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Massachusetts Universal Coverage Bill is No Such Thing

By Kip Sullivan

Legislators around the country are looking to the law recently passed in Massachusetts for answers on how to cope with the health care crisis in their states. Will Massachusetts really be the first state to achieve universal health insurance? Should Republican voters across the country see this legislation as evidence that Republican Governor Mitt Romney, who is likely to seek… return to article

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    One element that is always overlooked in any discussion about universal health insurance is that there is no guarantee that the insured will be provided with the health care benefits [medical procedures] that they need.

    For example, there are regulations that are intended to protect Medicare and Medicare managed care beneficiaries.  An expedited [or fast] appeals process was established as one of the safeguards.  The Center for Medicare and Medicaid Services [CMS] is the federal agency that is supposed to enforce the regulations, but it does not always do so; thus beneficiaries are left unprotected from indiscriminate denials of benefits by the insurers.

    I have been a health care advocate on behalf of my parents for almost a decade, and I can testify to the wrongdoing perpetuated by CMS.  Unfortunately, this has been of little interest to the many politicians and journalists whom I contacted in an attempt to share the well documented details of my experience.

    The Chicago Tribune published an editorial several weeks ago that endorsed the Massachusetts law, and suggested that Illinois create one of its own.  I tried to find out via their editorial board if they had any idea how such legislation would be properly regulated, but I did not receive a response to my phone calls or correspondence.

    United States Posted by John Olsen on May 6, 2006 at 3:43 PM

    “Odds are good that Romney will rue the day he took credit for this bill.”

    Although this statement might turn out to be true, how many politicians, whether Republican or Democrat, are doing anything at all to deal with the health insurance problem? Although this legislation may have its faults, it can serve as an example of what to do or not do for states as well as the federal government when tackling this issue in the future.

    United States Posted by lostlib on May 9, 2006 at 3:12 PM

    What is utterly missed, but could be the most important thing this article indirectly brings up and that’s how much more expensive it is to rely private business to provide essential services.

    The article explains the 20% overhead private companies need to do what takes Medicare 2% to do the same.

    What is neglected is the very likely provision guaranteeing participating insurance companies X% profit, based on their expenditures and gross.

    The reasoning goes that the companies providing a valuable service, and in doing so experience considerable risk should have some sort of shield against unpredictable economic conditions that could cripple their ability to provide those services.

    To ensure against something like that happening, Republikkkunt corporate-welfare pushers always include some sort of “guaranteed profit %” mechanism in bills like this.

    An idea as to What X% will end up being can be obtained by looking at other formerly Govt. run services, that have been privatized. Only a few places have replaced the Govt. completely in any one sector. Those are the best indicators.

    One such place is Texas. In this state energy de-regulation and privatization is complete, and the profit the laws allow them to make is abouta 15-20%. If by some miracle, no company ever makes less than the minimum, and almost always they make the max. t.

    That 15-20% profit needs to be added to the 20% the article assumes will be cost of doing business for the private insurance companies that are selected to to the work.

    When that is added in, the absurdity of thinking private business can do anything the Govt. can do better, quicker and more cheaply becomes starkly apparent. Medicare ends up spending 98% of its budget on providing services.

    Private business insurance plans will consume for their own needs 35-40% of all money directed their way, and use only 55-60% for services.

    This is an absolute outrage. It’s time people start demanding that Govt. take back utilities, and healthcare.

    United States Posted by johnnyincentx on May 18, 2006 at 7:02 AM
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