Thursday, April 15, 2010

Uninsured Don't Think the Answer is Forcing Them to Buy

I've been recapping the Massachusetts experience with mandatory health insurance, asking what it can tell us about the federal plan just passed. Back in 2008, I wrote:

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 [in 2008] 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.

1 comment:

Larry Lennhoff said...

Access to health insurance ranks 3rd until you have a heart attack, or until you discover that the cancer that might have been caught during a regular checkup has metastasized and is inoperable.

Part of me is sympathetic - the results seem to follow the Maslow hierarchy pretty closely. But I don't think the political process worked by saying 'we have X billion dollars to help the poor. Let's ask them how they want it spent." Health care, for the first time in ages, was politically doable (barely, and with many compromises that I hope will be fixed over the years). There was no support at all on the federal level for more affordable housing, or for scholarships for ESL. Heck, even the stimulus package was a battle, and there is no support for doing a much needed second stimulus.

Given the choice to the poor was 'have some health care or have nothing at all' I think they made it well by the passage of the bill, even if they disagree.