Mass. Residents Face Monthly Fines For Going Without Health Insurance

Residents in Mass., who refuse to get health insurance will soon face monthly fines of up to $76 , says the AP:

The fines are part of an increasingly aggressive approach written into the health care law designed to pressure Massachusetts residents into getting insurance. The law, intended to create near-universal coverage in the state, was approved by lawmakers and signed by former Gov. Mitt Romney in 2006.

It remains unclear how many Massachusetts residents still don’t have insurance, but the number could be in the hundreds of thousands.

The penalties, which vary with age and income, are based on half the lowest cost plans available through the Health Care Connector. They accrue each month an individual remains uninsured and will be due as part of tax returns filed early in 2009.

The penalties apply only to adults deemed able to afford health insurance by the Health Insurance Connector Authority, which oversees the health care law. People can apply for hardship appeals.

The highest fine of $76 a month — or $912 a year — will be levied against those over the age of 27 making more than three times the federal poverty level of $30,636 for an individual.

Married couples who are both uninsured will have to pay fines individually. A couple earning more than $41,076 would have to pay $1,824 in penalties for the year.

The fines drop for younger adults and fall even lower for those making less than three times the poverty level. There are no fines for individuals earning less than $15,325 a year.

The fines will accrue for every month that a person “who can afford” insurance goes without it, and will come due at the end of the tax year.

What do people in Mass. think of this? The government says it has prompted 300,000 uninsured people to get coverage.


No health care? Higher fines in Mass.
[BusinessWeek]
(Photo:Getty)

Comments

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  1. vastrightwing says:

    what do people in MA think of this? It’s another tax.

  2. danic101 says:

    Gotta Love the Nanny State telling me what to do. Can we force Massachusetts out of the union?

  3. PinkBox says:

    I’m confused. Three times the poverty level would be around 90k, yes?

    Does that mean a single person making 90k would be taxed if they didn’t have insurance, and so would a couple making only 41k a year?

  4. reimero says:

    I think it’s a great idea, personally. Heaven forbid people actually make financial decisions for themselves. I mean, if you don’t want to pay for auto insurance, don’t drive, or (in some states) have a large savings account. If you don’t want to pay for homeowner’s insurance, don’t get a mortgage. If you don’t want to pay for health insurance, don’t… uh, live in MA?

  5. ThinkerTDM says:

    That’s nice. Instead of regulating the ridiculous acts of the health insurance companies, the “lawmakers” decided to force people to sign up for it.
    How about people who are rejected because they might have something wrong with them?
    Is this the way things are going? The health insurance companies aren’t making enough money, so they have their “friends” make a law that forces people to give them more. While still providing barely enough coverage.
    Man, I’m glad I’m living in America!

  6. JustAGuy2 says:

    @causticitty:

    It’s a typo. The $30,636 IS 3x the poverty level. It compares to the $41,076 for a couple.

  7. lesbiansayswhat says:

    This sounds awful. Is there a reason besides ‘healthcare is good for you’ that is allowing this legislation to go through? Otherwise, I can see no other reason than a huge insurance lobby being responsible for this. What programs do the taxes go to? What gets me is that they claim they’re pushing for universal healthcare..which usually meant provided by the government, not ‘we’re forcing you to get healthcare and then calling it universal’ healthcare.

  8. PinkBox says:

    @JustAGuy2: Ahh, thanks!

    And ouch. If you are self employed and make only 30,636, good luck finding insurance worth buying that you can actually afford!

    You’d be paying money for virtually no coverage.

  9. misstic says:

    Where do the fines go? Are they being collected and used solely to fund the state-run insurance program? or is it going into some general fund?

    I hate govt intervention.

  10. Pylon83 says:

    This seems pretty foolish to me. It’s taking away the free will of Mass. residents who can afford, but rationally choose not to get, health insurance. This is over-regulation and I’m certainly glad I don’t live in Mass.

  11. cloudedice says:

    Health Insurance in the State of Massachusetts is already high due to the requirement that no one can be turned down for health insurance. I can’t imagine this is a good thing.

  12. jtheletter says:

    I’m a resident of MA and this is just stupid. If they’re already going to force you to pay by adding it to your tax bill then why not apply the charge to GIVING THYE PERSON COVERAGE instead of making it a FINE?? I mean, does fining people make any sense? They’re most likely not buying insurance because fo the cost, so the solution is to further financially hobble them, brilliant. If MA really cared about getting people insured they wouldn’t be assessing fines, they’d be using the buying power of an entire state to drive down health insurance costs by cutting deals with insurers, jsut like any other corporation does. My company was recently bought out by a huge corporation, and my health coverage went up and costs down because the corp has negotiated much better rates since they have thousands of employees that will be guaranteed customers. Why can’t the state do the same?

  13. chili_dog says:

    The flow of “refugees” from the Socialist Republic of Mass will grow even larger.

  14. protest says:

    this is the biggest load of crap i’ve ever heard. VASTRIGHTWING called it, it’s just another way to get money out of people, a highly unethical, criminal sort of way.
    it should be your right, in a free country, to choose not to have health insurance. and someone really should tell MA that “universal healthcare” is not a term for a group of people who all happen to have whatever health insurance they can afford, it’s a group of people who are all insured by a government program. i also would like to know where this “tax” money goes, since i’m sure it doesn’t go to subsidizing healthcare.
    not that i ever really considered him before, but i will definitely not be voting for this Mitt Romney douche.

  15. DojiStar says:

    It’s actually a very good idea and is working very well, other than delays in paperwork processing.

    The insurance companies are offering about 8 different plans, some with prescription, some without. They range from $200/mo on up to over $1k/mo. You can get insurance from a choice of I believe 3 different companies. These are some state run agencies. We are talking BC/BS.

    If you don’t make a lot of money, you can get insurance for free.

    If you make under $41k it is subsidized at a substantial discount.

    I makes private insurance available to everyone. No matter if you are self-employed or employed, you can get this insurance.

    It gets the state out of the insurance business by moving people from mass health and medecaid to private insurance companies. So now the state doesn’t need to have that huge bureaucracy to run.

    It is one of the better things to go on in this state in a long while.

  16. TomK says:

    What good is it to have health insurance when the insurance companies have doctors working full time to deny you your benefits and lawyers working full time to create arcane rules so they can bill you until you need help then drop you for not reporting a 15 year old yeast infection?

    Fuck private health insurance. These asshole corporate bureaucrats have been stealing everyones healthcare money and paying their CEOs hundreds of millions of dollars while little children die because doctors who have never seen them decide their liver operations are unnecessary.

    Plans like this are just a way to force people to give their money to the ethically reprehensible asshats who are killing thousands of americans each year with these dirty tricks to get out of paying for insured sick people.

    We don’t need a healthcare system where the companies providing healthcare are legally required to screw the people to provide better returns for their blue blood old money stockholders. We need to cut these lying thieves and manipulative republicans out of our healthcare and allow competent adults to design a system that places healthcare outcomes ahead of corporate returns.

    Fuck Mitt Romney and his dirty games to drive people to hearth insurance companies that will screw them when they most need help. In corporate america having health insurance is no guarantee you will get needed care. We need to get everyone healthcare, but not by giving the healthcare dollars to a bunch of crooks who make the RIAA look like fuckin ghandi, and who are legally obligated to screw their customers to maximize return, and who, because of a corrupt supreme court who thinks the 14th amendment was designed to protect the rights of oppressed corporations, have all the rights of personhood with none of the associated responsibilities or ethical obligations, and who are happy to watch your loved ones die in pain if it means fatter bonus checks.

    In other words I’m not to big on this.

  17. Pylon83 says:

    @protest:
    I doubt that the state imposed these fines with the intention of raising funds. People are too quick to jump into the conspiracy theories. It seems that the Mass. govt. is truly interested in ensuring all their residents have healthcare, and the threats of fines are a way to do it. I don’t agree with the law, but I also don’t think they are using it as an excuse to extort money from people.

  18. DojiStar says:

    @protest:

    You should have the right to choose or not choose healthcare insurance, but the overwhelming majority of people who refuse to get insurance also feel they have a right to free healthcare. So who do you think ends up footing the bill for the non-paying uninsured. The people with insurance, that’s who. Medical rates go up to compensate for the delinquent accounts because someone chose not to have insurance. Then insurance premiums go up and those insured have to pay more.

  19. johnva says:

    @lesbiansayswhat: I think the purpose, in theory, is that it will drive healthcare costs for everyone down if everyone is insured since there will be fewer uninsured people out there costing the healthcare providers money that they have to make up for by raising prices on everyone else. The main reason that there are so many uninsured people in America is that health insurance is very expensive, because healthcare is very expensive. So the high expense makes it unaffordable for a lot of people, which in turn makes it even more expensive and more unaffordable. You get a vicious cycle, and I think one goal of plans like this one is to break that cycle. Whether mandated coverage is a good way to do that is an entirely different question, and a much more questionable one. Personally I don’t think it’s going to cut it.

  20. misstic says:

    Oy! I can’t believe this is turning into a healthcare debate! /sarcasm off :)

    If what another poster said it true and this is getting MA out of the business of providing state run insurance, that is good. The govt has no business dictating our healthcare. Just look at the VA and other govt run programs. Thanks but no thanks!

    I would much rather see health insurance become competitive and easier to afford privately like car insurance than for the govt to step in. You cannot manage finite resources when the needs are infinite as they are in healthcare.

  21. dugn says:

    @DojiStar: Agreed. Where do the previous posters on this thread think the ‘magic money’ comes from to pay for uninsured people who have to go to the hospital or receive medical care?

    This is a reasonable, non-punitive penalty against those who otherwise choose not to have one of the extremely affordable offerings mandated by the state for private companies to provide.

    Going without some level of health insurance when you could is effectively riding on the backs of others (and a larger penalty to the taxpayers in the long run) – betting that you’re never need medical care. Until you do, it’s works fine. The moment you need care, it’s broken.

    Anytime taxpayers have to pay for someone else’s lack of responsibility or unforseen calamity (excepting extreme cases), I’m against it. This solves one of the most egregious examples of government-funded handouts for many in that group of people.

  22. I live in MA and hate this. Minimum coverage through my job comes to about $1300/year. I’m the type who has to be half-dead before I will even set foot in a doctor’s office, so for the last five years I haven’t opted for the coverage. During that time I had one ER visit to the tune of around $1000 which I paid out-of-pocket, and no other medical expenses. If I had coverage for those five years, it would have cost me $6,500.

    I know I’m an odd case, but I can’t be the only one who was forced to carry insurance even though I don’t need it and likely won’t use it. Like previous commenters, when I see that $25 a week coming out of my check, I think of it as just another tax.

  23. GothamGal says:

    You just know that this legislation was originally introduced by some dipsh*t from the Republic of Cambridge. As a native Bostonian who escaped to the fascist state of California (only because of the weather), I find this ridiculous.

    I would be appalled that I am required to have insurance. One of the reasons that I do not drive is because the cost of auto insurance is astronomical. I would rather pay for cabs and I still save money. My hate of auto insurance started back in Massachusetts where the cost is so high and we can expect the same thing to happen with health insurance as everyone else pays for the previously uninsurable.

  24. Randal Milholland says:

    I’ve lived in Mass. since 1999 and I have to say it’s pretty moronic. Being self-employed, I already get taxed to Hell as it is. I appreciate the reasoning for why they government wants us to have insurance – the problem is a lot of insurers have been lessening what they WILL cover but not what they’re charging us. So I’m paying more for less.

    What’s really annoyed me is everyone keeps comparing it to how you have to have insurance to drive here. I can choose not to have a car (I can also choose not to be alive, I guess). My choice is, at the end of my lease, I’ll be moving on to more affordable states to live – which has been a common theme. The past few years the state’s been reporting increases in the number of people leaving and the main reason is cost of living.

    Divorcing myself from my general disdain of a government agency telling me I have to spend money because their lobbyists say so, I really don’t believe the state government is serious about this. $76 a month is still cheaper than having health insurance and they know it. If they really wanted every citizen to have the insurance, the fine would be more than the cost of being insured. The state will get the full $76 a month. Even if only 5% of the population pays them that, it’s more money in the state’s coffers.

  25. CumaeanSibyl says:

    Personally, I just think it’s hilarious that Mittens is trying to pass himself off as a conservative these days.

  26. Saboth says:

    Hmmm so apparently everyone is able to afford $200-$700 a month in health insurance on top their other bills and taxes?

    People saying this will lower insurance are most likely wrong. Did requiring everyone to wear seatbelts lower your car insurance premiums? Nope. Once everyone is required to have insurance, the companies will be able to do whatever they want with their rates, just like the cable monopolies do.

  27. smitty1123 says:

    Why is it that when a few people are getting fucked most people’s solution is to try and fuck everyone?

  28. TCameron says:

    The Libertarian sympathies in me say that this is wrong, as the government is forcing themselves upon me again in another facet. The same libertarian inside understands how money will be funneled into private companies. (Greedy Capitalist pig, I know.) I also believe that health care is very important, and can put a strain on the entire economy if some people don’t have it. I am a Massachusetts resident, and feel as though this may be a step I would have liked to seen not taken, but I have never felt so weird about an issue before.

  29. johnva says:

    @misstic: The VA has improved a lot and actually gets better healthcare outcomes than many private insurers. You have to understand that a lot of their patients are very complex health cases with a lot of things wrong with them.

    Health insurance is never going to be as cheap and competitive as car insurance. It’s simply not the same type of market. You can opt out of the need for car insurance by not driving, but you can’t opt out of the potential need for healthcare. So what do we do about all the uninsured people? We will end up paying for them one way or another when they eventually need care.

  30. TomK says:

    @johnva:

    The main reason there are so many uninsured people in America is because latent racism means America doesn’t have a welfare state like any other industrialized western nation. Whenever the subject of helping the less fortunate comes up, fat drug addict fucks like Rush Limbaugh and egg loving perverts like Matt Drudge find offensive racist caricatures to force into the dialogue into the gutter, where the idiots in the bible belt, who are too dumb to realize they are in the same boat as the minorities they hate, vote however the clowns (I’m sorry, serious bipartisans) the republicans put on TV tell them, even though it is against their interests.

    France pays way less than us per capita, and gets better healthcare outcomes, and covers anyone. In light of this your explanation doesn’t hold water. The reason our healthcare is so expansive is we have to pay for healthcare, and a corporate bureaucracy (the insurance companies), and the R&D for Pzeifer to come out with new dick pills, and full price for those pills (instead of buying in bulk). If we cut out the billions of dollars for insurance agencies and their CEOs and stopped spending R&D dollars to find patentable allergy pills that were 2% more effective, we’d have lots of money to bring down healthcare costs.

  31. johnva says:

    @SuburbanSocialite: I don’t think you’re appreciating what health insurance is for. Yes, you don’t use as much healthcare if you’re young and healthy. But there is still a significant risk that you will incur catastrophic expense. What will happen if you get in an accident (that isn’t even your fault)? Or get diagnosed with a serious disease like cancer that you didn’t see coming? It can happen, even when you’re “healthy”. It’s not smart to completely go without insurance. At least get some high-deductible insurance and an HSA or something. If you use it for nothing else you will pay much less for the same medical care than if you paid out of pocket.

  32. vastrightwing says:

    DOJISTAR: you described a socialist’s wet dream, but still forcing people to pay for something they don’t want to pay for is a tax. Let’s call it what it is. The insurance companies are also wetting their pants over this. You should see the Blue Cross ads that scare you into getting insurance to avoid being a “criminal”. This is so NOT about health care.

  33. mammalpants says:

    is it just me or does mitt romney totally seem like the type of guy to lay on a beach in a speedo with white sunblock on his nose giving orders to drop bombs?

  34. Dr_awesome says:

    I live in MA and I CANNOT afford an additional $200 a month. Between rent, a car payment, food, gas, and a phone bill I can barely make it through the month as it is. This law sucks and I plan on getting the hell out of this state as soon as I’m able to put together a few dollars to cover my moving expenses.

  35. nonzenze says:

    “This seems pretty foolish to me. It’s taking away the free will of Mass. residents who can afford, but rationally choose not to get, health insurance. This is over-regulation and I’m certainly glad I don’t live in Mass.”

    I would accept that ‘rational choice’ of yours, if you agreed to pay all your hospital bills, in full, after receiving life-saving service. Otherwise, you end up like the other uninsured – mooching off the rest of us. Alternatively, we could repeal the law that requires hospitals to take care of everyone, irrespective of his ability to pay. Take your pick.

  36. sonichghog says:

    @johnva: Yes, that worked so well for Car insurance didn’t it. Rates went up when you HAD to have insurance. Why bring prices down to what the market will bear if you are forced to buy anyway….

  37. MercuryPDX says:

    Call me crazy, but it seems cheaper to violate the law ($76/mo) than it does to comply ($200+/mo)… unless they’re getting some break that makes those numbers equal.

  38. johnva says:

    @TomK: I agree with you (except I don’t think it’s about racism, primarily). It’s about economic class and about greedy people trying to make money off the healthcare system.

    I NEVER said I agreed that this is a good healthcare reform plan. I don’t think it is. I’m just saying what I think the economic theory behind it is. In reality uninsured “free riders” are only part of the reason why healthcare costs are going up so dramatically. There are many reasons and they all need to be addressed in a comprehensive way.

  39. clevershark says:

    This is brilliant! this way if you can’t afford health insurance you’re f*cked not just once but twice!

  40. nonzenze says:

    Dr_Awesome, there are two ways to read your comment. If you really can’t afford the insurance the state will subsidize it for you or even pay for it outright. OTOH, if you can actually afford health-care but just don’t want to cut back on non-essentials then you are effectively a mooch.

  41. johnva says:

    @sonichghog: You SHOULD have to have car insurance to drive a car, for the same reason that it’s problematic to have a lot of uninsured people in the healthcare system. Otherwise you get people who are costing everyone else money but not paying for the portion of the risk that they cause. The difference is that no one is forcing you to have car insurance from a private company; you just have to if you want to drive a car. Since there is no way to opt out of this requirement in health insurance, I think a better plan would be some form of socialized healthcare.

  42. RvLeshrac says:

    @johnva:

    Except that most insurers try as hard as possible to deny you coverage when you experience any of those events.

    And, typically, succeed. You forgot to cross that T in your signature four years ago on some completely unrelated paperwork! CHEMOTHERAPY DENIED!

  43. nonzenze says:

    @MercuryPDX: First off, health insurance is deductible from Fed income taxes, which is worth $20-40/mo. Second off, if you buy the insurance, you actually have insurance which is now more attractive because the effective cost is reduced. Even better for you, if you actually take advantage of the insurance and go see the doctor every year or two for preventative care you will likely add years to your life (mammograms/colonoscopies are some of the most effective procedures you can get)

  44. TomK says:

    @johnva:

    It is about class. racism is the tool the upper class uses to drive a wedge between the lower class. If all lower class people are pissed at the rich, the rich lose in a democracy, so they cynically try and turn groups of poor people against each other. Thats where the racism comes in.

  45. MercuryPDX says:

    @johnva:
    What will happen if you get in an accident (that isn’t even your fault)?

    You sue.

    Or get diagnosed with a serious disease like cancer that you didn’t see coming?

    The company insuring you denies coverage then drops you like a rock and when they dig back in your medical history and find you had an ear infection which obviously contributed to your inoperable brain tumor, and qualifies as a pre-existing condition?

  46. johnva says:

    @RvLeshrac: Yes, the insurers are pretty bad and do some pretty unethical things because they have an inherent conflict of interest (profit vs. paying for care). You’re still much better off being insured than being completely uninsured. At least if you’re insured and they deny your claims persistently you can sue them. Longterm, however, I do think there needs to be some serious government regulation/intervention in healthcare and health insurance. Our for-profit system is basically a failure.

  47. rjhiggins says:

    @misstic: “Just look at the VA and other govt run programs. Thanks but no thanks!”

    Actually, Medicare is by far the most efficient health-care program in the country.

    Everyone agrees our current system is horrible, yet every proposed solution is shot down as being socialist, anti-choice, anti-American, etc. The fact is, we’re all paying dearly for those who have no insurance. I for one applaud a state that’s willing to try something new. Too bad our national leaders don’t have the courage to attack this problem.

  48. hollerhither says:

    I don’t think my high premiums should be funding others who have chosen not to be insured.

    Unfortunately I have seen very few (no?) examples where private companies have lowered their prices to consumers for ongoing services when the cost of providing those services decreases. Instead, they apply the profits elsewhere — expansion, reinvestment, payouts to shareholders… I don’t expect insurance companies to be any different. Our company’s costs in MA for insurance have gone up year after year and I’ll probably need hospital care myself from the shock if I’m told in a year or two that we’re getting some kind of a price break resulting from this new legislation.

    And what *are* those “fines” going toward? I guess I should know this, but I don’t.

    However, I think it’s an interesting experiment as opposed to doing nothing at ALL about the problem. Maybe it will inspire other, better solutions — someone had to be first.

  49. johnva says:

    @MercuryPDX: There isn’t always someone to sue in an accident, which is why you may still have to rely on your own insurance. For example, you could be walking down the sidewalk and get hit by a car that runs off the road. If that person then takes off, you might never find them. Or if you do, they might not have nearly enough money to pay for your healthcare. And even if they do a lot of that money will go to your lawyers and not your care, especially in a timely manner. “Sue” is a simplistic solution that doesn’t cover many possibilities.

    And I agree that the insurers act pretty badly and deny claims for no reason. They have no real incentive to treat patients fairly in the current environment and a lot of incentive not to (profits). That’s why I think we need radical reform of the current system. You’re still better off having insurance than not, since you can at least sue them, etc if they try to pull something like that.

  50. Pylon83 says:

    @nonzenze:
    Honestly, I think I would rather see the required care laws overturned than be required by law to have health insurance.

  51. B says:

    I’m torn on this one. On one hand, the Government forcing people to get health care isn’t right, but preventive maintenance is cheaper than emergency care, and if people would eat right, take care of themselves and get regular checkups instead of using the emergency room, the overall costs of health care would go down.

  52. MercuryPDX says:

    @nonzenze: OK, so now we’re at $160 vs. $76.

    Not trying to be an ass here but when I was laid off in July, Cobra was $236/mo.. I am generally healthy (last doctor visit for a problem was in 2004) so I passed on it. As a freelancer/Contractor I got quotes ranging from $180 (with an obscenely high deductible of $400) to $475 and up per month.

    I got pinkeye about three weeks ago and reluctantly went to the Urgent Care to get treated. The bill came for $187 with a “no-insurance discount” bringing it down to $155.

    So I paid $155 in December, when I could have been paying $900-$2375 for insurance from July to December instead.

    Don’t get me wrong, I would LOVE for my current gig to go full time so I can get company paid health insurance… but for now I consider myself ahead of the game.

    If I’m still uninsured by the time I get to colonoscopy age, WA State has plenty of Free or At Cost clinics to take care of it.

  53. nonzenze says:

    @Pylon83: Seriously?!?! Do you really want to be left for dead if something happens to you?

  54. johnva says:

    @MercuryPDX: Routine care isn’t really the reason you want to have health insurance. You want it because of the potential for problems that could cost $1 million or something. It’s expensive because of that kind of thing, not because of people paying $150 doctor bills for pinkeye. I think I read somewhere that 70%+ of the cost of health care goes towards catastrophic or chronic conditions.

    Moreover, your own post actually shows what happens when people don’t have health insurance: they delay or forgo preventative care sometimes. That makes things even worse when they do have something bad.

  55. Curiosity says:

    @johnva:
    While I don’t say this often, I think the statements that you present are completely idiotic, irrespective of whether you may be.

    It is true that our current system is perhaps as idiotic as your statements, but it is also true that it seems that you present the impression that you have no idea of economics.

    While you may want universal health care, and your intentions may be noble, your ideas are suspect – you seem to forget the classic “problem of the commons”.

    It goes something like this: a group of sheep-owning farmers own land in a ring around a common area. They each benefit individually from letting their sheep graze on the common land, since that frees up some of their own farmland for other uses. However, if they all let their sheep graze on the commons, they all suffer, since the land will be stripped bare, and so they will end up watching their sheep starve, since their own land has all been turned to other uses.

    To simplify this – unless there is a common goal (say a common defense) where individual interests cannot be served by individual investment, common investment to serve individualized gains leading to the stealing of resources and disaster if individuals have not expected the system to fail.

    Try a market economy where the threat of failure drives progress rather than governmental patches.

    I am curious does anyone think that people younger than 30 will be getting Social Security (a similar but not the same problem)?

  56. Curiosity says:

    @johnva:
    Not to say that I don’t think that catastrophic insurance (like for your car) isn’t a good thing.

  57. greatgoogly says:

    Speaking as someone from Massachusetts this plan is a gift for the insurance company scum. It does nothing to control costs but certainly ads to the bottom of line of insurance companies. What is next, mandating people to buy a new car ever 4 years to help out the car dealers?

  58. csdiego says:

    I have no problem in principle with the requirement for everybody to have insurance. If the insurance companies can’t turn anybody down and everybody has to have insurance (i.e. the risk pool is larger), the average cost of coverage should go down.

    But I think the numbers are wrong here. Three times the federal poverty level is still just barely enough to scrape by on in Massachusetts. $152/month (judging from what the article says about the fine being half the cheapest premium), or $1824/year, is too much to pay for insurance that probably doesn’t really cover anything, on an income of just $30K/year.

    I loved living in Massachusetts and I wish I still did, but I’m not sure I could afford to move back now.

  59. Pylon83 says:

    @nonzenze:
    First off, I have health insurance. Second, I just feel like this law seriously oversteps the line between reasonable and unreasonable regulation. I think that if I had to choose between forcing everyone to get insurance and ending mandatory emergency care, I’d choose the latter. I’m not saying I am in favor of ending such care, but I do believe it is the lesser of the two evils. This law is encroaching upon the free choice of Mass. residents and I think it is intolerable.

  60. hexychick says:

    So basically you have a choice of paying a fine or paying an outrageous monthly premium for insurance. That’s messed up.

  61. Caroofikus says:

    Everyone seems to be saying you shouldn’t drive if you don’t have insurance, so how about we get rid of the fines. Let’s change it to you’re not allowed to live unless you have healthcare insurance.

  62. Myotheralt says:

    @reimero: i thought it was illegal to drive w/o car insurance?

  63. johnva says:

    @curiosity: What on earth are you trying to argue? Private health insurance suffers from this commons problem just as much as government care would, if the insurers are mandated to accept anyone who wants insurance. The only way that private insurers can cut their costs when the costs of care are rising so much is to deny more care and deny coverage to more high-risk people. This may well help the insurers succeed and profit, but it doesn’t serve the public well as far as healthcare.

    People are our most important piece of national infrastructure. This is why the government invests in things like public health and education – it helps our economy grow and compete more effectively against other nations. This is more important than ever before with the global markets we have now. If a large chunk of our people can’t afford healthcare and can’t afford good education, then our economy will eventually pay a price because we won’t be utilizing our human resources as effectively as we should be. This is why this is everyone’s problem. And our current system is beyond awful. We pay more than anyone else in the world and we get very little for the money. We have the worst of both a market and socialized healthcare system.

    As far as Social Security, I don’t know what will happen politically. But Social Security’s budget is relatively secure: it holds bonds promising it money it needs to meet its projected obligations and possesses the power to tax current workers to pay out most of the benefits for current retirees (actually, currently, the tax is taking in more than SS is paying out). Eventually, due to demographics, the tax will no longer be sufficient and SS will have to rely on the money owed to it via bonds. The general federal budget will have to pay that money back to SS in order to not default on the bonds. So really it is a crisis for the general budget, not SS. Republicans are trying to tell you that Social Security will go bankrupt when in fact it is not SS but the federal government that will be facing a shortfall. They are saying this because they know that the only way to make up for this shortfall will be to raise federal income taxes or cut spending dramatically (such as military spending). They simply don’t want income taxes to be raised to cover the money borrowed from Social Security because the income tax is progressive and would impact high income taxpayers more than the Social Security tax. Don’t be fooled by the rhetoric.

  64. Pylon83 says:

    @myotheralt:
    Such a law would be a State law, so it may vary. However, I’m not aware of any states without such laws.

  65. LVP says:

    There goes my dream of moving to Nantucket.

  66. MercuryPDX says:

    @johnva: “Routine care isn’t really the reason you want to have health insurance.”

    It is for me. If I could have gotten away with a $25 copay and $5 prescription instead of $155, I’d of taken it.

    Maybe I was going to the wrong doctors, but my last physical was a joke. It lasted all of 30 minutes where the Dr. asked how I was feeling, if I had any problems, listened to my chest with a stethoscope, told me to quit smoking, took my weight/temp/BP, told me to lose 20lbs., drew 3 vials of blood and sent me on my way declaring me healthy

    Please tell me if your routine physicals are any different from that.

    I understand that if something catastrophic happens I am screwed, but that’s pretty much the case whether I am insured or not.

    @curiosity: I’m in my late 30’s and even I have doubts SS will be around for me.

  67. backbroken says:

    Now MA politicians can tout that they are providing universal health care!

  68. techguy1138 says:

    @TomK: I think the point of this state plan is that they can NOT just drop you or deny you benefits.

    It seems like a pretty steep price to pay.
    A person make 30k will pay around 1/3 in taxes off the top.
    20k a year is ~390 a week taking out $50 + a week is a large chunk.

  69. digitalgimpus says:

    That’s really the big decision. Should there be any “emergency care” for someone who obviously doesn’t want it?

    People without health insurance really are stealing from the system since we’re all paying for it on their behalf. It’s not even a fund setup for the purpose (such as medicare, welfare, social security, etc.) and a budget.

    Screw em… if you turn down the option for coverage and are capable of having it, you should be blacklisted from the ER. No care for you. if it’s something contagious put them in solitary confinements in jail.

    If you don’t have coverage because you physically can’t work, afford it (legitimately), whatever… that’s a different story. But those just trying to save cash hoping for no emergency? Who cares.

    Interesting arguments.

  70. madrigal says:

    I live in MA. I picked the cheapest of the plans my job offered. My health insurance went up this year. It used to be $45 every two weeks, and now it is $51 every two weeks.

    If you want everyone to have healthcare, make it cheaper. Also, service should be better. I sprained my ankle, went to the doctor 3 months afterwards because it was still swollen, and she barely looked at it for 5 seconds. Not worth the co-pay.

  71. NoWin says:

    @myotheralt: @reimero: i thought it was illegal to drive w/o car insurance?

    I thinks its more that “to register a car requires the cat to have a basic insurance coverage (compulsory)”. So, if you drive a non-insured car, its actually un-registered, and you get ticketed. But my fine state of MA probably has a violation-citation of “no insurance” in itself….

  72. NoWin says:

    ? “the cat” ? ….meant to type “the car”, but we’ll tax and insure cat’s too….

  73. rbdfoxes says:

    @rjhiggins: I agree with the “try something new,” but really really, this is NOT it.

    I’ve posted about this before, but I have worked in a medical office in Mass for the past year, and you can really tell that the insurance companies are creaming their pants over this. They are offering “cheap” programs with crappy benefits, and are SO EXCITED that now everyone in Mass will have to pay them. I have had many insurance companies call me (the office manager) over the past few months offering to “help me” make sure that our company is in compliance with the new laws (and of course then pitch me their “health-care solutions”).

    I would much rather have a government-run real universal coverage where the biggest problem is likely to be competency, than be forced by the government into the arms of for-profit companies who will never escape their own greed.

    NOTHING in this country will change until the people see that it is in their own benefit to take care of the poorest and not hoard everything for themselves. It’s amazing that people don’t see the absurdity in saving your WHOLE LIFE for retirement…but that is for another thread, and I am looking forward to moving to Australia, where I may end up paying 30% of my income in taxes, but I won’t have to worry about health-care or retirement.

  74. johnva says:

    @MercuryPDX: Well, as you’ve figured out, health insurance isn’t a great deal if you only concern yourself with routine expenses. You could do better on that just saving more of your money and paying out of pocket (though you will typically pay more paying out of pocket than the “negotiated rates” the insurers pay).

    Seriously – what do you plan to do if you get an illness that costs millions of dollars to treat (assuming you don’t have that much spare cash in the bank)? Just die? Or get the care and then declare bankruptcy (which is a lot of people’s solution in that situation)? If you do the latter, then you would be contributing to the problem by making the healthcare providers take a big loss that they have to make up for by raising prices elsewhere.

  75. barty says:

    @causticitty: If you’re self-employed, been in business for longer than 2-3 years, and still only making $30k a year, you’ve got other problems rather than finding health insurance.

    However, high deductible health insurance that covers the big bills isn’t THAT expensive. If you’re in good health, having to pay for the annual physical or occasional sick visit (I have been averaging a sick visit maybe once every two years) out of pocket won’t kill you. I had to self-insure last year and it cost me about $80 a month.

    In my opinion, most people who claim they can’t afford health insurance are looking at the kinds of plans you’d get working at a good sized company. Low to no deductible and covers virtually everything you can think of with no pre-existing condition clauses. They see a $200-300 a month (for a single person) premium and freak out and then go whine to their elected officials about how health insurance is too expensive.

    For someone that is single and under the age of 50, a high deductible plan with an HSA is probably the most economical choice for health insurance you can make. Even if you’re married and have no kids or have kids that are outside the age where they’re going to the doctor every 2-3 months (or more!) its not a bad idea. One of my former employers offered such a setup, and it was great. They chipped in about $1000 a year (unfortunately they got it back if you resigned or got fired) and you paid about 40% less than what the HMO or PPO plans went for.

    @MercuryPDX:A $400 per YEAR is pretty low actually. When people refer to high deductible coverage, they’re talking about $2000 and higher. You pay for the occasional office visit out of pocket but if you have to go to the hospital for a night or three, you’re not stuck trying to pay a $20k bill. Your Cobra coverage was for the same coverage your old employer was providing, that’s why it was so high.

    To everyone who thinks insurance companies are out to screw you by digging up old pre-existing conditions, the LAW in most states is that they can’t go back more than 5-7 years unless you’re found to have some chronic condition. Then they can only deny (or charge you additional premiums) for the treatments related to that condition. So if you have some chronic stomach ulcers, they can’t come along and deny a legitimate claim when you break a bone in an accident.

    @johnva: I’d really like to see Social Insecurity go under just so I can start taking that money and putting it into investments that will do better than keep up with inflation. With what the government has and will steal from me over my working lifetime in this Ponzi scheme I could have put into solid investments and have been a millionaire many times over by the time I retire. Just because some people are too damn stupid/lazy/ignorant/afraid of saving for retirement for themselves is no excuse for the government to continue to perpetuate this fraud on the American people.

  76. coffee177 says:

    Qoute from DOJISTAR:
    You should have the right to choose or not choose healthcare insurance, but the overwhelming majority of people who refuse to get insurance also feel they have a right to free healthcare. So who do you think ends up footing the bill for the non-paying uninsured. The people with insurance, that’s who. Medical rates go up to compensate for the delinquent accounts because someone chose not to have insurance. Then insurance premiums go up and those insured have to pay more.

    End Qoute:

    I could not have said it better. Mitt Romney’s work in Mass. is a good thing. Especially his health plan that he instituted. You have to have health insurance. Of course what I would probably add to this is a clause that if you dont have health insurance under the Mass. Plan then its up to the hospital/doctors if they want to do FREE service to them. Free as in donated not billed out to others to cover costs.

    Those that complain about the healthcare plan working in Mass. are basically those that want everything free in life. Guess what? Nothing is free in life.

    jd

  77. tinmanx says:

    Car insurance companies have a law that guarantees revenue, and now health insurance companies have one (only in Massachusetts right now). What next? RIAA gets a law passed that requires everyone to purchase at least 10 CDs a year to prove that your not “stealing” music?

    Why don’t they pass something useful like a law that limits the cost of a doctor’s visit? The last time I went to the doctor they billed my insurance several hundred dollars for eye drops (not the bottle, just what they put in my eyes), and the total came to several thousand dollars. Of course the insurance company didn’t pay nearly that much, but it’s just crazy.

  78. Sasquatch says:

    I live in MA, and I have to say that this law infuriates me.
    Luckily, I landed a job that provides insurance in December thus
    sparing me the tax penalty for FY07, but I’m one of the lucky ones.
    This law doesn’t “provide” anything besides a penalty for anyone who
    can’t afford health insurance. I know they think that anyone making
    over $15,325 a year “can afford” it, but these are people who have no
    idea how much the cost of living really is in MA. This was just
    Romney’s last big “fuck you” to the state that loathed him. I still
    don’t understand how that stupid Mormon fraud hoodwinked the people of
    MA into voting for him. Let’s hope he doesn’t pull off the same trick
    on the country.

  79. gingerCE says:

    While this plan isn’t perfect–at least it’s something. At least Mass. did something about health care while other states and the govt. continue to do nothing.

    As for those complaining about paying–first, see if you can get it subsidized by the state in any way–if not, then pay it. Yes, you may not need it for a few years BUT what if you do need it? I have been in the emergency room when a patient from a car wreck was told she had to pay 30K or get transferred to a county hospital (from private)–well, they transferred her. And she’ll still get the bill! You don’t know when you’ll need coverage–like you don’t know when you’ll need to use your car insurance, but both are there to protect you from financial ruin. And neither is free–you have to pay.

    And look into tax deductions. You might qualify to deduct your insurance costs on your fed or state taxes. I know self-employed people get to deduct health insurance costs 100%.

  80. MercuryPDX says:

    @johnva: “What do you plan to do if you get an illness that costs millions of dollars to treat?”

    Just die. Pardon the morbidity:

    I’ve watched elderly relatives extend their lives, only to live out that “extra time” in the hospital bed they died in.

    I’ve watched my mother die in her late 50’s from breast cancer that metastasized and began eating away at her bones while she tried one round of chemo, radiation, or “new” treatment after another in an effort to extend the painful life she was already living.

    I’ve watched my dad (now 75) survive two heart attacks, open heart surgery, a stroke, and several mini-strokes which robbed him of full mobility, his ability to speak a coherent sentence without frustrating pauses when the gears in his brain slip, his ability to do simple math in his head or on paper, and a daily regimen of medical prescriptions and monthly doctor visits that still don’t guarantee he won’t have another stroke or heart attack.

    I’ve seen enough to know when your ticket is up, it’s up. There’s no fighting or extensions.

  81. orielbean says:

    the point behind these plans – you all will eventually become ill or need some sort of care at some point. If you have some skin in the game via constant healthcare insurance deductions, the cost of your care is offset by the contributions you put into the system all these years. If you do not have skin in the game and go uncovered and get ill, the cost of your care will come from the contributions that others have dilligently paid into the system.

    It is essentially a tax on the healthy person who doesn’t go to the doctor or ER often. However, there’s a third group of people – those who don’t pay into the system, get a little sick, then get VERY sick because they go untreated for too long and get hugely expensive illnesses because of it. That small group of people are the ones who drive the costs through the roof. If even a few of that small group were covered and get preventative care before a chronic condition sets in, it reduces the overall costs significantly for everyone.

    Someone mentioned it earlier – the tragedy of the commons. In this case, the “commons” are affordable healthcare. The insurance companies can’t make uncovered people get covered, yet they get stuck with the huge costs when those preventable conditions go horribly wrong. The companies then in turn raise rates and start denying the covered people more frequently. The commons are stripped bare of reasonable coverage for the majority of normal people that get regular checkups.

    The current system is broken. How do we fix it? How do we continue to attract doctors to the field but control their billing and costs? How do we manage non-profit hospitals from raising rates to build new wings and expensive/unnecessary MRI machines all the time with the “non” profit they make off of patients? How do we keep the insurance companies from denying reasonable charges? How do we make our big government act in a responsible manner to be a single-payer system instead of the Medicaid/care hodgepodge that currently exists?

    There is no clear and simple answer. “Stop getting sick and breathing so much!!” However, getting all citizens to contribute skin into the game is step one. Step two would be making sure all people are getting comprehensive physicals on a regular basis to control costs for the other citizens. This all has an uncomfortable nanny-state ring to it, yet none of our vaunted free-market solutions have done anything to improve this growing problem.

  82. hollerhither says:

    @tinmanx:
    Don’t you think the doctor’s office was passing along the cost of the eyedrops from the pharmaceutical company?

    Really, the whole system is screwed up, but at least this is an attempt at a fix. The debate, or work, shouldn’t begin and end with the MA plan — but perhaps it’s going to inspire a few states to take a look at their own system.

    And BTW I am *not* a Romney fan whatsoever; but if he signed this bill to give himself successful political capital, and other politicians are similarly inspired to do so, fine by me.

  83. johnva says:

    @barty: Social Security is not supposed to be a savings plan. It’s more like insurance. You can’t compare it to investments fairly. However, it’s also incorrect to really call it a pyramid scheme. It’s mostly pay-as-you-go, and it will be even in the future. The taxes being paid by current workers pay for current retirees. The “trust fund” is only meant to cover the SHORTFALL in benefits created by the fact that a large generation was followed by a smaller generation. Not the whole cost. The trust fund is funded by the current excess taxation for SS and much of it is loaned to the federal government (though not all of it). What the Republicans are proposing is basically not paying back the trust fund for the money they borrowed from it to pay for wars, etc. They don’t want to pay it back because raising taxes to do it would mean higher income taxpayers would pay for the current wars in a delayed fashion. Instead, they want everyone receiving Social Security benefits to pay for the debt they are taking on instead of rich people in the form of reduced benefits. It all boils down to “tax the rich vs. tax the poor”. There is no Social Security crisis; there is a general budget crisis created by the fact that the general budget has borrowed money from SS.

  84. bustit22 says:

    @MercuryPDX:

    Mark Emery in Canada was suggesting the same thing. He said you get covered under Canada’s universal healthcare UNTIL the age of 70. After that you’re on your own.

    It has some merit to it.

  85. STrRedWolf says:

    I hear this is one of the reasons why folks won’t vote for Mitt Romney — he screwed up Mass. this way.

  86. hi says:

    so the poor people who can’t afford health insurance are going to be fined money for not being able to afford health insurance…? im confused. this will put poor people more in debt.

  87. gingerCE says:

    @MercuryPDX: Okay, I understand your point, but what is your price point? At 10K will you decide not to get treatment and die? Or at 25K? Or at 100K? At one point will you say it is too expensive and decide your life isn’t worth the cost to get treatment? What happens if you get into a car accident? Do you refuse treatment because of the cost?

    I know a 21 year old, quoted $600 a month for insurance because she has asthma. I know someone who was turned down for insurance because she once suffered depression for 2 months–another for diabetes. These are treatable diseases but they can’t get coverage.

    And I understand about your parents, but I wonder if the decision was theirs, would they choose to use insurance and try or just not get treatment. Even if the treatment didn’t work, at least they had the choice to try. And in some cases, believe it or not treatment works. My parents have had strokes and open heart surgery and both are thriving and doing really well. The health care they got they look at as their second chance and they now take care of themselves much better than they ever did before.

    Yes, your choice to have no coverage was taken away from you in Mass, but 99% of the people there, even those currently uninsured would take the chance for treatment if they became ill or were in an accident. This bill gives them that chance without bankrupting them.

  88. johnva says:

    @MercuryPDX: Well, that’s a nice attitude to have. Unfortunately most people don’t have the guts to go through with “just dying” if it actually happens. Instead, they go to the hospital and get treated and hope they can pay the bills later. Without insurance, they can’t, and so they end up bankrupt and the providers get stuck with the bill. Or they go deep into credit card debt to pay for their medical care. And there are plenty of conditions that might not kill you without care but would incapacitate you and prevent you from working.

    Seriously, I would look into some sort of HSA plan with very high deductible. I don’t know if you have or not, but you would remove a lot of your risk without paying nearly as much as for insurance with a lower deductible (yes, $400 is low) and would get some tax benefits too for your out-of-pocket expenses.

  89. bohemian says:

    Step 1: Mandate that every consumer in your state be required to buy a product.
    Step 2: Do absolutely nothing to assure the product even serves the intended purpose.
    Step 3: Do nothing to control the cost of the product.
    Step 4: Punish those who don’t comply.

    Fucking brilliant.
    It might have a shred of a chance of sort of working if they put some controls on both what can be charged and to qualify plans as being useful enough to even be called insurance. I have seen plenty of plans that have so many loopholes, deductibles and copayments that they are utterly useless. Nobody is going to even get their money back out of the plan so it is pure profit for the insurance company while pretending to be a solution to health care coverage.

  90. MsClear says:

    I live in MA and I’m generally supportive of the law. It’s not the single payer plan that I really want, but it’s something. It’s a step toward that happy day when I sincerely hope we’ll have a national health care plan in the US.

    My hubby and I bought coverage for him while he goes to B-school. It was better coverage than the PATHETIC “sickness and accident” plan offered by the school and much cheaper than the “family plan” at my employer, which is outrageously expensive. We got a decent plan that will cover catastrophic illness for $2K per year. It also includes preventative health care services. Yes, we do have a deductible and coinsurance, but we are covered against disaster.

  91. MsClear says:

    And it’s a myth that the state has nothing to do with ensuring the plans are “affordable.” The state was involved with that process. At the beginning, insurance companies were floating $300 for a basic plan. Governor Patrick called a meeting and the prices came down. In MA, you cannot be turned down for coverage for having asthma or any other medical condition. And the insurance must meet certain standards.

  92. MercuryPDX says:

    @bustit22: I’m sure my one Great Aunt who died at 72 sucked up more health insurance dollars to spend the last two months bedridden in the hospital than I would use in two years.

  93. MercuryPDX says:

    @gingerCE: Okay, I understand your point, but what is your price point?

    That’s not something that can be decided on ahead of time. A lot is dependent on the situation, stage of life one is in, how much savings/assets one has.

    @johnva: Like I said earlier… hoping this freelance gig goes full time so I can have health insurance once again. Thank you for the HSA advice.

  94. johnva says:

    @MercuryPDX: I don’t know how old you are, whether you are married, etc but you can easily get $2,500 deductible HSA plans for about $50-$70 per month where I live. YMMV, of course. But I think that’s a pretty small price to pay for some measure of peace of mind and I wouldn’t hesitate to do it if I was unemployed or self-employed. Luckily I’m in a large group plan right now.

  95. Curiosity says:

    @johnva:

    To restate it for you I am arguing that despite the amount of your rhetoric, your argument as you present it is incomprehensible and seems to be dependent on overarching intentions rather than a logical well thought out cohesive argument based either on CLEAR social policy or economics.

    Of course insurance has the same problems – however it seems that your solution is exacerbating the problem and minimizing the benefits (which I assume is for the social policy espoused in the socialist idea of human capital).

  96. MYarms says:

    LOL next thing you know Mitt Romney will be forcing the country to become Mormons when he becomes president.

  97. johnva says:

    @curiosity: I don’t believe I was actually attempting to present a solution. I was just arguing that our current system is not acceptable.

  98. hollerhither says:

    @curiosity:
    Hmmm, actually seems to me that your argument/writing is “incomprehensible,” whatever your theory may be. I don’t know if you’ve been in academia too long, but plain English (lacking superciliousness) will get you a lot further:

    “To simplify this – unless there is a common goal (say a common defense) where individual interests cannot be served by individual investment, common investment to serve individualized gains leading to the stealing of resources and disaster if individuals have not expected the system to fail.”

    Read that to yourself a few more times?!

  99. mgyqmb says:

    Wow, $30,000 is the poverty level for an individual?

    I get by on 1/3rd of that (also in college for those inquiring minds). Does that qualify me for anything?

  100. johnva says:

    @hollerhither: Maybe I’m not making myself clear, but I’m just responding to what other people are saying. This isn’t the best forum to discuss something as complicated as the U.S. healthcare situation. It’s not exactly something that can be boiled down to short statements because it’s a huge mess and there are a lot of different problems with it. I’m not an expert on it by any means, but the more I read about it the more I’ve realized that there aren’t going to be any easy solutions.

  101. ideagirl says:

    @TomK: what you said…

  102. cableonesucks says:

    This makes me sick. If I don’t want health coverage then I don’t want it and I won’t pay for it. Who says I don’t have enough in the bank to fund it myself?

    Who are they to play God with my health and my life and my pocket book.

    This really makes me sick. No wonder the rest of the planet hates us.

  103. Martha_Jones says:

    I think it would make sense if healthcare was affordable. If we’re going to go down this road though we should just have standardized healthcare.

  104. Grrrrrrr, now with two buns made of bacon. says:

    Hello…Massachusetts? An individual making $30,000 a year or a couple making $40,000 isn’t exactly living the high life (especially anywhere within a 75 mile radius of Boston, where the cost of living is 2 or 3 times higher than almost anywhere except the Bay Area).

    Yeah..fine ‘em and make ‘em pay money they already don’t have because they can barely afford to make ends meet now.

    That’ll show ‘em!

    @mgyqmb: $30k a year doesn’t go very far when you have a mortgage and taxes to pay.

  105. goodkitty says:

    It’s amazing how every problem like this boils down to corruption and greed.

    The insurance companies want unlimited profits. The AMA wants doctors to remain a semi-godlike profession. The ambulance-chasing lawyers want to retire rich because someone didn’t clean a needle properly. The OHRP doesn’t want to rock the boat with standardized checklists for doctors, because they have gubbermint jobs. The pharma companies want to lock everyone into protected drugs forever.

    Forget healthcare laws, mortgage laws, privacy laws… come on people, lets fix US first. You know, you and me who will take advantage of anyone and everyone to get ahead a little more in the next 30 seconds. What in the world is going on? Was “Idiocracy” really that correct?

    Once we stop looking around every corner for scammers I think all of this stuff should get a lot easier. Is that possible or will human nature mean everyone must be forever nannied in every little thing?

  106. coren says:

    @mgyqmb: No, it’s triple the poverty level.

  107. coren says:

    Hoorah for legalized gambling!

  108. Trauma_Hound says:

    Another reason to vote for Ron Paul.

  109. Charles Duffy says:

    This is one of the big differences between Hillary’s plan and Obama’s — the former requires folks to buy insurance even if they don’t want it, while Obama’s plan offers low-cost, high-quality (government-sponsored) options, but doesn’t use force of law to force folks who don’t want to to sign on.

    Given the general consensus of .ma.us residents in this forum, I think Obama’s plan is much more likely to go over well with the public as a whole.

  110. barty says:

    @johnva: I’m aware of how SS works, but it doesn’t mean its not a scam on the people of this country. Basically it “insures” the stupid and ignorant against their own poor decisions…ie., not putting a dime away for retirement and/or treating whatever retirement savings they have as a way of paying off debt for crap they don’t NEED.

    If it really is a “pay as you go” system, then I want to stop paying. Give me MY money (it doesn’t belong to someone else, it sure of hell doesn’t belong to the government) and let me decide what to do with it and I’ll forgo whatever pittance I’ll receive at retirement based on what I’ve paid in now. Of course a politician can’t control the votes on the aforementioned irresponsible people in this country if they don’t confiscate my money.

    @mgyqmb: No, because the government still considers you dependent on your parents. Even IF you don’t trully get much from your parents (ie., you’re on scholarship and paying for everything else out of your own pocket) the government doesn’t give a crap. The sooner you learn that the government isn’t your friend if you work and are productive, the better.

  111. ltlbbynthn says:

    Why doesn’t Mass just give them health insurance?

  112. S-the-K says:

    Well, Mitt Romney won’t be getting my vote. He’s no different than the Democrats. They all believe in government-controlled Socialized medicine.

    If people want to spend their money on cell phones, iPods, HDTVs, luxury cars, “bling”, etc., instead of health insurance, then I say let them pay the penalty when they get sick. Before I had an employer-sponsored health insurance, I purchased my own health insurance in case something really bad happened.

    Of course, charging people for insurance when they can’t afford insurance sounds a lot like credit card companies charging overlimit and late fees to people who can’t afford their bills. :-)

    If you don’t qualify as “poor” and you choose not to buy insurance, you should have to pay MSRP like everyone else. Granted, MSRP looks grossly inflated to me, but hospitals have to recoup their costs from caring for “poor” people somehow.

  113. deVious says:

    @DojiStar: Well-said.

    I wonder if MA is taking steps to deal with the insurance company side of things as well – the need for change on their part is high to say the least. The value of health care is somewhat reduced when the primary goal of your insurance company is to limit the treatment you can receive as much as possible.

    And don’t get me started on the need in this country to start focusing on preventative medicine . . . I don’t want to think about how much money is being spent on adult onset diabetes brought on by obesity.

  114. BugMeNot2 says:

    MA has always had free care. I work in a hospital and see it every day. It’s called the “emergency room”. Every hospital has one and it doesn’t matter if you are an illegal immigrant, have no insurance or or don’t feel the need to pay for it.

    Read up before you comment. The insurance and benefits sponsored by MA are better then what I get from my employer. [www.mass.gov]

    It’s about time small businesses are forced to provide health insurance. Too many people on 1099 without health insurance.

  115. professorr says:

    What do the people of Massachusetts think up Chapter 58? We think that it is a huge sell out to the greedy insurance industry and that our legislature is a wholly own subsidary of the same! We think that Mitt Romney is a flaming idiot. We think that a lot of state politicians will be out of work come November 2008. I work for the Commonwealth, but they classify me as a freelance consultant and provide me (and thousands of others) with no benefits. So, the state won’t give us insurance as a perk of emplyment, but they will mandate that we buy it or be fined. Perhaps these idiots can try to cure homelessness next year by fining the indigent half the rent for the lowest priced apartment in their area.
    The whole thing is totally unsustainable since the price of coverage will be whatever insurers say it is and hundreds of thousands of citizens will bail on the system again. We will never solve the problem of health care access until we get the parasitic insurance companies out of the equation. The rest of the civilized world has found a way to provide access to all citizens. Are we stupid or just stubborn?

  116. MellowCat says:

    Insurance companies “must meet certain standards.” That sounds all warm and fuzzy, but what happens when they don’t?

    In Texas, as in most states, there are Departments of Insurance that oversee the insurance companies. The DOI usually assesses fines to non-compliant insurance companies, right? Well, isn’t it interesting that these insurance companies continually break laws and fail to meet the standards regardless of getting fined over and over. The fines are not enough to deter them from unethical behavior because they’ve got an assload of money to pay these fines. It’s more profitable to screw policyholders and doctors and pay the fines than to conduct business ethically and within the law. I truly believe the state DOI’s WANT the insurance companies to “slip up” because it’s a cash cow in fines for them. That is prolly where the “fines” in MA will end up, in some half-ass regulatory department slapping band-aids on everything to appear to be performing a function.

    I, too, worked in healthcare and think most folks can truly grasp just how corrupt insurance companies are. MA requiring residents to throw more money at them is just sickening.

    Uninsured people ARE funded by Insured people, no doubt. Illegal immigrants will clearly still get their free healthcare that you and I will have to pay for regardless. Even the copays and deductibles insured people are supposed to pay VERY OFTEN do not get paid. Nobody cares because the insurance company already got their money. Mark my words, the cost of insurance will not go down because “the risk is spread.” They will find a way to screw you.

    I agree that Medicare is the most efficient insurance “company” I’ve ever dealt with. Go figure. That type of deal would be my recommendation. Then if you want supplemental, go get it from a private company.

  117. FLConsumer says:

    The biggest problem I have with this idea is that it forces EVERY citizen to give money to private companies. Considering 30-40% of the healthcare costs in this country are to handle medical billing / insurance reimbursement overhead, I have a serious problem with this so-called plan.

    I have friends who work on both sides of the issue (hospital billing/collections and insurance company approval/reimbursement depts) and the stories I hear are enough to make a sane man cry in rage. The current healthcare system w//private insurance companies *IS* the problem. Forcing everyone to be a part of it isn’t even close to a solution, isn’t even a band-aid approach.

    As to what needs to be done… We need to literally throw out the existing system and start over. As much as I believe in preventative care and that access to health care is a fundamental right and obligation of a country/common human decency, I don’t want to see universal healthcare in this country. If the current system is corrupt beyond belief (including politicians who got bought off, incl. Romney), can you imagine how corrupt a 100% political/gov’t system would be?

    I don’t have any easy answers. Doctors in this country get paid far too much for how poorly their patients’ outcomes are (I say that being a med student), and the expenses incurred in healthcare are too high. Everything from the insurance overhead to malpractice insurance, to the cost of pharmaceuticals.

    I fear, ultimately, that the current healthcare system will never be fixed. They’ll just keep trying to patch the system, but no one has the cajones and teeth needed to truly overhaul the system.

  118. anns says:

    @lesbiansayswhat:

    It’s not about whether healthcare is “good” or “bad” for you. Of course it’s good for everyone to have good primary care, prevention, and disease management. But that’s not the point.

    It’s about the fact that people who don’t buy health insurance and don’t have the money to pay for treatment expect their hospital to treat them for free. If you call 911 with ten cents in your bank account and no insurance, the ambulance is required by law to take you to a hospital, and the ER is required to treat you.

    Who do you think pays for that? If you don’t want insurance, you ought to waive your right to free treatment. Save up for emergencies, or pay your insurance to do it for you — just take some responsibility for your own health.