HEALTHCARE SYSTEM in Massachussets? (Boston, Harvard: health insurance, home, purchase)

[Tiger Beer]

Is this system working well for all in Massachussets? I heard there is some kind of state coverage?

[skytrekker]

I think Massachusetts has mandated that all adults over 18 must obtain health care insurance- or face some kind of penalty-perhaps others could make this clear.

The state has several companies to apply for coverage- I believe your ability to pay- will be on a sliding scale- those households with lower incomes will be heavily subsidized.

Connecticut has a new Program called the Charter Oak Program- although not mandated- the income guidelines are the same

here is the CT program income guidelines coh: Qualifying for Reduced Premiums

[AngelEyez02403]

The MA health care mandate is working for some but not for the people it was supposed to "help". The law requires that each individual purchase health insurance. There is an out of it would cause a family/individual to choose between health insurance and adequate shelter, food, or clothing. These individuals must file with the state and be approved.

Most people receive insurance through their employers. College students (like myself) have been required to have health insurance to attend school in the state for decades. If a student is no longer covered under their parent's plan, then usually the university offers their own health insurance program.

There is the MassHealth program which offers free care - you have to be a MA resident to receive it and be below a certain income level. I believe it's fairly easy to get on---I know a number of people who have been on it for a year or so while in between insurance, jobs, schools, etc.

For young adults (ages 18-25) who are no longer covered under their parent's plan, there are specialized plans through Commonwealth Care. They offer less coverage, but are "affordable" to students and young professionals. However, you are not eligible for commonwealth care until 6 months after you are off your parent's plan---and you are penalized in the meantime.

There are other plans through Harvard Pilgrim, Blue Cross, etc. They all vary re: premiums, co-pays, deductibles, etc.

I personally think the mandate is ridiculous since the same people who were uninsured or underinsured before are still underinsured and broke.

[Tiger Beer]

I wonder if anyone ever talks about getting rid of the healthcare insurance industry altogether, and we could just pay for all healthcare at costs.

Here in japan, my son was delivered and we had are own room and 5days of meals and board. The at cost total for that was $2,000. I can't imagine the cost of that in the u.s. without insurance within the current inflated costs for healthcare systems.

[lukyelle]

Originally Posted by Tiger Beer

I wonder if anyone ever talks about getting rid of the healthcare insurance industry altogether, and we could just pay for all healthcare at costs.

Here in japan, my son was delivered and we had are own room and 5days of meals and board. The at cost total for that was $2,000. I can't imagine the cost of that in the u.s. without insurance within the current inflated costs for healthcare systems.

Yes, here in the US that'd be more in the ballpark of $200,000 probably.

One thing that is great about Massachusetts is the quality of healthcare available here (that is if you can afford it, and/or have a good insurance program). I'm fortunate enough to have insurance through my employer and pay a bit extra for a program that let's me choose to see specialists w/o a PCP authorization. The choices here in the Boston area in terms of doctors and clinics are just amazing. Not to say there are amazing doctors and clinics in other parts of the country, but the concentration here of top-notch help is, I believe, in a league of its own.

[heather3]

Originally Posted by lukyelle

Yes, here in the US that'd be more in the ballpark of $200,000 probably.

One thing that is great about Massachusetts is the quality of healthcare available here (that is if you can afford it, and/or have a good insurance program). I'm fortunate enough to have insurance through my employer and pay a bit extra for a program that let's me choose to see specialists w/o a PCP authorization. The choices here in the Boston area in terms of doctors and clinics are just amazing. Not to say there are amazing doctors and clinics in other parts of the country, but the concentration here of top-notch help is, I believe, in a league of its own.

I stayed in the hospital for 5 days when I gave birth, via C-Section, and the cost was about $8000. That was 9 years ago, but I'm sure it wouldn't be $200K. My friend's son just had vascular reconstructive surgery at the Mayo Clinic and their total bill was $120K. So, $2K is a great deal to have the appropriate stay and a healthy baby boy!

[lukyelle]

Yes, 2K is definitely a good deal. I was just trying to make the point that if you pay 100% out-of-pocket for hospital care in the US, it's A LOT more. Or at least that's what I gather from stories I hear about people having to file bankruptcy due to medical bills due to lack of insurance. But $8000 for a 5-day stay and delivery of a baby, even 9 years ago, not as bad as I would've thought! Maybe our health care system isn't as bad as some make it out to be. I've always been fortunate enough to have insurance when I've needed major(ish) care, so I don't get a sense of what the full bill is, just the co-pay.

[dorazine]

The official mandate is all persons over 18 must have insurance or pay the 77 dollar a month fine when they do their state taxes. Depending on your income you can get MassHealth or another subsidized provider for as cheap as free.

As far as everyone else indicated the level and concentration is remarkable. I don't believe I have ever heard of a medical area of the magnitude of the Longwood Medical Area anywhere in the world.

[brightdoglover]

The Health Connector is the site for viewing the insurance options.
A friend of mine had graduated grad school and had no job. He got Commonwealth Care for nothing. There are various subsidized options relative to income.
Is the fine $77/month? I thought it was less, enough that someone wouldn't mind taking the hit if they don't want coverage.
I believe everyone's health insurance is quite high in Mass., anyway, and maybe more so because of the mandate, at least, that's what people tell me who belong to small business organizations (contractor, chiropracter).
My employer h.i. isn't free but it's good.
I hate that everyone is one divorce, one pink slip and one hurricane away from being uninsured. But yes, the care is terrific- not just because of the Harvard/Partners and other university schools and all, but because a lot of the people who learn in-town and at those famous places move out to the suburbs and make a great staff at community hospitals.

[Browsing Duo]

Here's a recent study in Science Daily article reporting a Harvard study that the MA health care reforms are working well.
US Health care: Massachusetts health-care reform increased access to care, particularly among disadvantaged

The Boston Globe did an exhaustive study in the last two months reflecting the same thing, but it's behind a paywall if you're not a subscriber. One thing I recall about the BG article was that employers in MA did not stop covering people, something that critics of any national plan are concerned about.

I moved to MA three years ago and easily got health insurance. In my old home state, New York, I had trouble getting insurance that was affordable because I was in my early sixties, though I was in excellent health. The MA premiums are but they I'm covered. The routine health care has been great. I had no trouble finding a good doctor and I'm out in Western MA. It's hard to believe all the screaming that's going on about developing a health care system where everyone is covered. MA should be proud of itself for getting this up and running and covering almost 100% of children and close to that percentage of adults. There's a lot more to be done in bringing down costs, which have always been very high here because of the world-class research hospitals.