Saturday, September 19, 2009

US health Care Plan may make it harder for the poor

Criticism continues to poor in on the US Health Care proposal that has just been released from the Senate Finance Committee.

Many of the reforms are based on the Health Care plan in Massachusetts. Since enacted in the state, the government has had trouble keeping up with the increasing prices for health care, especially during the global recession. In fact, some unintended effects of the plan have made it harder for the poor to receive health care. Critics say that the problem with the federal reform bill is that is patterned after Massachusetts plan.

From the IPS, Adrienne Appel explains how the Massachusetts plan has made it harder on the poor.

All the major plans in Congress are mirrored after the reforms in Massachusetts, including the requirement that everyone purchase insurance at market rates - which grow yearly - or face a hefty fine. The fine is up to 1,000 dollars in Massachusetts.

"Once failure to buy health insurance is a federal offence, what's next?" Steffie Woolhandler, a Harvard physician and member of Physicians for a National Health Programme, recently told a Congressional committee.

The Massachusetts reforms were crafted three years ago by Republican Governor Mitt Romney, the venture capitalist and presidential candidate.

"The Massachusetts plan is not sustainable. It contained no cost control and raised no new revenues. We're basically just spending money," Benjamin Day, executive director of MassCare, which campaigns for a single-payer system, told IPS.

The Massachusetts reforms are attractive to Congress because the state outlawed abuses by insurers and cut in half the number of people without insurance, meaning that 97.4 percent of residents were insured, the highest percentage of any state.

But, "Skimpy, overpriced coverage like this left one in six Massachusetts residents unable to pay their medical bills last year," Woolhandler said.

The requirement that all residents buy health insurance or be penalised is a centrepiece of proposals being debated by Congress, though it has proved highly unpopular in Massachusetts and surprisingly unsuccessful.

About 352,000 people in 2008 chose to be fined rather than pay 4,000 dollars or more per year for health insurance, according to figures just released by the U.S. Census.

The Massachusetts reforms were enacted two years ago to try to decrease the hundreds of thousands of people showing up at hospital emergency rooms desperate for health care and with no money to pay for it.

There was a system in place to cover this care, a tax on wealthier hospitals that was redistributed to poor hospitals that provided most of this free care, and it was working well. But the wealthy hospitals asked for reforms.

"The individual mandate is a huge boon for insurers. And hospitals got a huge rate increase," Day said.

"Patients are not an organised group and they had no voice, much less uninsured people. It's not quite the ideal political experience," he said.

"We had a free care pool for the uninsured and for many people it was better than what we have today," Day added.

The poor now have to purchase drugs that previously were free, and pay every time they see a doctor or go to the hospital.

Poor people continue to seek free care at hospitals and clinics, but under the reforms the hospitals are no longer compensated for this care. The clinics and hospitals are buckling under the stress, and have had to cut staff and programmes.

Boston Medical Centre, which treats anyone regardless of ability to pay, is reimbursed just 64 cents for every one dollar it spends, it says. It is suing the state as a last resort.

Health reform "should not and cannot be financed on the backs of the poor. We hope our suit serves as a cautionary tale to federal policymakers as they take up national health care reform," said the hospital's CEO, Elaine Ullian.

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