With Chapter 58 and health care reform, Massachusetts’ leaders proclaimed that the state was committed to most of its residents getting health coverage. It is a hard thing to achieve, even harder to sustain. In government, there is often a big push for the "flavor of the day," but then attention turns and initiatives fade away. This is one of the risks we face with health coverage in Massachusetts.
On Monday, June 30, the "mini-grants" to community organizations that help people get and keep health insurance ended... again. This has been an almost annual occurrence since 1998. While some of these groups have been allowed to use the money they have until August, by September 1, all state money that supports these 40+ organizations will be gone. If the Commonwealth is serious about our collective commitment to provide health coverage, this system must change.
There is clear data and compelling evidence reaching back to 1998 that shows that community outreach and enrollment assistance makes a huge difference in getting and keeping coverage. Real people don’t enroll in health care by simply calling an 800 number; first they gather information from trusted sources; frequently they seek out local expertise.
And keeping coverage is harder – it requires filling out forms that health policy experts can’t even understand. The need for local, trusted experts is true for people in communities throughout the state – from North Adams to Chatham, Uxbridge to Salem; for the past ten years people have sought help locally. This is because health care is especially complex, and our need for it exposes our greatest vulnerabilities. At last count, there were 152 different publicly funded coverage options available to people. Knowing what is offered, whether you are eligible and how to STAY enrolled is something hardly anyone can do alone.
Before the public spotlight moves on from health care to the next great initiative of the day, state leaders would be smart to implement a sustainable approach that respects and integrates the vital role of community organizations in solving the health coverage crisis. Local groups, community health centers and community hospitals are responsible for many of the newly 340,000 people being enrolled in coverage. Almost certainly, without them, many of these people will soon begin to fall out of coverage when their annual re-determination of eligibility occurs. Bottom line: the state NEEDS community groups to succeed.
Community enrollment assistance must be integrated into the overall plan for health coverage in Massachusetts. The public discussion must shift: instead of asking whether to fund community groups, we need to ask how to fund them, and make sure people have the community support they need. No initiative can succeed with funding constantly stopping and starting; staff being hired, gaining expertise and then being laid off, to be eventually replaced again. The job of the Commonwealth is not done until we provide lasting support for people where they seek help – in their communities and local institutions. January 2009’s legislative session is the time to begin.
Massachusetts healthcare law/mess
I cannot understand how the lawmakers can decide who gets health care and who doesn't.When the State passed chapter 58 I was so happy to be able to "afford" insurance.When my husband retired we lost our health insurance.The COBRA was $1000.00 a month.We could not afford that.I found out quickly that the state insurance wasn't much better,the lowest plan for me was $410.00 a month with a $2000.00 deductable.This amount is impossible on a retirement income.I called my Senator,I called Governor Patrick repeatedly to be told "too bad insurance is exspensive."They make a law that forces residents to buy into bad insurance products.This is not Health Reform.The fact is the poor get health care,the wealthy get health care but not the people in the middle.They should call this the Shame Law.(now I found out the $410.00 plan is going up to $610.00 a month.This looks like a "Bait and switch"to me.
Helping, or propping up a broken, harmful system?
Readers here may not know, but the mainstream media has been ignoring many thoughtful Letters to the Editor that point out problems with the state's mandatory insurance law. Until last Sunday when they printed one in the Business section on this very issue of outreach grants. I don't enjoy raining on anyone's parade but I offer this LTE here b/c it's a sincere and important difference of opinion that deserves to be heard, along with the below article from an international newspaper about how the MA Mandated Insurance Law is hurting many state residents.
'Health reform' is hardly that 6/29/08 Globe Biz section
.. While the work of Rosman's group [Health Care For All MA] and the other 44 outreach nonprofits has been instrumental in getting state subsidized, commercial insurance for many thousands, the broader view shows that the inefficient, bureaucratic nonsystem that is "Massachusetts Health Reform" is a big, money wasting false promise. ...Extra layers of administration add to the already stunningly fragmented patchwork that is now the law of the land. A common sense use of our healthcare dollars should remove all middlemen, including nonprofit agencies and insurance companies alike. A national single payer heath system is the only solution."
Nancy E. McAvenia,Whitman MA
http://www.boston.com/business/articles/2008/06/29/fidelitys_inaction_speaks_volumes/
AND
In sickness and no wealth: costs hurt the middle class
Financial Times of London, July 1 2008
By Rebecca Knight in Boston
Kathryn Hunt, a college-educated former stay-at-home mother, and graphic designer Dianne Bridges, are among the army of middle-class Americans struggling to pay for healthcare.
Ms Hunthad a privileged upbringing and never imagined paying medical expenses would bring her to the brink of homelessness. "We were well off, I spent every summer at the country club," she says. "I was a rich, Christian Republican. Now I am a poor Democrat."
The Boston-based divorcee, who had coverage through her husband's employer before they parted in 2001, earns a wage low enough to qualify her for Commonwealth Care, Massachusetts' heavily subsidised health insurance plan. But Ms Hunt, who suffers from Type 1 diabetes, lives pay cheque to pay cheque to cover her numerous doctors' appointments and prescription medications.
"I had one doctor tell me I should leave the country," said Ms Hunt, a pharmacy technician earning $11 (€7, £5.50) an hour. " 'Can you get to Canada?' he asked. 'This country has forsaken you, and people like you.' "
Under the Commonwealth Care plan, Ms Hunt pays $110 a month for health insurance. But the array of drugs and procedures she requires and the limits on her coverage leave her with "co-payments" of about $165 a month. "I could not pay the premium without my church stepping in."...
http://www.ft.com/cms/s/0/1176c4b2-4708-11dd-876a-0000779fd2ac.html
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