Chapter 58 of the Acts of 2006 ensures that a system of healthcare exists within the Commonwealth which is close to our goal of a "Universal Healthcare System" - a significant benefit, and a right of all citizens: to have affordable, dependable access to healthcare.
Under this act, all residents are required to purchase health insurance coverage if it is affordable to them. Many employees receive coverage either directly through an employer, or indirectly through the MA Health Connector - a clearinghouse for insurance plans and payment options. Others, who fall below the level of income at which insurance purchase is considered "affordable," are then eligble through a free public plan.
This has brough the rate of uninsured residents to the national low - well under 3%. However, there is considerable opportunity for growth and improvement. The current system is providing too great a profit margin for insurance companies, while keeping the income benchmark for affordability too low. In so doing, the system becomes cost-prohibitive to those it is seeking to aid. Today, while the number of citizens without access to insurance is at an all-time low, the number without access to care is soaring.
In the coming months, Massachusetts has some decisions to make in enacting further reform. A set of fiscal crises at both the local, personal level and within big business and banking has crippled the economy. MA residents are facing increased healthcare costs, steadily rising - among the highest in the world! - and decreased quality and accessibility of care. The Commonwealth's plan is well-founded, and well-supported. However, it has been poorly-enacted and is poorly-regulated.
An opportunity exists to build a system whereby citizens can afford solid coverage, still in a tiered market format, the Commonwealth can keep uninsured numbers low at little cost to the budget, and the insurers even have the ability to turn a profit on higher-tiered plans while offering strong coverage for no profit. This would apply only to necessary healthcare treatment, and all homeopathic and alternative medicines would provide inroads to additional profit activity. Suggestions for such a plan may include:
- single-payer system - wherein the Commonwealth or a public agency acts as intermediary in accepting payments from consumers and issuing payments to insurers and providers.
- standardized basic benefits - a higher level of minimum care standards to be included in a low-tier plan, without cutting basic and common needs of patients and services of providers.
- highly regulated insurance market - forcing insurers to comply with strict guidelines for lowest and graduated levels of coverage and cost. Basic benefits at minimal cost must be accessible to all consumers without discretion.
- expansion of 'affordability' definition - to include additional out-of-pocket costs, which could significantly impact overall cost of care. Additional costs considerations could include co-payments and insurance deductibles.