on 04/05/2008 2:14:13 PM PDT by vrwc1
[ Post Reply | Private Reply | To 42 | View Replies]

To: vrwc1
First, I apologize for the spelling error.

shortage ... the article is dated 5 April 2008. So the shortage exists today. If there is now any shortage (as discussed in the NYT article) of doctors it has to be due to their personal choice, limiting patients for many different reason, retirement, not wanting to practice in Massachusetts, not enough medical school students or other. The article does not explain fully.

If the article says "The state ranks well above the national average in the per capita supply of all doctors and of primary care physicians." ... then evidently there's no problem. No shortage. Enough doctors for all the citizens. We can't have it both ways. The point raised was: this bill was passed in April 2006 ... was there a shortage prior to passage in April 2006? You don't know and I don't know. That is a major complication and hurdle to overcome if it were in fact true. If not then other problems exist and complicate the implementation and administration. The NYT article only claims an imbalance because patients want to take care of 'long differed care'. A choice the patient or prospective patient made in the past and doctors must cope with now.


Using the NYT article only 340,00 of 600,000 uninsured have gotten coverage. That's a huge amount. I can only think the Legislature figured on 600,000 getting in a price "X" or did the data they used showed substantially less uninsured in the State. I don't have access to their data they had for deliberation on passing the bill, usually received in hearings, to determine their intent .

The problem at this point appears to be the Connector Board. Since the Connector Board in their various interpretations of the statute changed the meaning and possibly the intent of the statute. Specifically, in their determination of who is covered, they left people out (I misread that and I apologize). The Connector Board by this action actually caused a 'shrinking the pool' of recipients and one could infer a cost savings. The statute didn't leave people out, it appears clear in its wording of exactly who the Legislature intended to be covered by stating what the minimum level of health insurance was deemed to be.

If (1) there are less people covered than envisioned by the Legislature and the statute they wrote, and (2) the costs to the State are higher as a direct outcome of the Connector Board's decision to lower the price paid by those enrolled ... then The Connector Board in cutting the pool, thereby cutting it's income ... because of outside pressure. Result in budget deficits for the State.

Maybe it was the Democratically controlled Legislatures' intent that the statute be interpreted and administered in just this way. Then again, maybe not. The Legislature hasn't stepped in, so my guess is that they are okay with the decisions of the Connector Board.

Many laws shouldn't be written to begin with, however when they are there is an expectation that they will be administered and carried out by the appropriate authority. That authority bears the responsibility to administer them for the good of the people (or face some type of malfeasance charges) or go back to the Legislature and argue for their repeal. This admittedly does not occur to often and definetly not in this case.
47 posted on 04/05/2008 3:49:22 PM PDT by K-oneTexas (I'm not a judge and there ain't enough of me to be a jury. (Zell Miller, A National Party No More))
[ Post Reply | Private Reply | To 46 | View Replies]

To: socialismisinsidious

Well, yeah, that too, but the article leads with central planning exacerbating the problem, and that alone is pretty unusual for America’s Pravda.


48 posted on 04/05/2008 8:20:37 PM PDT by Pharmboy (Democrats lie because they must.)
[ Post Reply | Private Reply | To 39 | View Replies]

To: Pharmboy; george76

Thanks Pharmboy, good point.

Pinched to Death at the New York Times
American Digest | April 5, 2008
Posted on 04/05/2008 6:45:31 PM PDT by george76
http://www.freerepublic.com/focus/f-news/1997411/posts


49 posted on 04/05/2008 9:33:18 PM PDT by SunkenCiv (https://secure.freerepublic.com/donate/_____________________Profile updated Saturday, March 29, 2008)
[ Post Reply | Private Reply | To 25 | View Replies]

To: AdmSmith; Berosus; Convert from ECUSA; dervish; Ernest_at_the_Beach; Fred Nerks; KlueLass; LucyT; ..

http://www.freerepublic.com/focus/f-news/1997163/posts?page=25#25


50 posted on 04/05/2008 9:56:02 PM PDT by SunkenCiv (https://secure.freerepublic.com/donate/_____________________Profile updated Saturday, March 29, 2008)
[ Post Reply | Private Reply | To 25 | View Replies]


Navigation: use the links below to view more comments.
first 1-5051-55 next last

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.

Free Republic
Browse · Search
News/Activism
Topics · Post Article

FreeRepublic, LLC, PO BOX 9771, FRESNO, CA 93794
FreeRepublic.com is powered by software copyright 2000-2008 John Robinson