or subscribe to our
Twitter service


Undernews is the online report of the Progressive Review, edited by Sam Smith, who covered Washington during all or part of ten of America's presidencies and who has edited alternative journals since 1964. The Review, which has been on the web since 1995, is now published from Freeport, Maine. We get over 5 million article visits a year. See for full contents of our site

March 3, 2009


Suzanne L. King, Boston Globe - Massachusetts has been lauded for its healthcare reform, but the program is a failure. Created solely to achieve universal insurance coverage, the plan does not even begin to address the other essential components of a successful healthcare system.

What would such a system provide? The prestigious Institute of Medicine, part of the National Academy of Sciences, has defined five criteria for healthcare reform. Coverage should be: universal, not tied to a job, affordable for individuals and families, affordable for society, and it should provide access to high-quality care for everyone.

The state's plan flunks on all counts.

First, it has not achieved universal healthcare, although the reform has been a boon to the private insurance industry. The state has more than 200,000 without coverage, and the count can only go up with rising unemployment.

Second, the reform does not address the problem of insurance being connected to jobs. For individuals, this means their insurance is not continuous if they change or lose jobs. For employers, especially small businesses, health insurance is an expense they can ill afford.

Third, the program is not affordable for many individuals and families. For middle-income people not qualifying for state-subsidized health insurance, costs are too high for even skimpy coverage. For an individual earning $31,213, the cheapest plan can cost $9,872 in premiums and out-of-pocket payments. Low-income residents, previously eligible for free care, have insurance policies requiring unaffordable copayments for office visits and medications.

Fourth, the costs of the reform for the state have been formidable. Spending for the Commonwealth Care subsidized program has doubled, from $630 million in 2007 to an estimated $1.3 billion for 2009, which is not sustainable.

Fifth, reform does not assure access to care. High-deductible plans that have additional out-of-pocket expenses can result in many people not using their insurance when they are sick. . .

Access to care is also affected by the uneven distribution of healthcare dollars between primary and specialty care, and between community hospitals and tertiary care hospitals. Partners HealthCare, which includes two major tertiary care hospitals in Boston, was able to negotiate a secret agreement with Blue Cross Blue Shield of Massachusetts to be paid 30 percent more for their services than other providers in the state, contributing to an increase in healthcare costs for Massachusetts, which are already the highest per person in the world. Agreements that tilt spending toward tertiary care threaten the viability of community hospitals and health centers that provide a safety net for the uninsured and underinsured.

There is, though, one US model of healthcare that meets the Institute of Medicine criteria: Medicare. Insuring everyone over 65, Medicare achieves universal coverage and access to care, is not tied to a job, and is affordable for individuals and the country. Medicare simplifies the administration of healthcare dollars, thereby saving money. We need to improve Medicare, and expand this program to include everyone.

A bill before Congress, the United States National Health Insurance Act, would provide more comprehensive coverage for all. The bill includes doctor, hospital, long-term, mental health, dental, and vision care, prescription drugs, and medical supplies, with no premiums, copayments, or deductibles.


Anonymous Anonymous said...

Of course its a'failure.'
You can't make 'universal' health care work in a single state, any more than you could make an efficient public service such as public schools work for a single neighborhood.
All the failures are cost-related - they neglected to get the insurance brokers out of the picture.
The "more than 200,000 without coverage" is NOT a failure, however.
That is barely 3% of the population of Massachusetts - here in New Mexico we have 23% with out health 'coverage.'
Who's the bigger failure?

March 4, 2009 7:09 AM  
Anonymous wellbasically said...

Why don't you form a company that offers insurance coverage without all the bureaucracy for a lot less money and maybe it will be really profitable and take over?

March 4, 2009 5:06 PM  
Anonymous Anonymous said...

GingrichCare is a failure; it's the MA system that forces people to buy insurance at gunpoint, with private insurers to have free rein in denying care and pricing it out of the reach of people. Single-payer healthcare is a much more efficient plan. If someone else goes w/o healthcare, it can affect you.

For instance:

+ Someone gets tuberculosis, but can't afford a doctor. They work with food, and expose people -- maybe your family -- every day to TB.

+ Someone's been diagnosed with a seizure disorder, but they can't afford continuing to go to the doctor, or afford their meds. They continue driving to their job, to their child's school, to the grocery store, etc. They have a seizure behind the wheel and take not only themselves out, but another car full of a family that they plowed into.

+ American businesses will never be competitive with businesses in other countries as long as healthcare is not a basic human right here; it's getting too expensive due to the greedy HMOs/PPOs for many businesses to even offer healthcare bennies.

+ Many businesses get rid of -- or won't hire -- anyone over 35-40, due to the extremely high healthcare insurance costs. That's a lot of people who are being idled -- who could be working -- in this economy.

+ Think of the many people who'd go into business for themselves, if healthcare was guaranteed. Many people are stuck in jobs they'd rather leave, but cannot as they must stay for the healthcare bennies. That makes them virtually slaves, and too many businesses have no problem with that.

March 21, 2009 12:43 PM  
Anonymous Anonymous said...

What we need is the same healthcare system that helps Bush and Cheney and Paul and Feingold be extended to the rest of us. That would be the easiest way to do it. That and have the taxes on those that earn more than $108,000 to pay their fair share of Social Security and other taxes to even out the payments for all. Less bureaucracy so less paper work and with easy access we will need more doctors so the AMA needs to be relieved of their idea of rationing doctors for us.

Less anxiety will also help everyone's overall health too. Health will go up as costs go down. A good thing indeed.

March 21, 2009 5:20 PM  
Blogger JusticePrevails said...

I am opposed to any type of National Healthcare Program being proposed by our Congress and President. It is just too costly for the American people. If it goes through, then I think every American citizen should demand that the healthcare plan offered and used by the Senators, Congressmen, President, and all federal government workers be scrapped and they should all be mandated to participate in the same mediocre healthcare plan they are mandating the rest of us to accept. Those elected by the people have had it too easy for too long. It’s time that we, the people, take back our government and make them accountable for what they do to the rest of us. Those who receive preferential treatment and care should not have the right to dictate to the rest of us what we should do without them having to do it themselves.

June 22, 2009 6:53 AM  
Anonymous Anonymous said...

we need to cut Medicare and start a universal insurance program...the future lies in illegal aliens and we need to make sure they are healthy...

December 7, 2009 1:09 PM  
Anonymous Anonymous said...

end Medicare....the health of illegal aliens is far more important

December 7, 2009 1:10 PM  

Post a Comment

<< Home