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The Massachusetts mandate

Later this month, the Supreme Court is expected to rule on the individual mandate included in President Obama’s Affordable Care Act. If it’s upheld, how will it work? You don’t have to guess entirely, because a very similar plan including an individual mandate was enacted six years ago in Massachusetts under then-governor Mitt Romney – a plan that will survive even if the Supreme Court strikes down the federal bill.

The 2006 Massachusetts law requires individuals and small businesses to have health insurance or pay fines. It expanded insurance plans for low-income workers and children, and set up a new way for individuals to shop for insurance online. Today, 98 percent of Massachusetts’s adults and almost 100 percent of kids are insured, and polls show overwhelming support for the law.

But problems persist. Primary care doctors remain in short supply, and health care costs continue to climb – an issue the entire nation is grappling with. Right now, the Massachusetts legislature is on the verge of passing “health reform, part two” to address the issue of high costs.

Need to Know medical correspondent Emily Senay, M.D. traveled to Massachusetts to see how health reform is working there. She talked to doctors, insurers, politicians, small business owners, and the people most affected by the state legislation – patients in search of affordable care.



  • Burtnor

    Thanks for this show. About time someone helped to dispel the misinformation. Congrats to the enlightened state of Massachusetts.

  • James Paterson

    Great overview of Mass. Healthcare reform system. I would be interested in seeing the comparative monetary results of the experiment. The cost containment initiatives seem to be at the core of the entire debate. Whether we pay for the uninsured through taxation or mandatory coverage, the bill still comes due. The one controllable variable is the overall costs, and the incentive system under which doctors make their treatment decisions. It seems that there is a delicate balance that doctors have to   maintain in order to utilize effective diagnostic tools, without ordering unnecessary tests simply to rule out every possible diagnosis. Maybe a good addition to the Physicians Code of Ethics would be to “Do no harm to the financial health of the overall patient care system.”

  • colon blow

    Well maybe if that fat bxxx didn’t have all of her fancy computer stuff and big house and car and maybe ate less she’s be able to afford her little pills to keep her from having a spaz attack. Unbeeeelieeeevable!!!!!!! The “entitlement mentality!”
    But her career is a community organizer. What do you expect? She probably expects everyone to pay for her student loans too.

  • Zuzana Dratovnikova Livingston

    There is no better feeling in the world than being made into a useful idiot.

    The cost containment initiative seems to be in the center of the debate? No. The center of the debate is targeting the middle class who didn’t quite die yet. The center of the debate is to impoverish them completely in hope that they will shut up. The community organizer with the seizures whose employer pays her premium even though he doesn’t have to….. why don’t we research into that a bit? Who employs a community organizer such as Alliea Groupp?  ACLU? Congratulations to ACLU for picking a perfect lobbyist. She may actually never need to find a real job now since somebody else is paying her healthcare. I have to say she did all right. For herself.

    Alliea says “she wishes she could make a different choice but she couldn’t”. Your College degree must have been one of those wonderfully needed liberal arts if the only job you could find right after the  College paid only $1000/months. That is $250/wk and it seem to me that if that was true than you would qualify for something like MassHealth where you get everything free – but I am not sure so let’s give you a benefit of a doubt. That is the past – although according to the link above it seems like that still is your only experience so far. How about this, Alliea: Do not lobby for people like myself having to pay for your seizure medications either directly (with premiums although I am healthy and do not need any medical care) or indirectly (when people with useful degrees are fined). Instead, lobby for a better use of taxpayers dollars that are being misapropriated. Maybe the billion and a half that Obama administartion gave to Muslim Brotherhood/Egyptian military/temporary government would be of some help to pay for your medications? Maybe the 147 million dollars that Hillary gave to Hamas would solve somebody’s medical problems in America? Don’t you think there is enough taxpayers money already being frivolously thrown around? Do I have to continue to show a myriad of such disgusting examples of wasting dollars?

    One doctor in this report is already playing God by eliminating unnecessary tests and will be rewarded by keeping his patients healthy. Now – who will define healthy? And how - without the tests? Well, he will be rewarded, so he’ll make it work somehow, I am sure.  The other doctor in this video says  that up from 300 they are doing more than a double of tests, was it colonoscopy? And the narrator concludes that there is a huge need for more medical providers because so many more people now are utilizing the healthcare services and with the same breath elaborates how little things really have changed for the existing patients.
    What was not shown in this video are the doctors I worked for for whom it absolutely does not work. What was not shown in this video is my talking about the healthcare system in the Europian communist country I emmigrated from. How in heavens is this video relevant to the situation in the rest of America when you are comparing folks who have been subjected to the mandate for 6 years already (under the threat of a fine if they don’t) to the rest of Americans?  ACLU, the fanatical Taliban style social engineer, sure needs those Americans who are worried about loosing their freedom of choice to hear how 2/3 of Massachusetts population is happy with it and how not much have changed.   

    One more discrepancy to be noticed in this video: while the single young enterpreneur gets his insurance through Health Connector for some 200 dollars, the family insurance for either just  two parents or the five member family is OVER $770 and $745; not a couple of hundred dollars as stated by the narrator. Last but not least, the co-pays and deductibles should something serious really happen to someone on the Health Connector chosen plan are so large that there is almost no difference between those plans and the traditional ones like Delta, Aetna, BCBS, etc.
    Megan was a sweetheart when she visited us and I wouldn’t have believed it from somebody’s elses mouth but it  seems to me that PBS will cut and paste to fit their agenda.

  • Zuzana Dratovnikova Livingston

    James, when the patient is you – will you be as concerned about the doctor’s doing no harm to the overall patient care system?

  • Zuzana Dratovnikova Livingston

    Nobody helped to dispel the misinformattion; it’s the same smoking mirrors. The doctors who hate it because they financially suffer (don’t you think for one second that the state pays them their regular charges, please) will NOT say it into the public media and you are probably intelligent and enlightened enough to figure out why.

  • Zuzana Dratovnikova Livingston

    Here is also an overview with a lot more truth in it when it comes to the effects of this fantastic cause:

  • MercyMe

    Point 1:  The community organizer job was her first job out of college. She has moved up two positions since then. Point 2: Her “fancy computer stuff” is a laptop and printer. I would hope a college grad could afford such and in 2012 this is no longer a “luxury” for most Americans. Point 3: Big house? Not borne out in the video and sq. footage was provided. Certainly did not look like a “model” home. And Point 4: Diet has no relationship to epilepsy. If you cannot relate to this young woman’s situation, consider yourself VERY blessed.

  • MercyMe

    Be grateful for “community organizers”. They’re the reason you have a right to vote. See Suffrage Movement. What video did you watch? First of all, the woman is no longer a community organizer and her current employer pays for her DISCOUNTED plan provided thru the state. Otherwise, she might still have inadequate coverage. As far as healthcare draining the middle class – who do you think is paying for the uninsured now? 

  • MercyMe

    Square footage was NOT provided.

  • MercyMe

    To Zuzana below:  The doctor’s are not being paid by the state. Everyone has INSURANCE. That’s the point of the mandate.

  • Pat Colpaert

    I voted for President Obama and health care,we need it.  I did not vote for Gov. K-Sick,nor did I vote for the casinos,nore did I vote to sell the turnpike,prisons,automatic garbage trucks.  All paid for by the tax payers hard earned money.  If it don’t make sence then its  probably not true.  How did K-sick get in there?

  • Anonymous

    Great report.  Sounds good to me.  I like progressive ideas, which is why I like Barak Obama.

    I have been lucky and healthy all my life – but I was never a big earner.  As I got older I was lucky that a state health care system helped save my eyesight.  

    Today I am on  Medicare.  I would and could pay a higher deductible if it would help with the soundness of the system. Otherwise I hope a spirit of cost containment, cognitive service, and devotion to helping others imbue the hearts and minds of our doctors.  

  • frankj

     Zuzana you are wrong prove it

  • Vinay

    Great report and great info.  It is admirable that Massachusetts has taken the leap to cover everyone.    Good stuff..

  • Anonymous

    Aaah, the sound of smug self-delusion.  The claims of success by Romney, Patrick, and others, are ridiculously premature.  Whether it’s the business owner changing insurance providers every year in his struggle to find affordable coverage, or the state’s ongoing shortage of general practitioners, the situations shown in this report clearly show that “health reform” in Massachusetts has so far solved NOTHING – it’s merely kicked the can down the road by forcing everybody to pay the very interest that has screwed up health care in this country almost beyond repair.  Some of us have learned from experience that private health insurance is a crock, and therefore don’t appreciate our rights as citizens and consumers being taken away with rosy promises of future “cost containment” efforts that the State itself freely admits it hasn’t had the guts to take on yet.  And of course a majority of voters in Massachusetts supports the mandate – by the report’s own admission, the majority of those voters are insulated by the employer-provided insurance they already have, which also, conveniently, insulates them from the unsustainable acceleration of health care costs that are increasingly afflicting everybody else.
    “Solving” the problem of health insurance access by forcing everybody to buy it whether they want it or not is an idea straight out of “1984″.  Enforced charity isn’t charity.  By taking this approach, Massachusetts swallowed the insurance industry’s BS hook, line, and sinker, and enacted the only funding mechanism that could, if only temporarily, support it.  ”Enlightenment” had nothing to do with it.

  • DaveH

    Oddly enough, your post has proven that you didnt watch the whole video.

  • DaveH

    Oddly enough, your post has proven that you didnt watch the whole video.

  • DaveH

    I can’t wait until everyone finally acknowledges the fact that insurance companies do not provide ANY healthcare.  They are “payment middlemen” and they charge a fee to pay bills.   We could save money by removing their fee from the equation.

  • Anonymous

    DaveH, I’m more than a little curious about something.  What, exactly, is the factual basis for your sweeping claim about my post proving that I “didn’t watch the whole video,” the entirety of which I did in fact view, and quite carefully I might add.  In fact, I distinctly remember the reporter saying something to the effect of, “all discussions of health care in Massachusetts eventually return to the issue of cost,” followed by the reporter – and at least one subsequent interviewee – asserting that the debate on that particular Gordian Knot was deliberately put off for later.  So it seems to me that your comment about my post is skating on some very thin ice.
    With that said, I think you are 100% correct about insurance “providers” not actually providing anything.  And it’s clear from the audio of the recent Supreme Court deliberations that Justice Scalia, at the very least, understands that distinction as well.  So here’s hoping…


    We pay taxes and WHAT DO WE GET FOR IT? How about A WALK FOR NATIONAL HEALTH CARE people? I am so sick of well meaning people walking, riding, and etc. for this and for that. We all contribute Trillions of dollors in Taxes, and we don’t demand Health Care out of our money! Come on PEOPLE. Walk for National Health. It’s your money, not the Government’s.

  • Stephen G. Ford

    Well Zuzana… if you’re the SAME Zuzana that is in this piece… I hope you get CANCER…  and EPILEPSY and LEPROSY and pretty much ANY OTHER FREAKING DISEASE YOU CAN!  And when you come SNIVELLING about not getting TREATMENT the will look at you and SHRUG!  YOU and your HUSBAND are EXACTLY what is wrong with this COUNTRY!  LEAVE!