A probably unwelcome thank you

[docorion]

I would like to take a moment, on the 5th anniversary of chapter 58 of the Acts of 2006 (better known as the Massachusetts health reform law) to thank some of the people responsible for making it happen. (Some of these are people I know personally, having interviewed them for a paper in graduate school. Some, like Mitt, I know only by reputation

Comments

[fj]

So how has this act changed healthcare in MA? Or health in general?

the problem is, it's more a health insurance law than a health *care* law

[quietann]

98% of people in MA have health insurance. It may not be *good* insurance, but it keeps at least a few out of the ER. (But our host here knows more about that than I do, as he is an ER doc.) It's at least somewhat easier for small businesses to get insurance, or subsidize their employees' individual policies

Re: the problem is, it's more a health insurance law than a health *care* law

[docorion]

Good point. The law changed none of the broken incentives; it pushed that work off on future legislatures, assuming there would continue to be gobs of money as the economy continued to boom. Um, yeah, that didn't work. Although it is possible that the economy put pressure on the health care system to become more efficient, and get the incentives right, that wouldn't have been present if we were still growing at whatever unrealistic percentage per year we were in 2006.

[docorion]

More (most) people have at least some form of insurance; all insurance must cover at least 3 PCP visits annually, and a raft of screening. If you don't have insurance because you can't afford it, filling out a (long, complex) form will often get it for you. If you don't, your costs are often underwritten by the state through a mechanism which in part involves a tax on people who refuse, for one reason or another, to purchase insurance (short form: if you cannot prove you had "credible coverage" for most of the year, you are subject to a tax penalty which is based on the cheapest form of insurance you could have purchased had you chosen to do so) and in part involves a tax on businesses which do not provide coverage despite the law requiring they do so (and the rest involves spending state general revenue, but honestly it isn't that much

[likethewatch]

Is there really debate on why women consume more health care? I would think the answer is obviously that their reproductive health is more complicated than men's.

[docorion]

Well, that's a factor, but even if you control for that, women consume more health care. Women visit doctors more often, get more tests and procedures, and are prescribed more pharmaceuticals, than men, across the spectrum of disease. Until recently, insurance companies controlled for that by jacking up the premiums for women; chapter 58 put an end to that.