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APHA Scientific Session and Event Listing

Alan Sager, PhD, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118 and Deborah Socolar, MPH, Health Reform Program, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, 617 638-5087, dsocolar@bu.edu.

A 2006 Massachusetts law promises to cover 90% of today's uninsured. Sponsors acknowledge it lacks sufficient funds for premium subsidies. Its lack of genuine cost controls, and flawed design reflect unwillingness to cut health care industry waste and mean continued erosion of coverage. Massachusetts health spending per person is the nation's highest,one-third above the U.S. average. The law's boost to spending will hinder implementation of its coverage provisions and undermine existing coverage. Many people mandated to buy private insurance will have to pay more than they can afford, face high out-of-pocket costs, pay fines, or seek permission to remain uninsured. Further, state-approved skimpy plans will encourage payers to reduce benefits in existing coverage. But reallocating the half of current health spending now wasted would permit covering everyone well. This would require new cost controls resting on statewide negotiations with physicians, who control most health spending.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Identify reasons why high costs will undermine implementation of the 2006 Massachusetts insurance mandate, and why the law is underfunded.
• Discuss likely choices that people under the Massachusetts mandate will face.
• Discuss central choices facing reform designers between relying on higher spending or recycling wasted funds, and relying on patients or caregivers for cost control.

Keywords: Health Care Reform, Universal Coverage

Related Web page: www.healthreformprogram.org

Presenting author's disclosure statement:

Any relevant financial relationships? No