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In Response to Re: How unpopular or popular is Obamacare?:
After I returned I looked it up and learned that Massachusetts has the lowest rate of residents without health insurance of any state in the nation. Only 3.4% of Massachusetts residents are uninsured, making that the lowest in the nation. The closest is Hawaii (which also has a state wide health insurance program) with 7.8% of their residents uninsured. So congratulations to you in the Bay State for showing that a health care reform plan exactly like Obamacare could actually work.
Posted by golfinsailor
Just being insured does not solve many problems in health care and health care coverage.
"The state continues to struggle with rising health care costs. State health reform in 2006 purposefully focused on expanding coverage to residents while leaving the thornier task of cost containment for future years. As a result, affordability continues to be an issue. Per capita health spending is 15% higher than the national average and although premium growth has slowed in recent years, Massachusetts has the highest individual market premiums in the country. Legislation focused on comprehensive provider payment reform and endorsed by the Governor is currently pending in the state’s legislature."
Kaiser Family Foundation: Health Care Expenditures per Capita by State of Residence - last update year 2009 - it shows data by state. States that are rural or have large rural areas do have higher med cost because of the low number of probiders. That is why WY has the highest premium cost plans under the ACA.
What else affects cost ? Utilization.
Look at states that have a high expenditure per capita that are not classified as rural by any means. Others in this bunch were guaranteed issue states.
Here is the map format for the same data for a quicker view.
So how is the ACA attempting to control of health care cost & in turn, premium cost and tax expenditures?
- There is the approved list of preventive measures. Many of which will depend on personal responsibility to get and activate in their individual lives in order for the end result of healthier people and less cost to be successful.
- There is the low reimbursement rate to the limited providers within the health care exchange plans. The limited number of providers might also keep down cost.
- There is the more insured philosophy . . . . . which should reduce cost shifting but not completely eliminate it.
- Then there is the somewhat limited Essential Health Benefits which won't cover everything under the sun with the possiblility of more regulation for control, like Medicare and Medicaid do now.
- Limited formularies, perhaps even some Rx prescription step therapy requirements.
- Strict requirement for what is treated as an emergency (ER), what is required to be pre-approved before doing, utilizing the after hours nurse call service rather than UC facility.
- Then the government will be running various test programs under Medicaid to see what work for the least amount - these will also filter to the exchange plans if cost savings are seen. Maybe even to Medicare.
- What about predetermining factors of benefit - you know, physical measure things that would improve the outcome of the medical measure?
If we don't have this type of control by government or by private insurance companies, or both, then cost will continue to rise, premiums will rise and we will be again wondering where the money will come from to continue the entitlement a few years down the road.
Even other countries that have different health care systems are facing this health care cost battle too.
With more advancement in medical knowledge, the cost rise -