Obama’s Pass on Mass-Care

Michael Graham at the Boston Herald makes a good point. You never hear Obama (or Congress) discuss Massachusetts’ universal health care model (“Romneycare”) while touting the merits of Congress’ proposed health care bill because Romneycare has failed in several significant metrics that Congress’ proposed legislation is intended to remedy.

[Romneycare is] exploding the budget: Our “universal” health insurance scheme is already $47 million over budget for 2010. Romneycare will cost taxpayers more than $900 million next year alone.

It’s killing us on costs: Average Massachusetts premiums are the highest in the nation and rising. We also spend 27 percent more on health care services, per capita, than the national average. Those costs, contrary to what we were promised, have been going up faster here than nearly everywhere else.

It’s creating bizarre marketplace mutations: In Massachusetts, ObamaCare 1.0 is such a mess our governor is talking about imposing draconian price controls. He’s even suggested going to “capitation,” a system where doctors get a fixed amount of money per patient – and then that’s it. Which means it would become in your doctor’s financial interest never to see you again.

The percentage of uninsured Bay State residents has gone from around 6 percent to around 3 percent.

Moreover, this ReasonTV clip, which I’ve linked to several times points out that Romneycare denies nearly 24% of medical claims, compared to the 4-6% of claims Massachusetts’ private insurers deny.

Romneycare makes Gov. Daniels’ (R-In) plan look like a much better model. Specifics below:

[Healthy Indian Plan] is for uninsured Hoosier adults between the ages of 19-64. Parents or caretaker relatives of children in the Hoosier Healthwise program are likely candidates for HIP.

Eligibility Requirements:

1. Individuals must earn less than 200% of the federal poverty level (FPL). A single adult earning no more than $21,660 a year, or families of four earning approximately $44,000 likely meet the basic financial requirements.
2. Individuals must not have access to employer sponsored health insurance coverage, whether or not it is utilized by the individual.
3. Individuals must be uninsured for the previous six months.

Plan Structure

The Plan provides:

• A POWER Account valued at $1,100 per adult to pay for medical costs. Contributions to the account are made by the state and each participant (on a sliding scale based on ability to pay). No participant will pay more than 5% of his/her gross family income on the plan.
• A basic commercial benefits package once annual medical costs exceed $1,100.
• Coverage for free preventive services including annual exams, smoking cessation, and mammograms.

Why a POWER Account?

• POWER Accounts give participants a financial incentive to adopt healthy behaviors that keep them out of the doctor’s office. When they do seek health care, plan participants will seek price transparency so they can make value conscious decisions to better manage the funds in their account.

What Is Covered

• Services include: physician services, prescriptions, diagnostic exams, home health services, outpatient hospital, inpatient hospital, hospice, preventive services, family planning, and case and disease management
• Mental health coverage is similar to coverage for physical health, and includes substance abuse treatment, inpatient, outpatient, and drugs

Other Plan Specifics

• Sliding scale for individual contributions (based on % of gross family income):
  • 0-100% FPL: 2%
  • 100%-125% FPL: 3%
  • 125%-150% FPL: 4%
  • 150%-200% FPL: 4.5%- 5%*

* Caretaker relatives/ parental adults in this income bracket contribute 4.5%, and the childless adults contribute 5%.

• No co-pays except for ER use, which are based on a sliding scale and will never exceed $25 a visit.
• If all age and gender appropriate preventive services are completed, all (state and individual) remaining POWER Account funds will rollover to offset the following year’s contribution. If preventive services are not completed, only the individual’s prorated contribution (not the State’s) to the account rolls over.

It’s just absurd that at the ‘health summit’ last week no one stood on the desk and shouted: “Has anyone in the room wondered why the cost of [insert elective medical procedures such as botox, hair implants, laser eye surgery] drop every year due to demand for them spurring medical innovation [jump into tangent: "that means jobs, people"] that drops costs and creates a competitive fierce competition by doctors for consumer dollars?”

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Socio-Political, TV