Universal health care took much of the stage throughout the summer. Debates were constant, and many people sat glued to their television screens watching the vote. The reforms that were implemented do several wonderful things. They extend the length of time children can be covered under their parents' plans (as a college student, this is something I will appreciate in the future), make it more difficult for insurance companies to drop expensive customers and remove lifetime caps on medical costs. Yet huge issues remain. People are kidding themselves if they think this reform will suddenly make everyone able to afford adequate health care.
In Massachusetts, we've led the way, signing health care reform into law in April 2006. Talk constantly centers on the availability of affordable options and the high coverage rate of 97 percent of Massachusetts residents. "Affordable" hangs in the air like some sort of lifeline, and Massachusetts deserves a lot of credit for making health care accessible to many people who wouldn't otherwise be able to afford it. In our haste to cover everyone, however, we're failing to look at the rope that lifeline is made of, and the avoidance of deeper concerns could have lasting effects.
Commonwealth Care, the program that offers low- to no-cost health insurance to Massachusetts residents who qualify, generously offers subsidized plans to those who earn up to 300 percent of the federal poverty level, making the cut-off income a little over $32,000. Once someone earns more than that, however, individual plans range from approximately $400 to $1,200 a month, which many consider unaffordable, especially compared with individual employer-sponsored plans, which typically range from $100-500 a month.
The current structure of the plans poses the threat of an ever-widening economic gap, even though that gap is precisely what health care reform attempts to close. The individual plans, as well as the subsidized plans, on average provide much less coverage than typical work-sponsored health care. Those who have a job without benefits, or without adequate benefits, are therefore put in a difficult position. If they don't have some form of health care, they risk Massachusetts tax penalties and unforeseen medical expenses. But if they do enroll in health plans, they pay a lot for not very much coverage.
Commonwealth Care offers three tiers of programs — bronze, silver and gold. Each tier has low, medium and high levels, with bronze being the lowest, most basic and most affordable option. The care offered, however, still leaves the door open for a substantial financial burden. Under the bronze benefits plan, for example, one must pay up to the annual deductible ($2,000) and then a 20 percent co-pay for an extended hospital stay. Since hospital bills for extended stays can run into hundreds of thousands of dollars, a 20 percent co-pay could lead to significant debt. The doctors and hospitals accepted by these plans — both unsubsidized and subsidized — are extremely limited. One of the "smaller network" plans specifically states that its doctors are limited for lower cost, even though it is more expensive than some of the other options.
The gold plans — geared toward those who expect a significant amount of medical coverage or who want (and can afford) to be more than adequately covered, should the need arise — clearly show the inequalities that still exist. For extended hospital stays under the gold plans, the cost to the patient is a $150 copay — nothing else. According to a report published in October 2009 by America's Health Insurance Plans, the average insurance premium for an individual is $2,985, which comes out to around $250 per month. None of the individual plans offered in Massachusetts through Commonwealth Choice even comes close to that. The least expensive plan was slightly over $400 as of Oct. 1.
No easy solution exists. But these are issues that need to be talked about, not swept under the rug. People are being unfairly penalized for working at a job that either does not offer benefits or can only offer them in conjunction with Massachusetts Commonwealth Choice. The people who need to pay more for health care are the people who are already earning less money. They are the ones who cannot afford sick days, so when they are unhealthy, they need the most support. Instead, they often receive the least.
Our current health care system still needs to be changed significantly.
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Melissa Weigand is a junior majoring in English.
