Crit­i­cism con­tin­ues to poor in on the US Health Care pro­posal that has just been released from the Sen­ate Finance Committee.

Many of the reforms are based on the Health Care plan in Mass­a­chu­setts. Since enacted in the state, the gov­ern­ment has had trou­ble keep­ing up with the increas­ing prices for health care, espe­cially dur­ing the global reces­sion. In fact, some unin­tended effects of the plan have made it harder for the poor to receive health care. Crit­ics say that the prob­lem with the fed­eral reform bill is that is pat­terned after Mass­a­chu­setts plan.

From the IPS, Adri­enne Appel explains how the Mass­a­chu­setts plan has made it harder on the poor.

All the major plans in Con­gress are mir­rored after the reforms in Mass­a­chu­setts, includ­ing the require­ment that every­one pur­chase insur­ance at mar­ket rates — which grow yearly — or face a hefty fine. The fine is up to 1,000 dol­lars in Massachusetts.

“Once fail­ure to buy health insur­ance is a fed­eral offence, what’s next?” Steffie Wool­han­dler, a Har­vard physi­cian and mem­ber of Physi­cians for a National Health Pro­gramme, recently told a Con­gres­sional committee.

The Mass­a­chu­setts reforms were crafted three years ago by Repub­li­can Gov­er­nor Mitt Rom­ney, the ven­ture cap­i­tal­ist and pres­i­den­tial candidate.

“The Mass­a­chu­setts plan is not sus­tain­able. It con­tained no cost con­trol and raised no new rev­enues. We’re basi­cally just spend­ing money,” Ben­jamin Day, exec­u­tive direc­tor of Mass­Care, which cam­paigns for a single-payer sys­tem, told IPS.
…

The Mass­a­chu­setts reforms are attrac­tive to Con­gress because the state out­lawed abuses by insur­ers and cut in half the num­ber of peo­ple with­out insur­ance, mean­ing that 97.4 per­cent of res­i­dents were insured, the high­est per­cent­age of any state.

But, “Skimpy, over­priced cov­er­age like this left one in six Mass­a­chu­setts res­i­dents unable to pay their med­ical bills last year,” Wool­han­dler said.

The require­ment that all res­i­dents buy health insur­ance or be penalised is a cen­tre­piece of pro­pos­als being debated by Con­gress, though it has proved highly unpop­u­lar in Mass­a­chu­setts and sur­pris­ingly unsuccessful.

About 352,000 peo­ple in 2008 chose to be fined rather than pay 4,000 dol­lars or more per year for health insur­ance, accord­ing to fig­ures just released by the U.S. Census.

The Mass­a­chu­setts reforms were enacted two years ago to try to decrease the hun­dreds of thou­sands of peo­ple show­ing up at hos­pi­tal emer­gency rooms des­per­ate for health care and with no money to pay for it.

There was a sys­tem in place to cover this care, a tax on wealth­ier hos­pi­tals that was redis­trib­uted to poor hos­pi­tals that pro­vided most of this free care, and it was work­ing well. But the wealthy hos­pi­tals asked for reforms.

“The indi­vid­ual man­date is a huge boon for insur­ers. And hos­pi­tals got a huge rate increase,” Day said.

“Patients are not an organ­ised group and they had no voice, much less unin­sured peo­ple. It’s not quite the ideal polit­i­cal expe­ri­ence,” he said.

“We had a free care pool for the unin­sured and for many peo­ple it was bet­ter than what we have today,” Day added.

The poor now have to pur­chase drugs that pre­vi­ously were free, and pay every time they see a doc­tor or go to the hospital.

Poor peo­ple con­tinue to seek free care at hos­pi­tals and clin­ics, but under the reforms the hos­pi­tals are no longer com­pen­sated for this care. The clin­ics and hos­pi­tals are buck­ling under the stress, and have had to cut staff and programmes.

Boston Med­ical Cen­tre, which treats any­one regard­less of abil­ity to pay, is reim­bursed just 64 cents for every one dol­lar it spends, it says. It is suing the state as a last resort.

Health reform “should not and can­not be financed on the backs of the poor. We hope our suit serves as a cau­tion­ary tale to fed­eral pol­i­cy­mak­ers as they take up national health care reform,” said the hospital’s CEO, Elaine Ullian.

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