New England Press News—commentary

Universal health coverage. On paper it looks good, but I take issue here with some of the assertions this Globe editorial makes, especially its assertion that money be pumped into the initiative only when absolutely necessary. We think this initiative needs far more money then the General Court will ever give to it, or else a bigger investment from business. Lacking either of those, we think this ambitious law will die before it even knows what happened to it.

There are major problems with mandating that every citizen in the Commonwealth obtain health insurance, under penalty of law, and then barring people from using the health clinics without having said insurance. When I first heard of the law, I was all for it…until I was actually required to pay for health insurance. The rub? The cost. The health insurance premiums weren’t priced to be within reach of the poorest individuals and families in the State. Prices are high here; an ever-increasing amount of cash goes for rent, food, utilities, and transportation…and lately, those costs have been going up at a rate that outpaces raises—if the person is lucky to get a raise (in my case, I got a 5% salary cut for going from full-time permanent to relief on my job). And I haven’t even gotten to clothing, laundry, dining out (which is so prevalent with our on-the-go constantly lifestyle, almost every American can say they ate out during this past year.). And for no small portion of the citizens of this State, the cost will continue to be a real deterrent for them to obtain health insurance. This law did not adequately address the cost to those poorest individuals here in Massachusetts. As written, this law will never cover them, because it demands payment from those who are near-poor: The ones who make above the official poverty level…but not rich enough to be able to pay for the health insurance. What makes this law so bad, in its present form? A cost is now imposed on those who cannot afford it, at penalty of paying the Department of Revenue half of what buying health insurance through the Commonwealth Connector would cost. That imposes an economic hardship on the poorest of the poor. Couple that with a nearly 10% rise in the premiums charged by Commonwealth Care, and it is a recipe for disaster for the poor in this State.

We think this law is no good, as it is written; perhaps because the coalition that formed this law put more of the responsibility of paying for health insurance on the individual…and not enough on either government or business. And that is precisely the problem…an intractable problem for the poor who do not make a living wage, which I’ll define as one that, once the taxes are paid, provide enough for a person to pay their rent or mortgage, pay for essentials such as heat and other utilities (including the phone and high-speed Internet), and transportation, be it for subway/commuter rail passes, or gas, insurance, and maintenance for the family car. We also think that universal health coverage is something that has been long, long overdue—not only in Massachusetts, but throughout the Nation. We propose that anyone—individual or family—making less then $40,000.00 a year ought to be entitled to obtain free health insurance from Commonwealth Care. We concede that even that might not be totally acceptable for every individual or family…but it would be a better position then those poor have now. The additional burden of paying for health insurance will bring people to the breaking point financially. And that’s not acceptable for individuals and families who presently must chose between what expenses they will or will not pay, with respect to necessities. Pay the insurance…or the rent. As things currently stand, if you fall ill and do not have health insurance—because you can’t afford even the cheapest health insurance offered by the Commonwealth—you can’t see the doctor in the clinic you have been using. I am in that position now, and it’s dangerous for me, having high blood pressure. I don’t have to worry, if I get the same treatment in the hospital, as I did just a few days ago. But, as the experts will tell you, it’s not a cost-effective way to spend health care dollars. All agree that it is better to finance the trip to the clinic, then it is to have the uninsured person go off to the hospital when he is sicker, and it’s more difficult to treat their ailment.

We think there is something fundamentally wrong with a law that prevents individuals who are sick from going to their doctors, in their own health clinics. We think the other, more sensible solution, is to fully fund the neighborhood clinics, and then allow them to see everyone within the community, without charge—regardless of the person’s ability to pay for his or her own health insurance (which we think ought to then be provided without charge for those making less then that $40,000.00 a year mentioned above). That encourages people to see their doctor, rather then waiting for an expensive condition to rear its ugly head, putting the person in the hospital and costing all parties much more to cure then it would have been to either prevent or treat early, when the problem was still small.