Too Soon to Declare Victory on Health Care in Massachusetts

If you believe the papers, the politicians, or the pundits, the Massachusetts plan to make sure everyone has health insurance--by forcing them to buy it for themselves--is a great success. The uninsured don't believe it, however. Neither do low-income people in Somerville, where I live. Neither do I.

According to the Boston Globe, "The number of uninsured adults in Massachusetts fell by almost half last year." Proponents of mandatory health insurance said "that not only are more people getting coverage, but that only a fraction of taxpayers contested the health insurance mandate."

Sounds like great news, right? It does--until you look at who supports mandatory health insurance and who doesn't. People who already have insurance favor the plan by 71%. Not surprising: it doesn't cost them anything out of pocket, and the taxes needed to fund the plan haven't kicked in yet. But a majority of people who don't have health insurance yet--the people the plan is theoretically supposed to benefit--don't support it, according to a study by the Massachusetts Dept. of Revenue.

In Somerville, where I live, we recently surveyed 537 mostly low-income residents or employees. We asked them what should be the top priority of CAAS, the anti-poverty agency where I work. Keeping housing safe and affordable was the $1 priority (not a surprise, given the high cost of housing in our area). English literacy and finding a job, or a better job, were essentially tied at #2. "Access to health insurance" ranked #3. The people who need health insurance the most are telling us that the Massachusetts plan is still a problem and not yet a solution.

What do they know that policy makers don't know? I have suggested in the earlier version of this blog:

1. Too many people will have coverage without care. The affordable plans people can purchase hardly cover anything. There’s a huge “deductible,” a payment people have to make up front each year before the insurance policy pays a dollar. If I go to the hospital for a week, sure, I’m covered after the first day. But if I go to see my doctor or dentist, or if I have to buy prescriptions or eyeglasses, I’m the one who’s paying. How many thousands of Massachusetts residents will be insured but never get any more health care than they have now, under this plan?
   
   
   
2. Too many people still won't have health coverage, period. For some desperately poor people, or even people with a decent income but a lot of expenses, there’s no plan on the market that can really be called affordable. Massachusetts graciously exempts them from the mandate. But that means they won't have health insurance, the same as before!
   
   
3. The plan penalizes the poor and subsidizes the corporations that sell health insurance. The mandatory plan has teeth because the tax collectors can fine you up to $912 if you don't buy health insurance. "You think you're too poor to buy health insurance?" they are saying in effect. "Well, how would you like to pay the state and get no health insurance, instead?" The money that we are forcing the working poor to pony up for health insurance they can't use and can't afford is going straight into the pockets of the big health insurers. We are robbing the poor and giving to the rich, and patting ourselves on the back while we do it!
   

We don't need to be forced to buy health insurance from for-profit corporations. What we need is a "Medicare for all" system that efficiently provides high-quality care to everyone, regardless of the ability to pay.