Health care gets mixed prognosis

More than two years have passed since Massachusetts became the first state to mandate near-universal health care, and two studies evaluating the program thus far suggest the experiment has been met with mixed results.

One study published in Health Affairs, a health policy journal, analyzed public opinion on the law and the effectiveness of the mandate and found that the percentage of Massachusetts’ companies offering health insurance to their employees increased and that public support for the law remains high.

At the same time, the rising costs of providing insurance to all employees could decrease employers’ ability to meet their responsibility to provide health coverage, however, according to an Oct. 30 study by the Center for Studying Health System Change.

The Massachusetts health reform law makes near-universal health care possible in the state because the law requires employers with 11 or more workers to offer health insurance plans on a pre-tax basis to their employees.

The number of uninsured people in the state has dropped dramatically since the law was passed, but there are some areas of health care that still require improvement, Boston University School of Public Health professor Alan Sager said.

‘The law has no cost control,’ Sager said.’ ‘There is a great reason to worry if we can keep up our promise and commitment of the 2006 law unless we contain costs.’

Clinical waste, excessive paperwork, theft and fraud are the main causes of wasted funds in the health care industry, Sager said. If the health care industry eliminates wasted funds, costs will be under control and the industry will thrive, Sager said.

The health care industry is also feeling the burn from the current economic crisis in rising premiums and tax hikes. Medical organizations like the Cambridge Health Alliance and Boston Medical Center, which generally serve all individuals in need of medical care regardless of their ability to pay or lack of insurance, received less financial support from the state than in recent years, Sager said.

Despite the economy’s downturn, the state’s efforts toward improving health care will not be hindered, Sager said.

‘Health care is the easiest problem to fix, because it is the only one where we are already spending enough money.’

The law requires that all Massachusetts residents have a minimum amount of insurance. Those who do not receive health care through their employer can use the Commonwealth Health Insurance Connector, an independent state agency, to find an insurance plan that fits their budget. Otherwise, they will be fined.

Nearly 440,000 state residents have signed up for a health care plan since the law was instated in 2006, connector spokesman Dick Powers said. ‘The rate of uninsured in Massachusetts is now the lowest in the country, having gone from 13 percent to 7 percent, according to the most recent U.S. Census Bureau data.’

Powers said despite the success of the law in convincing uninsured residents to use the connector, more work needs to be done to insure the estimated 300,000 Massachusetts residents still without health insurance.

Powers said the state will ‘continue to enroll’ new residents while working to keep the drags on the system manageable.’

‘We also have to do a better job of containing health care costs,’ he said, including measures to keep costs low for the state’s college students. In May 2007, the connecter added more youth-tailored options to aid students struggling to afford coverage.