Zhang

The following points is presented from a talk by Tim Murphy

Local aid, education, criminal spending increases, which brings the deficit, so we need the innovative policy to deal with the issue.

No.1 guiding

Heritage foundation play a vital rule of providing the data with the department.

We need to pay cares for certain people, so we need to start a momentum, do not take money way, we will done something innovatively.

All the healthcare money or universal health insurance money will come from the tax, reimbursement, or federal aid. How does it contribute.

The reason of so many uninsured, which are qualified for some program? Bad intake, follow-up, hospital tracing system.

{{{{All the model the law maker had used was the efficiency model and the cost/benefit analysis. He did not use the rest of the model to test whether there might be a better solution for the universal healthcare or there might be some universal insurance coverage.

35% of people under 30 do not have the insurance, even the employers offer, those people would take risk.

Now we are socializing the healthcare and thus everyone need to contribute at least part of the cost.

Now the incentive for the hospital is that the hospital would not get paid if the hospital did not provide the proof of not enrolling in one of the health program. By using this virtual gateway hospital has the incentive to help enroll the uninsured people.

(((poverty level is fro the federal data

He 100% or 300 is compromise from the data analysis and the common sense. Someone says 400%,but it is insane to set that high. At last it is set 300

(((LPF coverage including kids, which is really cheap and much cheaper than the adult.

(((No solutions to the extent that how the gov is going to fund this universal health insurance, the law makers even did not know.

Why health care reform in Mass?

1. Double-digit, annual increases in insurance premiums and the highest per capita health care spending in the nation.
2. 500, 000 uninsured in latest state survey
3. Small businesses and individuals facing significant barriers to entry for coverage
4. Limited availability of information to consumers and businesses precludes informed health insurance purchases decisions.
5. Potential loss of at least $ 385 million in federal government Medicaid funding
6. $1 billion and growing of “free-care” forcing all stakeholders to deal with costs for uninsured and under-insured.
7. Two “universal” health care ballot initiatives.

The uninsured in Mass: 2004

Total Commonwealth population: 6,200,000

Currently insured 93%

Employer, Individual, Medicare or Medicaid 5,740,000

Currently uninsured (7%) ~460, 000

100% FPL Medicaid eligible but unenrolled 100,000

100-300% FDL Low Income 150,000

>300% Middle Income 204,000

The law changed eligibility for certain populations and raised enrollment caps:

1. Children: expanded to 300% FPL
2. Insurance Partnership: expanded to 300% FPL
3. MassHealth Essential: raised cap to 60,000 people
4. HIV Family Assistance: raised to 1300 people

Massachusetts Health Care Reform

medicaid

cost/quality improvements

Insurance Reforms

ßShared Responsibility

contractor authority

commonwealth care

By McKinsey Research

Benefits and challenges of the US health system

Benefits:

1. Focus on quality of life
2. convenience
3. patience choice
4. innovation
5. access to new treatments and technologies

Challenges:

1. Highest per capita expenditure (16% of GDP)
2. access for uninsured (16% of the population)
3. compared to OECD, lower life expectancy and higher infant mortality.