Everyone should have access to health care. Massachusetts aims to achieve this goal with a double mandate: All residents must have health coverage (Section 12) and all employers with more than 10 workers must assume ultimate financial responsibility if employees or their immediate family members need expensive medical care and can't pay for it (Sections 32, 44).
What is the impact on individuals? The state will offer subsidies to help low income residents pay for coverage (Section 19), but most of the uninsured earn too much to be eligible. An individual making $29,000 or more would probably have to pay the full cost or find a job that provides health insurance. Individual coverage costs about $3,600 in Massachusetts -- a hefty bill. Moreover, under the new law, individuals purchasing their own insurance must buy HMO policies. Preferred provider plans (PPOs) -- which give you more ability to choose your own doctors and treatments -- are not allowed (Section 65).
The impact of this law on employers is substantial. The original bill required employers with more than 10 full-time workers to provide all of them (and their families) with health insurance or to opt out of that requirement by paying a $295 annual tax per worker into a state fund. This modest penalty was highly publicized by the bill's supporters as proof that the bill would not be a heavy burden on businesses. Nevertheless, Gov. Romney vetoed it, perhaps to display his Republican credentials as a tax-cutter.
The Massachusetts House of Representatives overrode the veto -- but the reality is that the $295 penalty is small potatoes compared with the other obligations in the law. Say, for example, you open a restaurant and don't provide health coverage. If the chef's spouse or child is rushed to the hospital and can't pay because they don't have insurance, you -- the employer -- are responsible for up to 100% of the cost of that medical care. There is no cap on your obligation. Once the costs reach $50,000, the state will start billing you and fine you $5,000 a week for every week you are late in filling out the paperwork on your uncovered employees (Section 44). These provisions are onerous enough to motivate the owners of small businesses to limit their full-time workforce to 10 people, or even to lay employees off.
This part made me gag.
What else is surprising about this new law? Union shops are exempt (Section 32).
Yup. Gotta pander to those union lobbyists.
As I've said before, this health care scheme does absolutely nothing to alleviate the true problem with health care, which is the high cost of health care. In fact, it goes a long way toward perpetuating the problem by forcing individuals and businesses in Mass. to lock into the system of insurance that caused the sky-high health care prices in the first place.
Health care is expensive - at least, more expensive than it needs to be - because almost no one in this country is personally responsible for paying their own medical bills. Yeah, we all pay insurance premiums and co-pays...but that is but a minor fraction of overall medical costs. The brunt of those costs fall on insurance companies, and because of that very few citizens spend any time at all considering what they could do to save money when they visit the doctor.
We are not personally responsible for paying the majority of our medical bills, so we sort of don't care (at least not in a direct way) just how high those bills are. Nobody spends any time shopping around for good deals on health care. Not that we really could anyway in the current health care environment. Health insurance and medical entitlements like Medicare have become so monolithic that competition between health care providers is almost non-existent. Sure doctors and hospitals need to compete with one another as far as providing the patient with decent facilities and adequate service goes, but what reasons do they have to compete with one another over costs? They don't have any reason because most Americans don't care what their doctor visit costs. Most of them just go to whatever doctor/hospital is near by and convenient so that those who actually do want to "shop around" are usually left with few chocies.
No one goes to a certain hospital because that hospital charges less for Tylenol and bandages. When it comes to health care most of us are like children turned loose in a candy store. We get what we want with no concern about cost and we usually take more than we need.
That has got to change because no entity, be it a business or even the government itself, can afford to provide unlimitied quantities of something (health care, in this instance) on a finite budget. It just won't work, and yet that is the pipe dream people like Romney and other supporters of state-mandated or state-backed health care want us to believe.
Collectivist attitudes on health care are dragging this country under. It is not fair to hold citizens responsible for the health choices of their neighbors. Health care must be made an individual responsibility. Doing so would raise the quality of care receive while reducing the cost.
But don't let the nanny-state, socialized medicine folks in on that little secret.