Aches and pains of Mass. medical health insurance market

Aches and pains of Mass. medical health insurance market

The Merged Market Advisory Council discovered that limited-network plans ship high quality protection extra affordably, offering the identical companies as plans with wider networks, however at decrease prices. Whereas many people have gravitated towards limited-network plans as a extra reasonably priced choice, many small companies haven’t. Health Connector for Business presents small employers a spread of slim and broad community plans, together with rebates of 15 % that ship financial savings of hundreds of {dollars} to small companies.

Well being protection is just too pricey within the Commonwealth, not due to state or federal well being reform, client protections, the supply of backed protection, or the person and small group insurance coverage markets being merged however, slightly, due to more and more excessive well being care costs.

The Well being Connector and different state companions look ahead to working with small companies on this vital facet of financial competitiveness and affordability. Because the state continues to handle the true problem of underlying well being care prices, the Well being Connector’s companies and packages for residents of all incomes and for small companies proceed to be right here to assist.

Audrey Morse Gasteier

Govt director

Massachusetts Well being Connector


A key, but neglected, resolution: single-payer system for the state

The editorial “Small-business medical health insurance market going through ‘loss of life spiral’ ” touches on a tough problem that’s significantly urgent right here on Cape Cod, given our preponderance of native small-business possession.

But regardless of its considerate evaluation of the issue, the editorial fails to notice the apparent resolution: a single-payer insurance coverage system. The Medicare for All bills proposed in the Legislature would cowl all residents for a way more complete set of advantages than any non-public insurance coverage, with no deductibles or copayments, no networks to navigate, and free alternative of suppliers. Financing could be by way of a predictable 2.5 % worker well being tax and a 7.5 to eight % employer tax. No extra annual renegotiation of advantages and no budgeting uncertainties.

Our small companies could be much less handicapped in hiring, with potential staff not making their alternative based mostly on the insurance coverage offered. As of now, they’re strongly influenced by that concern, as your editorial notes.

Even entry to major care, at the moment a really main issue, could be improved. The proliferation of competing well being plans, with differing fashions for profit-making, has made major care a nightmare of coding, digital recordkeeping, claims reporting, pre-authorizations, and appeals. Given the comparatively low reimbursement charges (the “paperwork” is unpaid labor), it’s no shock that discovering major care has develop into so tough for thus many individuals, even these with so-called good insurance coverage.

Some type of tax-funded common well being care must be on the desk, analyzed, and mentioned brazenly.

Dr. Brian O’Malley


The author is retired from greater than 40 years as a major care doctor and has represented Provincetown within the Cape Cod Regional Authorities Meeting of Delegates since 2015.

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