Need to Know, June 1, 2012: The future of health care

This week's host, Scott Simon. Photo: Will O’Leary

Need to Know’s medical correspondent, Dr. Emily Senay, travels to Massachusetts to examine how that state’s health care system is working six years after the legislature there adopted an individual mandate requiring individuals to buy health insurance and businesses to provide it or face fines.

The individual mandate is part of the federal healthcare plan championed by the Obama administration that is now under review by the U.S. Supreme Court. Massachusetts’s plan was adopted when GOP presidential nominee Mitt Romney was that state’s governor.

Help Wanted is an ongoing series tied to the day the national unemployment figures are released. The series will continue on the first Friday of every month through Election Day 2012, to coincide with the jobs report.

What’s on this week:

The Massachusetts mandate

Need to Know’s medical correspondent, Dr. Emily Senay, travels to Massachusetts to examine how that state’s health care system is working six years after the legislature there adopted an individual mandate requiring individuals to buy health insurance and businesses to provide it or face fines.

Watch more full episodes of Need to Know.

 

Comments

  • http://www.facebook.com/janice.hardwick Janice Hardwick

    Why haven’t we heard Romney speak of his successful public health care insurance plan in Massachusetts and would he do the same for America if elected?

  • Airkooled

     He can’t be seen praising Obamacare, which is based on his plan.

  • DMH

    Yes, I am in favor of mandatory health insurance!
    DH in Michigan

  • TW from MA

    The program on Massachusetts compulsory for-profit health insurance failed to mention that some key legislators who pushed it through later got lucrative jobs in the health insurance industry.  Nor did it state that after compulsory for-profit health insurance was passed that the regressive Mass. sales tax was increased from 5% to 6.25%.  Neither compulsory for-profit health insurance nor the sales tax increase were voted upon by the people.  Instead they were quickly rushed through the legislature.

    The show also failed to state the profit rate of the for-profit insurers or the salary of the Blue Cross CEO (it is probably in the millions).

    What Massachusetts and America need are single-payer health insurance (Medicare for all) without any private profit.  The Obama plan guarantees for-profit health insurers 20% gross profit. If a Rpublican had proposed it, he or she would have been laughed out of office. 

  • Mary Bess

    Yes, we desperately need single payer universal healthcare.  However, it should be administered by the US government like Medicare not by private insurers who have been holding our lives hostage to their profits.  We can’t afford them!  They are the reason Medicare is close to running in the red. Medicare would be financially sound were it not for the private insurers!  We need to get rid of them!

  • JRChecchia

    We need universal care.  Our present health care system is for profit which means we are held hostage by underwriters and wall street. 
    The argument about everyone having health ins doesn’t wash.  We are required to have auto insurance; that is not an option to “live or die” by.
    I believe the uninsured health care is in part subsidized by those that have ins which may be contributing to the annual increase seen in their premiums. 

  • Lindatstark

    If our citizens could sit down and watch this program.  It’s a hard issue but Massachusetts has the results we need to understand. Thank you for reporting all sides. It is so SAD how we decide policy these days. This is what we need to WATCH before we cast a vote.  Good information is so hard to come by. Thanks. 

  • Ffed and Mary Pneuman

    Responsding to your invitation to comment on your Massasschusetts health care program, we strongly favor a federal health care program and individual mandate.

  • Doris

    Of course there should be a national mandate for everyone to have health care insurance.  That is simple.  What is not simple is that this obvious need for a 21st century developed nation brings up other issues.  One is the question of personal responsibility, which is laudible but could easily be beyond the means of many people to cover.  I do not hear anyone objecting to the necessity for drivers to have auto insurance.  That seems to be generally accepted.  Why then is the need for a health insurance mandate such a big deal?  I am sure that people who have lived most of their lives in excellent health have no idea of the huge costs.  The rationale is the same. If you drive, you need insurance so that if you cause an accident, resulting expenses will be covered.  If you get sick and need hospital care, taxpayers should not have to pay your bill for emergency room care.  The cases are the same.  Medical costs would likely come down if all were insured.  At present uninsured persons are paid for by those who ARE insured.  This is not the American way, surely?

  • Fran in Evergreen Park, IL.

    Thank you for your very comprehensive report on the Massachusetts Health Care Plan.   The fact that premiums have risen less in Mass. than across the country indicates to me that universal health care is possible without wildly inflated costs.  As your report indicated, there are also common sense procedures which will reduce costs further.
      Yes, single payer is the best, but we have to work with what can be accomplished given our current system.      I support the Federal Affordable Health Care Act, including the individual mandate.      

  • Lkw777

    Drivers were all told they had to purchase auto insurance. So the vast majority do. Those who don’t comply don’t generally get to walk away after an accident; the insurance companies go after them to recoup their outlays. 

    Same with universal healthcare. It spreads out the costs; it spreads the risks, by including everyone, young and old, healthy and ill. It also ADDS millions more new paying customers, which increases profits for the insurers. As more procedures and tests are done, that should drive down costs (same as tvs, and iphones, and pcs did, etc.) Companies trying to continue to drive large cost increases will have to justify them to the gov’n for approval, or they won’t be allowed.

    If it’s done as NON-PROFIT, as it should be, the double-digit annual increases should cease and prices will be negotiated for the masses.  Resulting cost savings–instead of becoming profits for CEOs and shareholders–will be rolled back into the program.   It’s a win-win for all.

  • Lkw777

    Drivers were all told they had to purchase auto insurance. So the vast majority do. Those who don’t comply don’t generally get to walk away after an accident; the insurance companies go after them to recoup their outlays. 

    Same with universal healthcare. It spreads out the costs; it spreads the risks, by including everyone, young and old, healthy and ill. It also ADDS millions more new paying customers, which increases profits for the insurers. As more procedures and tests are done, that should drive down costs (same as tvs, and iphones, and pcs did, etc.) Companies trying to continue to drive large cost increases will have to justify them to the gov’n for approval, or they won’t be allowed.

    If it’s done as NON-PROFIT, as it should be, the double-digit annual increases should cease and prices will be negotiated for the masses.  Resulting cost savings–instead of becoming profits for CEOs and shareholders–will be rolled back into the program.   It’s a win-win for all.

  • Hotmailgkester

    I am canadian citizen I watch pbs on cable TV in canada . I watch your program about medical system in your country. In canada we as canadian have universe medical service covers by goverment of for ever canadian citizen. no canadian is denia medical cover if they cannot pay for it . The goverment of Canada pays for it .We as canadian citizen believe in universe medical cover for ever citizen in canada who needs medical service , if they can not aford the  medical service the goverment of canada pays for .are medical system is pad though are tax paid to  the goverment of Canada.

  • pahroc

    My health insurance has increased $300.00 a month in the last year and a half because of parts of Obamacare that have kicked in, i.e. more computers, more people and newly insured. How do I know, I asked. What has happened to America, I will take care of myself, leave me alone. I also know that complaining is a waste of time, more people want free health care than those that provide for themselves, we are headed into a hole.

  • Hotmailgkester

    I can not understand you america about your health system . you make money on sick people witch is not right. you help this people get will then you make more money off them . your medical system make a profit of sick people that is wrong .In canada are medical system dose not work that way we as canadian believe in making people healthy and not making a profit of people.

  • Mlagerqu

    I cannot understand why anyone would fight universal health care.  We are all eligible and forced to go on Medicare when we turn 65.  That is universal health care. 
    So , why not have it for our entire lives?  If we cut out the “middle man” of insurance companies, we would probably have enough money for all of us to have basic medical care.  It would be interesting to find out exactly how much Americans  and their employers pay in health care premiums and how much of that money is actually paid out for medical expenses.
     Employers could then offer an added deluxe version of medical care that would include elective / cosmetic / reproductive / etc. procedure and surgeries.

  • http://www.facebook.com/marilynn.lowder Marilynn Lowder

    I believe everyone should be required to participate in paying for their healthcare but I hate making the insurance companies richer.  I would rather trust my healthcare to the government than to the insurance companies.who are in the business for profit.

  • Proudcondor

    The company I work for has many employees that can’t afford to lose health insurance coverage. Many say they would have quit or retire long ago if there were national health coverage. That point alone, multiplied by tons of other workers, in other companies, caught in the same predicament, would make room for new employees. Isn’t jobs the crying need right now? Please don’t let them shoot down this wonderful new program.

  • http://twitter.com/rmichem Richard Michem

    Japan has some of the lowest disease rates in the  world. One reason is because everybody is required to buy into a national  health plan. So people see doctors more often because they do not have to worry about paying for medical care.                                                                                                                                       From a personal view, I do not have health insurance. After injuries from a criminal attack (20 years later, i am still in a lot of pain because of the injuries, watching my leg turn  slowly black and can no longer eat most of the food know to man because of jaw injuries were not treated right away) , in order to get money to pay for medical care. I started a book USAT just to  get money to pay to see a doctor. In so far as FORCED health insurance. We do not need a national health insurance plan. We need a national system of providing medical care.

  • jeff

    The Need to Know program regarding the MA state required health care was most interesting.  However I believe two very important issues were not covered.  First there is a rumor that the MA care enjoys Federal funding as well as state and local.  We need to know this, as I would not be in favor of my money going to another state.  Second, everyone dances around the issue of the right to choose to not have coverage.  What must be attached to that is the simple condition that no pay, no service.  It would be interesting to see someone who chooses no coverage to be turned away from the health care system.  In my state, the best way to get free care is to walk into a hospital and get treated. The result is that my insurance is indirectly paying for someone elses servics.  Lets fix that and see how many would then choose no coverage. This would not effect the low income who already have state coverage.  Check with the hospitals and service providers to see how many no pays we have to make up for…….Thank you,  Jeff in Colorado

  • Ese43

     MA has gotten permission to use some of its Federal Medicaid funds as part of MassHealth and overall subsidized insurance system. It gets, however, no more than would be the cases without comprehensive health insurance. So don’t worry, you’re not doing MA any special favors. Nor will we send CO a bill for our subsidies to various Federal programs that benefit your state “excessively.”
            I have sympathy for letting “libertarians” perish in their own bed, but it offends my humanitarianism, sympathy for the stupid, and additionally I don’t want untreated sick people (think aggressive TB) sitting next to me on a plane or in a theater.

  • Ese43

     Alas, Canada does most things better than the USA these days: health care, education, etc. In part because you are willing to pay (through taxes), in part because you don’t have as many “Republicans.” But watch out for Harper’s efforts to “Americanize” (or even worse “Republicanize”) Canadian public policy.

  • Cakecakecake28

    Why can’t we use our own tax money that we pay,and it be used for universal care? It’s seems that the rest of the world is 50 years ahead of us already. What’s the hold up America. Still can’t stop feeding the Oligarchs. Thank-you

  • Nancy

    I am concerned about 2 things in addition to other concerns already expressed by others.  If the Blue Cross/Blue Shield model is adopted in my state, then what happens when tests are eliminated and someone dies from a disease or condition that could have been prevented or treated had it been discovered through testing?  I understand doctors are rewarded for keeping people healthy without tests, but are they penalized when the results are not good?  The patient is the loser in this situation.  Secondly, I don’t believe all states have the same employment ratings as Massachusetts.  This system could have a different affect in other states. 

  • Bluegrassbloke

     You may wish to try to move to another country. I know that’s radical, but you are in a radical situation. I moved to White Rock, Canada many years ago, and have had excellent health care ever since. Health coverage concerns here are completely absent. I pay monthly premiums of CAN$64. If you are unemployed, disabled or can’t afford even that, there are subsidies all the way down to nothing to pay. And a quarterly sales-tax rebate…
    On my frequent visits to my US family, healthcare concerns are everywhere. How nuts is that?
    So many people refuse to believe a word I say about this. America is the best country in the world! To which I reply, Yes, but just be aware that not everything is the best!

  • Bluegrassbloke

     Moreover, those with very physically demanding work wear out far more quickly, and have to work in pain and faster growing exhaustion.

  • Bluegrassbloke

     Hotmailgketer, It may be helpful to encourage people to Google Saskatchewan Premier Tommy Douglas and the origins of N. American universal healthcare. Let them see how the AMA, Big Pharma etc., came to Canada -a foreign- country and spent millions on trying to defeat it! Some doctors threatened to quit. His reply? He called their empty bluff by publicly announcing: “I will go to Europe -and anyplace- else and hire new ones!”

    It is timely for PBS et al  to air the documentaries available on this.

  • Margaret

    I sincerely believe that it is insurance companies who control the country, but they are getting richer and richer and really sick people just die as though we are living in a third world country. If you cannot afford health insurance, God help you!” I have had two major heart surgeries — 6 by-passes first and secondly, a Mitral Valve replacement; both tough expensive surgeries. I worked for almost 50 years and still would be if I could because I can hardly make it on Social Security and paying what I pay for health insurance and prescription drugs just to stay alive! Thank God I was on Medicare and a supplement (which I can hardly afford or I would have died because I couldn’t afford these surgeries. The bills were in the neighborhood of $100,000 each time, not to mention the cost of the drugs I am taking. The Pharmaceutical companies are a “whole nuther” story. You actually must make the decision if you want to try to try to live or die.

    I was in complete shock when I heard the comments of the gentleman from Massachusetts whose wife is supporting the family because her husband’s company fell on hard times. The comment he made regarding his belief on “wants” and “needs” and that he does not “need” insurance because they are health. Whoa! I also thought I was comparatively healthy also until those chest pains began. I would never make a comment like that.

    I believe that Insurance companies have complete control over our lives. Why aren’t they responsible for managing and administering their own  healthcare plans for people instead of  requiring employers to do that?  Of course there would need to be a cap on what they can charge because they are in business to MAKE MONEY and that is all they are in business for. They could not less less whether you or I live or die. They are the Pharmaceutical companies must have been the catalyst behind the series, “American Greed” – I am reminded of the healthecare situation in this country everytime I see an episode.

     It has always put a hardship on companies who are trying to stay in business to furnish health insurance and it is also a hardship on those employees who get laid off and cannot for some reason carry their health insurance with them. Cobra is a good thing, but let’s be honest — 18 months at $700.00 per month is impossible for someone to pay when they are trying to live on unemployment, but the insurance companies call the shots; they make my health care decisions and they still think that the very companies who are trying to keep their doors open so people can keep their jobs should be furnishing the opportunity for health insurance. Because of this poor management system people can’t afford health care — so in effect — the insurance companies are running the businesses that furnish the jobs and so are in control of the economy in this country. Will it ever change for my children and grandchildren? I worry about it all the time. There is no peace in the “Land of Opportunity” especially when a person reaches “The Golden Years” mostly because of greed.

    My family suffered yet another bad experience in 2009 which has left a single daughter of mine without insurance coverage at all. She worked for the State of Louisiana for 21 years. In this state you cannot pay into the Social Security system if you are an employee of the State. They pay into to a State Retirement system managed by the State. At the time she began work (after struggling to finish her expensive education), a person could retire from a State job in Louisiana if they so chose after 20 years of employment and take the health care insurance with them and of course paying their insurance premium each month. Employees were glad to have the health insurance. However, when Jindal was elected Governor, things began to change. The retirement was “upped” to 25 years and an employee cannot take the health insurance with them unless they have worked 25 years. Also, the pension is less if you are forced to retire under 25 years. Ironically, there began to be layoffs. She was laid off after 21 years so she could NOT take the insurance with her and could NOT draw the full retirement. This has left her in a really precarious situation because she had prexisting conditions. It has been a nightmare!

    I know that we are not the only people suffering, but will there ever be a change for the better in healthcare? A person works all his life and then spends his last years worrying about whether he or she can afford healthcare and medication.

    Thanks for listening.

    Margaret (Louisiana)

  • http://www.facebook.com/profile.php?id=1337562573 Rosalie Apel-Cole

    I definitely believe in universal health care.  No company should make profits on the sick and the sick should not be denied health care if they cannot afford to pay for it.  Anyone who is opposed to universal health care is heartless.  Opposition to universal health care is opposition to being humane.  As others have pointed out, we are required to have auto insurance then why not health insurance?  Ultimately once everyone is insured, the cost of health care will be reduced because people would have access to preventative care and not wait till they end up with a heart attack or stage 4 cancer to finally be treated by a health professional. The cost would be spread out between a larger group.

  • Flyin’ Solo

    Then why not have others pay for your renters, home, auto, jewelery, jet ski, boat or flood insurance. If you believe that it is someone else’s responsibility to protect you against a possible loss, then you are living in the wrong country. You should be living in a Democracy, not a Republic. You have ZERO right to EXPECT anyone to help you do anything, EVER!

    You should be personally responsiblity for every aspect of your life and when it goes wrong, you deal with it instead of whining and expecting the mommy state to fix your boo-boo’s! 

  • Adrienne

    As everyone her watches PBS, I assume you are more intelligent than most. You’ve seen/heard the small-minded, big mouthed Republicans’ comments on this issue. They believe healthcare is something you buy if you want and if you can’t or won’t then f**k you.

  • Mag

    Thank you, Adrienne! I agree. The people I know from this group are all from the “I got mine” bunch. They don’t have a clue, nor do they care about the real health care issues out there, but it’s ironic that they are always first to claim to be the most religious!

  • Mag

    Rosalie, you are also right. I hardly think that comparing renter’s insurance, home insurance, etc., etc., is just absolutely absurd. Everybody here knows what healthcare is all about in this country and it is ludicrous to even entertain the idea that others should pay for flood insurance, jewelry insurance, auto insurance, etc. Be reasonable.  This is Health insurance to keep us alive about which we are talking — unless you had rather watch one of your loved ones die unnecesssarily. You only have to walk a mile in my shoes. It is always those who have NOT fallen on bad times nor really NEED healthcare insurance who yell the loudest. I expect to PAY FOR MY OWN INSURANCE just as most others do. I just need there wherewithall to do it — and so do my adult children. We have worked for it, but I don’t like the changes that have been made in being able to obtain it. Give us a break, please.  I worked for it, believe me! I just don’t want to be kept from being able to get it because of reasons out of my control. By the way, I’m happy for others that they can make the remarks below because evidently they have the money to do so. One of the very fortunate ones who no doubt has had the opportunity to thrive in this great country of ours –

  • Stevo

    Susanna & Rick Livingstone, interviewed in the piece, are among many that truly believe that America
    was founded on the belief that we have “freedom of choice IN EVERYTHING”…our “founders” would be the first to tell the Livingstones & all the others that America was founded on the principle of “doing what is best for the majority”…can you imagine each & every colonist running around only doing what is best for him/her. All the great societies were more or less founded on the principle of doing what is best for the majority. WAKE THE HELL UP, LIVINGSTONES of America…  

  • Marga000

    They TELL you it’s because of the Affordable Care Act, but most of the provisions haven’t kicked in yet and companies are increasing premiums because they CAN. So you’re paying extra premiums right now for no reason, other than a supposed preemptive increase by insurance companies who think they’ll take advantage of the discontent and tell people lies about the premium increases. They are increasing because the insurance companies are greedy.

  • Dcluff4u

    health care is a necessity.  sooner or later everyone will need it.   right now most of the country’s middle class is paying for the people that don’t have insurance, the poor. the county hospital of the city I live in is losing millions a year  paid for by my taxes and healthcare providers spreading the cost onto my cost of coverage. we must make all people pay for insurance and make sure there is economic competition for insurance companies. The Insurance itself can be the solution to rising costs and by stimulating the competition can provide innovating ideas for the problems of high cost health coverage.

  • Dcluff4u

    health care is a necessity.  sooner or later everyone will need it.   right now most of the country’s middle class is paying for the people that don’t have insurance, the poor. the county hospital of the city I live in is losing millions a year  paid for by my taxes and healthcare providers spreading the cost onto my cost of coverage. we must make all people pay for insurance and make sure there is economic competition for insurance companies. The Insurance itself can be the solution to rising costs and by stimulating the competition can provide innovating ideas for the problems of high cost health coverage.