Massachusetts Miracle

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AG looking into $16.4m severance

Blue Cross-Blue Shield payment to ex-CEO seen as extraordinary. Jeffrey
Krasner, Boston Globe, January 24, 2008 Attorney General Martha Coakley
is investigating the $16.4 million payment Blue Cross and Blue Shield
of Massachusetts made to William C. Van Faasen, the insurer's former
chairman and chief executive, who retired Jan. 1, according to a Blue
Cross-Blue Shield director and others with direct knowledge of the
probe. Coakley is also examining the new management structure at Blue
Cross-Blue Shield under which Cleve L. Killingsworth holds the
positions of chairman and chief executive. ... MA

Health insurance and its costly gaps

Joe Chabot, Waltham, Boston Globe, January 23, 2008 The frustration and
financial hardship caused by the insufficient private health insurance
coverage of Alison Bass's family is no surprise ("An underinsured kick in the groin,"
Op-ed, January 21). As a social worker in the Dana-Farber/Children's
Hospital Cancer Care program, I have witnessed these same problems with
increasing frequency over the past 10 years. Many private health
insurance plans are only adequate for routine care. ... MA

Health reform adds a form

State filers will see new tax document. Jack Dew, Berkshire Eagle,
January 23, 2008 Pittsfield - W-2, 1040, 1099. And now, HC. The
blizzard of tax forms is growing this year for every Massachusetts
filer, with Schedule HC joining the pile, asking whether you have
health insurance or not. The new form is part of the state's sweeping
health care reform, which includes a mandate that every Massachusetts
adult have health insurance if he or she can afford it. Tax filers with
private health insurance will have to fill out Schedule HC (for "health
care") with the name of their health insurance provider for 2007, their
member number and, if available, the federal identification number of
their health plan. ... MA

New therapy (sic) for old woes

Blue Cross measure aims to slow runaway costs, improve quality of
healthcare. Alice Dembner, Boston Globe, January 22, 2008
Massachusetts' dominant health insurer is proposing to overhaul the way
it pays doctors and hospitals, in what company officials said is an
attempt to slow runaway healthcare costs and improve the quality of
care. Blue Cross and Blue Shield of Massachusetts wants to stop paying
doctors and hospitals for each patient visit or treatment, a common
arrangement that most experts agree has led to unnecessary,
inefficient, and fragmented care that is sometimes harmful to patients.
... MA

Riding the mandate wave

Michael DeChiara, Community Partners, January 22, 2008 December was
intense ... this is the “take-away” from our Health Access Network
meetings in Amherst and Boston this month. Across the board, people
providing enrollment assistance in hospitals, community health centers
and community organizations were faced with a huge number of people
trying to get health insurance coverage before the December 31
deadline. John Bergeron from Hilltowns Community Health Center got the
prize for the latest request for assistance; he received several phone
messages on the evening of December 31 from people looking to comply
with the mandate. ... MA

An underinsured kick in the groin

Alison Bass, Boston Globe, January 21, 2008 The nearly 300,000
Massachusetts residents who signed up for health insurance under the
state's new initiative are in for a rude awakening. They may now have
some form of coverage, but many of them, even the very poor who used to
get free care, are going to be socked with steep medical bills. Welcome
to the shadowy world of underinsurance, where high premiums, copays,
deductibles, unexpected co-insurance charges, and skimpy coverage have
put the lie to the dream of health coverage for millions of Americans.
... MA

Health Reform’s Impact in One Community

Chip Joffe Halpern, Executive Director, Ecu-Health Care, North Adams,
and President of HCFA’s Board of Directors, January 19, 2008 Now that
we have a full-year plus of health reform implementation, it may be
helpful to examine the initial impact health reform is having on low
income uninsured residents in our rural community in western
Massachusetts. The primary access point for public health coverage in
the North Berkshire area is the non-profit organization, Ecu-Health
Care. Located in North Adams, we serve an eight-town area of 38,000
residents. In our area, we have been designated to provide outreach and
enrollment services for all of the public programs. ... Health

The Health-Care Debate

Romney championed a universal plan as governor. Will he be judged on
its success as a presidential candidate? Roxana Popescu, Newsweek,
January 17, 2008 At the Republican debate in New Hampshire earlier this
month, presidential hopeful Mitt Romney gave himself a gentle pat on
the back for the health-care system he helped create in Massachusetts.
"A lot of people have ideas about health care and improving health
care. We took the ideas and actually made them work," he said. At an
earlier stop on the campaign trail he called the plan "a good model for
other states." But at a Washington luncheon a few months earlier,
addressing supporters, Romney sounded less convinced ... The

Put docs before executives

Susanne L. King, MD, Berkshire Eagle, January 16, 2008

Lenox - Last week, The Berkshire Eagle published several articles about
the crisis in primary care in our county. This crisis should be of
concern to everyone because primary care is the bedrock of our health
care system. There is already a shortage of primary care doctors, and
those currently in practice in Berkshire County are having difficulty
recruiting new physicians to their practices. One-third of the existing
primary care doctors in the county will retire in the next 10 years. An
aging population has increased the need for primary care doctors, and
this makes the shortage even more dire.

Uninsured Massachusetts Consumer Who Cannot Afford Mandatory Purchase of Health Insurance Flies 3,000 Miles to Speak Out

Is Thrown Out Of Capitol By Speaker Núñez. Consumer Advocates Reported
For Misdemeanors in Clear Case of Selective Enforcement. Foundation for
Taxpayer and Consumer Rights, January 16, 2008 Sacramento - Speaker
Fabian Nunez directed the California Highway Patrol to prevent an
uninsured patient who traveled 3,000 to speak out against mandatory
insurance from telling his story in the Capitol rotunda Wednesday. The
Massachusetts consumer, Ron Norton, cannot afford to buy health
insurance under his home-state law requiring all residents to purchase
private insurance policies or face financial penalties. ... Uninsured

What do MassHealth and Commonwealth Care cover?

Community Partners, January 15, 2008 This chart, compiled by The
Massachusetts Law Reform Institute and Health Care for All, compares
the services provided by Commonwealth Care and each of the five main
types of direct MassHealth coverage. It reflects the minimum services
mandated by state regulations as well as additional services covered by
specific Commonwealth Care plans. Coverage differences exist between
the various MassHealth and Commonwealth Care plans. Commonwealth Care
members should pay special attention to which services, beyond the
mandated ones, their managed care organization covers. ... What

Doctors Give Massachusetts Health Reform a Failing Grade

Poor Early Outcomes Raise Red Flags, Only Private Insurers Profit.
Physicians for a National Health Program, January 14, 2008 Over 250
Massachusetts doctors have signed an open letter to the country warning
that the health reform model enacted by Massachusetts is failing and
that a single payer program is the only alternative. “It is urgent that
the rest of the country know that Massachusetts is a living laboratory
for the health care reforms being pushed in California and by the
Obama/Clinton/Edwards campaigns. Right now the Gov.
Romney/Massachusetts’ plan gets a failing grade on the ground,” said
Dr.Rachel Nardin, Assistant Professor of neurology at Harvard Medical
School. ... Doctors

The Power of Incrementalism

John McDonough, Executive Director, Health Care For All -
Massachusetts, January 14, 2008 I recall Schwarzenegger during his
early right-wing days as CA Governor decrying “economic girlie men” at
the 2004 Republican National Convention. Oftentimes, it seems like the
same sentiment is thrown at those of us who work hard for incremental
health system reform by folks seeking total system overhaul. We just
lack something – we don’t have the “manly” qualities of those who fight
for radical change. The chart below represents my counter-argument. ...
The

MA Proponent of Health Insurance Mandate Says "Mean" Penalties Needed To Force People to Buy Insurance

Perata Roadblock to CA Mandate Weakens After SEIU Contributes $450K to
Prop 93. Foundation for Taxpayer and Consumer Rights, January 11, 2008
Santa Monica, CA - Penalties must be "mean" or people will not be
compelled to buy health insurance under the Massachusetts mandatory
purchase law, according to a proponent of the law who also did the
financial projections for a similar plan pending in California. As
reported in the Boston Globe, Jonathan Gruber, a member of the
Massachusetts board responsible for implementing the plan, said, "The
mandate has to be enforced ... We need to think beyond what looks mean
and do what's right." ... MA

Health insurance penalties too low, panel official says

Says fees will not promote coverage. Alice Dembner, Boston Globe,
January 11, 2008 The penalties for Massachusetts residents who do not
obtain health insurance this year have been set too low to encourage
people to buy insurance, a member of an influential state panel said
yesterday. "The mandate has to be enforced," said Jonathan Gruber, a
director of the Commonwealth Health Insurance Connector Authority,
which oversees implementation of the state's health insurance
initiative. "We need to think beyond what looks mean and do what's
right." ... MA

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