Tuesday, December 25, 2007

NY Times Gets it Right/Wrong on Massachusetts Plan

Merry Christmas!

As I wrote on my EONS.com blog last week in my letter to Santa, affordable health care tops my Christmas wish list this year. The article from today's NY Times (12/25/07) highlights the fact that many states have failed to alter or expand their health insurance plans, although California appears on the verge of a major breakthrough. It mentions the Massachusetts plan that former Gov. Mitt Romney is touting on the campaign trail and mentions the issues with funding the plan that are cropping up.

But, again, the NY Times missed out because the real problem with that plan is that it ignores the needs of self-employed people who actually are above the poverty line. And all the data on employment shows that the self-employed category, which includes virtual company owners, is one of the fastest-growing sectors of the United States economy, if not THE fastest growing.

The Times piece is excerpted below. On top I've enclosed my satirical look at this issue that I posted on my EONS blog last week. For the full entry go to EONS.com and join the Building a Virtual Company group OR find me on the home page through the PEOPLE/EXPERTS link:

1) AFFORDABLE HEALTH CARE: Where do I begin Santa? I mean, I’m really lucky to have health insurance because I don’t have chronic ailments and I can get coverage. But, really, do I need to be paying almost $550 out of pocket each month for a HMO plan and dental insurance. I know the IRS may give me back a deduction for health insurance. But even so, it bites.

And please don’t tell me I’m lucky to be living in Massachusetts where everyone has health insurance, right?

Our former governor – the one named Mitt (like the glove) who is running for president – makes it sound like this plan he signed into law is working great. Well, Santa, consider the fact that for someone like me – one of the thousands of self-employed in the state and part of a growing part of the work force – all this plan does is penalize me if I don’t buy health insurance. The only way I benefit, if you could call this benefiting, is to earn less than $30,636 a year. Now if you call that benefiting you’re living on another planet, Santa, because I could barely survive with a teenage girl on that amount (though, yes, some people do).

I don’t know the answer to this health insurance mess, Santa, but maybe you, Prancer and Dancer could convene a summit and figure something out, OK? If I could be paying half of what I do each month I could afford better cookies for you when you come next year.

Health Care Expansions Hit Roadblocks

Published: December 25, 2007

SACRAMENTO — A year that began with great ambition for major expansions of health insurance here and in other state capitals is ending with considerable uncertainty, as a second wave of change runs headlong into a darkening economy and political divisions over how to apportion the cost.

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Rich Pedroncelli/Associated Press

Arnold Schwarzenegger, left, and Fabian Núñez drew up a blueprint for bringing near-universal coverage to California.

Though the governors of three big states — California, Illinois and Pennsylvania — proposed sweeping plans to restructure health care this year, none will finish 2007 with bills passed and signed. In each state, the initiatives confronted entrenched opposition from insurance and other business lobbies that made it far more difficult to build a consensus for change than in the smaller New England states that acted in recent years.

Yet it also was a year of intriguing achievement, here above all, where the Republican governor, Arnold Schwarzenegger, and the Democratic Assembly speaker, Fabian Núñez, drew up a bipartisan blueprint for bringing near-universal coverage to the country’s most populous state.

Mr. Schwarzenegger and Mr. Núñez have yet to close the deal by gaining the support of the State Senate. But they demonstrated in their yearlong negotiations that a consensus on basic principles could be reached, perhaps setting a template for other states and for Washington.

“It’s significant that what they’ve been talking about in California is similar to what many of the leading Democratic presidential candidates are talking about as well,” said Larry Levitt, vice president of the Kaiser Family Foundation, which researches health care issues. “There seems to be some convergence at least on the part of those supporting universal health care on how to get there.”

In addition to being the most populous state, California has among the country’s highest proportions of uninsured residents, about 20 percent. Indeed, there are more uninsured in California than there are total residents of Massachusetts, Maine or Vermont, the states that have set the pace for overhauling health care. Success here, therefore, would send a signal that such plans could be enacted in states with the heaviest burdens.

The Schwarzenegger-Núñez plan, which passed the Democratic-controlled Assembly last week, expands on the universal coverage law that Massachusetts passed in 2006. That state now requires insurance companies to offer coverage regardless of an applicant’s health status and mandates that most residents have insurance by Dec. 31, or face a tax penalty of $219.

State officials project that more than 300,000 previously uninsured people will sign up in time, a third of them in a surge over the last month. That has put Massachusetts more than halfway to its goal of insuring everyone.

The downside, and one noted by states with widening budget gaps, is that the program is expected to exceed its first-year budget by at least $150 million. And state officials are struggling to prevent double-digit premium increases next year.

Whether the momentum that began with State of the State addresses last January will continue into 2008 is not clear. It had been widely felt by health reform advocates that this nonelection year provided the best political climate for change.

Now the focus may shift to the presidential campaign, where the leading candidates for the Democratic nomination have each proposed major overhauls. Some state leaders may be tempted to wait out the year to gauge whether the next president will push for a national health plan that might subsume state efforts.

The essential problem, meanwhile, continues to worsen. The Census Bureau reported that the number of uninsured grew to 47 million in 2006, a one-year increase of 2.2 million. The share of United States residents who had employer-based coverage dropped to 60 percent from 64 percent in 2000, according to the Economic Policy Institute, a liberal research group. And though the rate of growth has slowed, the cost of employer-sponsored premiums still rose by 6.1 percent in 2007, more than double the inflation rate, according to the Kaiser Family Foundation.

Because of its national influence, California will continue to command attention as Mr. Schwarzenegger and Mr. Núñez try to bring along the Senate president pro tem, Don Perata, a Democrat. While supportive of universal coverage, Mr. Perata has said he is concerned about the plan’s $14.4 billion price tag when the state faces a budget gap of commensurate size.

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