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May, 2006


Mass Healthcare Bill: A Turkey By Any Other Name
By Stephen Simac

The Massachusetts legislature has constructed an albatross they call a universal healthcare bill. With the help of invested experts they built a bird that will not fly. The governor signed off on a contraption that will not even float and will drown the state in ever increasing medical care and insurance costs for older and sicker citizens.
Although many of the details have been spare in the press releases, one thing is clear. They call it a health care bill when it is actually a medical care insurance bill. It will mandate built in profits for insurance, pharmaceutical and hospital companies onto businesses and uninsured residents.

The crafters have all carved off a slice for themselves, but they will prove as short sighted as feasting on the goose that laid golden eggs. Medical care in the united states has been very profitable for some. The costs of medical care and medical insurance have risen faster than the rate of inflation for decades. This bill won't lower costs or even the rate of increase.

It's now at $3 trillion a year for Americans. We spend more on medical care than most other industrial nations combined, but by accepted standards of health, our citizens rank with some third world countries.

Simply paying for resident's medical costs is no guarantee of improving their overall health in any significant way. It is poor health that drives the spiraling costs. The system functions around treating illness and injury, instead of prevention and reduction of major causes of these.

Health promotion and education efforts are extremely limited in current medical care, and this bill won't change that. Any nods to health and wellness in their bill are like saddling a bird that won't fly with a parachute.

Warning: Medical Bill may cause Cardiac Arrest

Most people never want to need medical treatment, but reasonably fear having to pay for it. Some, because of their faith or lack of, will never use conventional medicine or certain procedures of it. Unless there is a religious exemption, they will be mandated to pay to insure for use by others. Conventional Medicine is the new state religion, you must tithe whether you attend services or not. Gold plated worship.

Some will need far less medical treatment than others, because of some undetermined combination of environment, temperament, genetics, lifestyle and luck. Others may prefer to use alternative or complementary care at least some of the time. For the most part they will pay out of pocket for their unorthodox choices. Claim will be that they haven't been "proven" effective. Determined by committees of doctors.

Those who use conventional medicine less have to pay insurance companies the same rate as those who use it more. At least in mandated vehicle insurance, there are good driver discounts. Medical Insurance companies depend on having many healthier members paying them, so they can afford to pay medical care providers for those who need it more and to make a tidy profit.

Massachusetts's legislators said we're a Commonwealth, we're all in this together, yet, and they tossed in huge chunks of guaranteed cash to insurance and pharmaceutical companies, some hospitals, and others invested in medical care at the expense of the commonwealth.

Keeping insurance companies as the wings of this albatross automatically adds 30% or more to overall costs. Profits and hassle thrown in, gratis. When you're forced to buy something, you want to at least get a bargain. This bill is a guaranteed giveaway to insurance companies just as the federal Medicare D is to pharmaceutical companies, although both have gotten their pound of flesh from each.

Work Makes Free
The uninsured that are working are primarily younger and earn less. Lower income workers already pay a greater percentage of their income on housing, food, transportation and now on required medical insurance. Younger people are already leaving Massachusetts in droves, how much faster when they can't afford housing or transportation, because they must pay insurance companies.

Even with the state subsidizing their payments most will have to make a choice. Cut out all frills, never go out and watch network TV, (that will be great for the economy) and they can afford their mandated insurance payment. Until it goes up. Or they can move across the state line, or to the Sun Belt, or just lose their job, become homeless and get on Medicaid.

Medicare/Medicaid costs are soaring into the stratosphere while medical providers complain that the payments are inadequate. Although certain specialties and procedures are paid very well. For the most part the payments and what treatment is covered are worked out with doctor and hospital's associations, so go figure. Private insurance may pay more for some procedures, if the paperwork is accepted.

Many businesses will reduce employees or choose to pay $300 per worker to the state for not insuring their employees, instead of thousands per worker to insurance companies. Businesses are already offering insurance plans with huge holes in them and making employees pay more for deductibles and rates. Insurance companies need payments from many more healthy members, and profits from investments of the capital accumulated to bear the costs of older, sicker members while reward company executives and investors. They prefer to roll old, sick members into taxpayer funded, Medicare/Medicaid, which end up with the costliest members. This bill will only increase Medicaid costs already projected to sink the state in the years ahead.

This Is Not Bunker Hill
The nation will watch Massachusetts' "bold" experiment and use it as a model. To avoid. They could have chosen to offer every resident under 30, while they are in a lower medical cost demographic, Free Care, which is an existing fund. That would have been bold.

No new bureaucracy would be needed, unlike the one birthed by this bill to "assist" residents in hooking up with an insurance company. Like a blind date you will owe alimony to until you move out of state.

The state could fund Free Care with sin taxes and fines on products and practices that are proven to contribute to illness and injury. There's no shortage of these. Set the many fine schools of Public Health in the state on determining this. Give them a seat at the head of the table when determining how to improve the health of the commonwealth.

As the Free Care fund begins to float with sin taxes and gambling revenues, expand it to older residents, and cut out insurance companies entirely. That would be truly bold.

Scratch Ticket for Granny's acupuncture. A truly, revolutionary bill would open up health care payments to licensed health care providers, including alternative and complementary treatments. Starting with those that practice more preventive and economic treatment of illness and injury. Determine effectiveness with outcome studies, based on these critical factors to the health of the medical system. Cost effectiveness is as important as symptom reduction if the beast is to survive.

Reform conventional medical education to emphasize health promotion and reduce costs of care by improving health. As it is, the current medical care system resembles a line of ambulances waiting for catastrophic crashes below a narrow, switchback road with steep cliffs, no guardrails or speed limits, and distracted, aggressive, impaired drivers. Not waiting long, either.

Encourage residents to change unhealthy behaviors with innovative programs and assistance. Those that can't or won't, then maybe individual mandates, but not for legislating built in profits for insurance, pharmaceutical and hospital companies at the cost of the commonwealth.

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