Romney's Health Care plan for Mass

[Lyion]

This is a very smart guy, and it wouldn't surprise me to see him in the White House in 08.

http://www.opinionjournal.com/editorial ... =110008213

Health Care for Everyone?
We've found a way.

BY MITT ROMNEY
Tuesday, April 11, 2006 12:01 a.m. EDT

BOSTON--Only weeks after I was elected governor, Tom Stemberg, the founder and former CEO of Staples, stopped by my office. He told me, "If you really want to help people, find a way to get everyone health insurance." I replied that would mean raising taxes and a Clinton-style government takeover of health care. He insisted: "You can find a way."

I believe that we have. Every uninsured citizen in Massachusetts will soon have affordable health insurance and the costs of health care will be reduced. And we will need no new taxes, no employer mandate and no government takeover to make this happen.

When I took up Tom's challenge, I assembled a team from business, academia and government and asked them first to find out who was uninsured, and why. What they found was surprising. Some 20% of the state's uninsured population qualified for Medicaid but had never signed up. So we built and installed an Internet portal for our hospitals and clinics: When uninsured individuals show up for treatment, we enter their data online. If they qualify for Medicaid, they're enrolled.

Another 40% of the uninsured were earning enough to buy insurance but had chosen not to do so. Why? Because it is expensive, and because they know that if they become seriously ill, they will get free or subsidized treatment at the hospital. By law, emergency care cannot be withheld. Why pay for something you can get free?

Of course, while it may be free for them, everyone else ends up paying the bill, either in higher insurance premiums or taxes. The solution we came up with was to make private health insurance much more affordable. Insurance reforms now permit policies with higher deductibles, higher copayments, coinsurance, provider networks and fewer mandated benefits like in vitro fertilization--and our insurers have committed to offer products nearly 50% less expensive. With private insurance finally affordable, I proposed that everyone must either purchase a product of their choice or demonstrate that they can pay for their own health care. It's a personal responsibility principle.

Some of my libertarian friends balk at what looks like an individual mandate. But remember, someone has to pay for the health care that must, by law, be provided: Either the individual pays or the taxpayers pay. A free ride on government is not libertarian.

Another group of uninsured citizens in Massachusetts consisted of working people who make too much to qualify for Medicaid, but not enough to afford health-care insurance. Here the answer is to provide a subsidy so they can purchase a private policy. The premium is based on ability to pay: One pays a higher amount, along a sliding scale, as one's income is higher. The big question we faced, however, was where the money for the subsidy would come from. We didn't want higher taxes; but we did have about $1 billion already in the system through a long-established uninsured-care fund that partially reimburses hospitals for free care. The fund is raised through an annual assessment on insurance providers and hospitals, plus contributions from the state and federal governments.

To determine if the $1 billion would be enough, Jonathan Gruber of MIT built an econometric model of the population, and with input from insurers, my in-house team crunched the numbers. Again, the result surprised us: We needed far less than the $1 billion for the subsidies. One reason is that this population is healthier than we had imagined. Instead of single parents, most were young single males, educated and in good health. And again, because health insurance will now be affordable and subsidized, we insist that everyone purchase health insurance from one of our private insurance companies.

And so, all Massachusetts citizens will have health insurance. It's a goal Democrats and Republicans share, and it has been achieved by a bipartisan effort, through market reforms.

We have received some helpful enhancements. The Heritage Foundation helped craft a mechanism, a "connector," allowing citizens to purchase health insurance with pretax dollars, even if their employer makes no contribution. The connector enables pretax payments, simplifies payroll deduction, permits prorated employer contributions for part-time employees, reduces insurer marketing costs, and makes it efficient for policies to be entirely portable. Because small businesses may use the connector, it gives them even greater bargaining power than large companies. Finally, health insurance is on a level playing field.

Two other features of the plan reduce the rate of health-care inflation. Medical transparency provisions will allow consumers to compare the quality, track record and cost of hospitals and providers; given deductibles and coinsurance, these consumers will have the incentive and the information for market forces to influence behavior. Also, electronic health records are in the works, which will reduce medical errors and lower costs.

My Democratic counterparts have added an annual $295 per-person fee charged to employers that do not contribute toward insurance premiums for any of their employees. The fee is unnecessary and probably counterproductive, and so I will take corrective action.

How much of our health-care plan applies to other states? A lot. Instead of thinking that the best way to cover the uninsured is by expanding Medicaid, they can instead reform insurance.

Will it work? I'm optimistic, but time will tell. A great deal will depend on the people who implement the program. Legislative adjustments will surely be needed along the way. One great thing about federalism is that states can innovate, demonstrate and incorporate ideas from one another. Other states will learn from our experience and improve on what we've done. That's the way we'll make health care work for everyone.

Mr. Romney is governor of Massachusetts.

[Yamori]

What a total crock of shit.

[Lyion]

What a total crock of shit.

Care to extrapolate, or is this your rebuttal in its entirity.

[dammuzis]

can you opt out of manditory crap health care?

[Lyion]

can you opt out of manditory crap health care?

If you mean, can you not have any health care coverage, period, in Mass. the answer is no. As has been proven, if you get yourself fucked up, someone ends up paying for you.

[mofish]

What a total crock of shit.

So easy for you to slam until you fucking need it. I can only hope you end up poor and uninsured. I think its the only way youre ever going to learn that sometimes people need help, and not everyone can be fucking John Gault.

Personally, I see basic health care as a right for every citizen. And Im not afraid to pay for it either.

[kaharthemad]

As much as this sounds like a good Idea I get the feeling of bad things to come and Im not sure why.

[kaharthemad]

question on this...How much will insurance be on say...a household of 5. 2 adults three children? and what about some people with pre-exsistings? Before a health care company could turn you down because of a pre-exsisting condition, i.e. over wieght, high blood pressure, prior sugicals, etc.

[Lyion]

question on this...How much will insurance be on say...a household of 5. 2 adults three children? and what about some people with pre-exsistings? Before a health care company could turn you down because of a pre-exsisting condition, i.e. over wieght, high blood pressure, prior sugicals, etc.

First, everyone is covered, Period. Its part of the bill.

Everyone is required to be covered, and will be. A large amount of the medicare/medicaid balloon is from young people who never buy insurance, then go pizza themselves on a motorcycle or fubar their bodies in some other way and stiff the taxpayers.

Insurance costs scale based on salary and family size, all the way down to free if people are at poverty level.

This also puts limits on what insurance companies can charge, and allows better deductibles for business owners.

Given your beliefs, this should pretty much ease you, Kahar

everyone must either purchase a product of their choice or demonstrate that they can pay for their own health care. It's a personal responsibility principle.

[Yamori]

What a total crock of shit.

Care to extrapolate, or is this your rebuttal in its entirity.

Ok:


First of all, it raises huge warning alarms to FORCE people to purchase something from private companies. By what right?

Will the government be efficient, just, and cost effective with yet another program based on awarding individual handouts? (Hint: take a peek at social security and welfare).

Car insurance could sort of be considered a (inaccurate) parallel, though it at least makes sense since government's currently own the roads and it can be considered a precondition for being allowed to drive on them. It is (in a de-facto sort of way) a voluntary choice based on choosing to work with a government monopoly or not.

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Second: they are determining who is forced to pay for health insurance based on ability to pay. How do they decide this? Unless they plan on being pretty unjust and simply going by income (ie: people who make over 40k a year must be forced to pay, period --- which obviously creates problems for people in debt, taking care of multiple children and other dependents, the self employed [whose income is not stable since it fluctuates directly with their business]), they will need to do individual investigations into people's financial cases. Does anyone not see a problem with this?

Besides the intrusive 'big brother' aspect, and no real objective basis to judge borderline cases... do you really want to see people in a position where they have to go to court or some form of hearing to beg a government beaurocrat (if they even let you do this) to NOT force you to buy something against your will because your financial situation is not stable enough and you cannot afford it in any way?

Is the possibility of creating a massive welfare mindset in lower income people (ie: to make their situation look WORSE so they can get free healthcare) a good thing?

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Third, insurance companies are private institutions. They exist to make profit. They make their profit by investing in people's good health (ie: people pay them to cover medical problems --- the insurance companies invest on this with the prediction that the individual cases they choose to take will statistically be likely to be in good health more than bad, hence profit for them). They are not a charity, and they are not a government institution.

What if a private company does not want to take a customer (if even that) who is an obvious gigantic risk? In other words, the government will be ordering a private company to consistently work at a large loss on certain customers.

Inversely, if there are any perks or profits or benefits to be made with this mandated insurance law - how will it be decided which insurance company is awarded the government money? Is the government well known for being cost effective, efficient, and impartial when it comes to giving large contracts to companies (save military equipment)? Remember, this is the government that pays about 300+ on the prices of simple things like basic construction equipment in some cases.

What will happen to the insurance industry when it is forced to take on (at a loss) a large number of chronic or high risk cases? Hint: the cost of insurance for everyone will skyrocket. The middle class will get it in the ass even more.

Even more insane, they say that insurance companies will be forced to charge LESS, while they will be taking on MORE FINANCIAL LIABILITIES. HELLO REALITY?! This is such a pathetic and clear example of government beaurocrats thinking that 'intentions' and 'wishing' can somehow change the facts of reality.

What will the effect be on doctors - if the government does not consistently pay normal rates for its welfare recipients? Will doctors be forced to work at a loss?


This is typical liberal-minded bullshit, where people see the 'benefits' of a program and go 'OOOO FREE HEALTH CARE LOLZ AWESOMEZ WHY NOT' and totally ignore the questions of: who pays for it, what are the ramifications, what are the potential problems, who gets fucked over by this, ect.

Like I said... what a crock of shit.

[kaharthemad]

Thanx Yam. I could not explain what was giving me the heebie Jeebies on this one...I think you hit the nail on the head.

[dammuzis]

we all know how well socialized health care has worked in other countries

[Harrison]

In Massachusetts you are required to have car insurance to drive, period.

And that's the way it should be.

[Lyion]

First of all, it raises huge warning alarms to FORCE people to purchase something from private companies. By what right?

Legislated law. We are a country of laws, and this does not violate anything in our consitution. Just as people are required to have car insurance, if you live in a state they can require you to be covered medically, or prove you can afford your own care.

Will the government be efficient, just, and cost effective with yet another program based on awarding individual handouts? (Hint: take a peek at social security and welfare).

Except this is merely legislating how insurance companies can behave and mandating that everyone be personally responsible. Yes, it will be cost effective and if you had read the article, you'd see it's not individual handouts.

Currently, the state pays billions in handouts for uninsured people. Because everyone has a right to medical care, everyone has an obligation to be covered or be able to afford their own care. Not only is this the antithesis of SS or welfare, it's fair and built for helping prevent handouts moreso.

Car insurance could sort of be considered a (inaccurate) parallel, though it at least makes sense since government's currently own the roads and it can be considered a precondition for being allowed to drive on them. It is (in a de-facto sort of way) a voluntary choice based on choosing to work with a government monopoly or not.

The government does not control the health care, it just regulates it, the same way it regulates other industries to prevent anarchy and price gouging to a certain extent.

The bottom line is people get hurt and many are not covered and the lions share hits the taxpayer. This system addresses that and ensures that someone is not doing what you are complaining about, getting a free ride on the taxpayer.

Second: they are determining who is forced to pay for health insurance based on ability to pay. How do they decide this? Unless they plan on being pretty unjust and simply going by income (ie: people who make over 40k a year must be forced to pay, period --- which obviously creates problems for people in debt, taking care of multiple children and other dependents, the self employed [whose income is not stable since it fluctuates directly with their business]), they will need to do individual investigations into people's financial cases. Does anyone not see a problem with this?

The same way the tax rate scales, the insurance rate can also scale. It's not difficult to be fair.

Obviously someone who has a personal doctor and pays for their medical via their business doesn't need coverage. They must demonstrate that they are covered and can get health care that isn't a 'free ride' on the taxpayer. Likewise, someone who is at or below the poverty level pays nothing. Where is the problem? The Government already has your complete financial record via taxes every year.

Besides the intrusive 'big brother' aspect, and no real objective basis to judge borderline cases... do you really want to see people in a position where they have to go to court or some form of hearing to beg a government beaurocrat (if they even let you do this) to NOT force you to buy something against your will because your financial situation is not stable enough and you cannot afford it in any way?

There are guidelines and people to determine this. The bottom line is EVERYONE needs medical coverage. If someone gets hurt, they go to the hospital. Even if they are young and not covered, they still end up costing money to others. You can moreso make this analogous with property taxes, versus 'buying' something.

Is the possibility of creating a massive welfare mindset in lower income people (ie: to make their situation look WORSE so they can get free healthcare) a good thing?

Actually this does the exact opposite. People right now do not take jobs because they can't afford health care. Thus the taxpayers end up paying for them. Because this mandates affordability and scaled costs it allows people to make more money without worrying about being priced out of health insurance.

Third, insurance companies are private institutions. They exist to make profit. They make their profit by investing in people's good health (ie: people pay them to cover medical problems --- the insurance companies invest on this with the prediction that the individual cases they choose to take will statistically be likely to be in good health more than bad, hence profit for them). They are not a charity, and they are not a government institution.

Insurance companies are not selling random generic things. They are heavily regulated industries that are under strict guidelines. They get insurance from the state/feds. They make a lot of cash, and I don't think even with this regulation are in any danger of losing money.

This bill analyzes what is fair, but also ensures that insurance companies are not pulling a 'Rainmaker'.

Inversely, if there are any perks or profits or benefits to be made with this mandated insurance law - how will it be decided which insurance company is awarded the government money? Is the government well known for being cost effective, efficient, and impartial when it comes to giving large contracts to companies (save military equipment)? Remember, this is the government that pays about 300+ on the prices of simple things like basic construction equipment in some cases.

What will happen to the insurance industry when it is forced to take on (at a loss) a large number of chronic or high risk cases? Hint: the cost of insurance for everyone will skyrocket. The middle class will get it in the ass even more.

Even more insane, they say that insurance companies will be forced to charge LESS, while they will be taking on MORE FINANCIAL LIABILITIES. HELLO REALITY?! This is such a pathetic and clear example of government beaurocrats thinking that 'intentions' and 'wishing' can somehow change the facts of reality.

What will the effect be on doctors - if the government does not consistently pay normal rates for its welfare recipients? Will doctors be forced to work at a loss?


This is typical liberal-minded bullshit, where people see the 'benefits' of a program and go 'OOOO FREE HEALTH CARE LOLZ AWESOMEZ WHY NOT' and totally ignore the questions of: who pays for it, what are the ramifications, what are the potential problems, who gets fucked over by this, ect.

Essentially, what you are saying is the system might make someone have insurance, and you don't want to have to have health coverage

The problem with this mentality is it ignores the whole problem this addresses, personal responsibility in regards to medical care. Someone not being covered is paid for by everyone else. Thus, it becomes a larger issue that should be legislated, like Romney has.

People choose or are unable to have medical coverage, instead relying on the government and in essence the 'free ride' on the taxpayers shoulders to cover their health care. There are a lot of options for this. Romneys approach is probably the least liberal of them, which makes your accusation a bit baffling. The liberal approach would be to create more taxes to give everyone base health care.

And I really don't think you have to worry about any of the insurance companies long term viability in regards to profit and coverage. The studies done prove they'll still be ridiculously raking in the dough.

The only real change will be more personal responsiblity.

[Adivina]

Car insurance could sort of be considered a (inaccurate) parallel, though it at least makes sense since government's currently own the roads and it can be considered a precondition for being allowed to drive on them. It is (in a de-facto sort of way) a voluntary choice based on choosing to work with a government monopoly or not.

Shit I never knew it was voluntary to have car insurance, its required here in MA and I just thought thats how it is all over.

[Lyion]

I think his point is if you do not want to pay car insurance, you can not own a car.

This is a poor analogy because everyone ends up needing medical insurance, because its essentially comparing a body to a car.

[Martrae]

You can choose not to have insurance and either not drive or risk fines and possibly revokage of your license or even jail time.

[Lueyen]

You can choose not to have insurance and either not drive or risk fines and possibly revokage of your license or even jail time.

With vehicle insurance though, you can choose not to drive, not to "buy" the product of insurance and still be in compliance with the law, this is where the analogy fails as already pointed out, but this analogy was the first to come to my mind also, something along the lines of "yet another type of business where the consumer is required by government to purchase the industries product".

Like Kahar, I too have reservations about this although it's hard to put my finger on. Yamori brought many good points up, and Lyion brought up many good counter points.

What it comes down to is that it all sounds too perfect, and if government can screw it up at all it will tend to do so. It would be wonderful, if it works, and I would be very happy to see something like this if it does work well for the most part. It will be interesting to see what the results in Massachusetts are.

I am very impressed with the ideas though, and if this is a good indication in general of the Massachusetts governor I do hope to see him campaning for 2008.

[Minrott]

Car insurance is not required in every state.

The thing that would worry me most about this law is the insurance company CEO rubbing his clean white hands together thinking, "Now that they HAVE to buy it, I can skyrocket the price while cutting out 'mandated benefits' like cancer treatment."

[Minrott]

And before you cut and paste to point out how that won't happen because it's so heavily regulated, tell me you honestly believe it yourself.

[mofish]

we all know how well socialized health care has worked in other countries

Yeah, pretty well actually.