Friday, May 8, 2009
The Columbia Journalism Review has another great update on the Massachusetts Health Reform and whether it appears to be working to provide access to health care. It may not be as successful as some in the press have reported. Trudy Lieberman writes,
. . . . Whatever residents think of the mandate and its tax penalty (this year about $1000), they have driven down the number of uninsured to roughly three percent of the population—the lowest rate of any state. And it has brought health care to people who didn’t have it before. “It’s easy to damn the whole thing, and I see the cracks,” says Meg Kroeplin, who heads Community Partners, a non-profit group in Amherst that works with outreach workers who sign people up for insurance. “But I see a ton of people who were told their whole lives they can’t have it and now they do.” Of the 432,000 newly insured residents, 76,000 got coverage from Medicaid, 169,000 qualified for state subsidized coverage, 148,000 got it from their employers, and the rest bought individual policies.
The cracks Kroeplin sees, however, raise questions about whether a system that relies on private insurance and public coverage with strict eligibility requirements can ever achieve universality and bring seamless, timely care to everyone. “Is care seamless in Massachusetts?” Kroeplin asks rhetorically. “No, it is not.”
Some people who need care will always be left out. Because the building blocks of Massachusetts coverage are disjointed, people still seek treatment at the state’s safety net hospitals and emergency rooms, which wasn’t supposed to happen as people became insured. The Globe just reported that more people are seeking care in emergency rooms, and that the cost of treating them increased by 17 percent from 2005 to 2007, a period that includes two years covered by the law. The problem, it seems, is more complicated than simply mandating insurance coverage. . . .