Massachusetts Health Reform Policy - Essay Example

Running Head: paper linking policy and practice Massachusetts Health Reform Policy Health care provision has been major debate in many countries. The paper has focused on health policy in Massachusetts. Provision of health care in USA has been under criticism by human rights activists. This brought Massachusetts to reform its health care policy to fit societal needs. In 2006 there was enactment of law that allowed universal coverage policy. The paper looks in detail legislation of Massachusetts health care reform and its impact on the Massachusetts community. Paper linking policy and practice Public policy refers to the course of action undertaken by any government to tackle a particular public issue or a set of issues. Public policy is a complex process which involves collaboration of various players to act toward achievement of that public policy. It involves development of laws, regulations, decisions and actions towards the policy achievement. This paper addresses health care policy and reform undertaken in Massachusetts health care in United States America (Kowalcyzk, 2006). Health Policy in USA Health care provision in USA has been a major debate over along period. The debate has centered on right to health care, accessibility, sustainability and the quality of health care system. Although United States heath care system is the most expensive in the world which consists a mixture of public and private system, Organization for Economic Co-operation and Development (OECD) indicated that use of health services was below its meridian. National Academy of Sciences and the institute of Medicine cited that US is the only developed state that does not cover its citizens, thus the debate on universal health care policy. The United States government policy which seeks to provide universal health care has been a major debate which has divided Americans along party lines. Those favoring the universal health care have been arguing that the large number of uninsured Americans undergoes hidden costs and other costs, thus universal health cover would lower the costs and improve the quality of health system, it would ensure all regions are covered and that most costs will met by national health insurance. Those against universal healthcare argue for people to be let free to choose their health insurance. The universal health program is yet to be achieved in US (Sered, 2005). Massachusetts health care reform (2006) Before enactment in to law of Massachusetts healthcare reform in 2006 as Chapter 58 of the Acts of 2006 of the Massachusetts Legislature, most of the residents approximated to range from 395,000 to 653,000 were uninsured. US laws require all people to be treated in all hospitals regardless of residency or whether one has money or not. This brought unpaid hospital bills and expenses due to the uninsured residents in Massachusetts (Richard, 2005). A fund known as "Uncompensated Care pool" was used to reimburse hospitals the expenses of uninsured residents and those of non residents. The fund was raised through state contributions, federal tax revenue and annual assessment on insurance providers. The fund accumulated due to an increase in insured Massachusetts residents prompting the legislation of reform on health care without additional funding. The Massachusetts health care reform was made law in 2006. The law requires every Massachusetts resident to obtain cover of health insurance. Subsidized health care is provided to residents earning up to 100% of federal poverty level and partially to those earning up to 300% of the federal poverty level. An independent body was put in place to subsidize coverage and to facilitate the selection and buying of private insurance. Tax penalties are given to residents who fail to obtain health insurance (Kowalcyzk, 2006). Legislation of the policy The plan to cover uninsured began in 2004 when Governor Mitt Romney called for a cover plan for the uninsured. At that Affordable Care Today (ACT) coalition brought mass health (Medicaid) coverage bill that would cover more people with subsidized programs. Pressure was mounted to Massachusetts by the federal government to reform in order to cover the expanded Medicaid program to take advantage of the Federal Waiver. The state was receiving $385 million to pay for services provided by the hospitals to the uninsured. Massachusetts free care pool was reconstructed to receive the funding (Sered, 2005). Changes were made by legislature in 2005 to Romney's fist proposal to include expanding mass health cover to low income children and also restore public health funding. Other changes included charging firms with more than 11 workers which did not offer fair and reasonable cover to its workers. Mitt Romney signed the health legislation in April 2006, with 8 sections which included health coverage to disabled legal immigrants who were not eligible for the federal Medicaid, also provision of dental health care to poor residents (Richard, 2005). Policy Analysis Latent and Manifest goals of the policy The statute required every individual to have insurance cover. Commonwealth Health insurance connector authority was created and its role is to offer commonwealth care program to residents with low income who do not qualify for the mass health. It provides purchase health insurance programs for non working individuals, provides individuals running small businesses health insurance which they purchase with pre-tax income (Kowalcyzk, 2006). Benefits and services of the policy The policy offers health insurance plans for purchase by individuals who don't qualify under large employer plan, also to self employed, those who work with different employers and part-time workers The health connector puts in place premium subsidy levels for commonwealth health care and gives definition for affordability to individuals. Common wealth care health insurance program was designed in the stature to provide subsidized health insurance program to low income adults in Massachusets who were not qualified for the mass health. It provides eligible residents with chance to access subsidized private insurance health plans. By 2007 the program had benefited by enrolling over 160,000 people (Sered, 2005). The policy required employers with more than ten workers to give fair and reasonable contribution to the employee's premium of health insurance. The contribution paid will fund commonwealth care and other health reforms and is paid to commonwealth care trust fund. Young adult coverage is supposed to be covered under insurers' family coverage plans. Reduced benefit plans are provided for young adults (Richard, 2005). Benefiting Population Since it implementation, The Massachusetts 2006 Health Reform Policy has benefited a lot of people. Those who have benefited include such people as the low income earners who were having problems having health insurance. The other benefiting people include the children from low income families whose families cannot afford health insurance. Also the unemployed people are also benefiting from the policy because they are also covered (Kowalcyzk, 2006). The policy is deemed to be beneficial to these people because those who cannot afford health insurance are covered and while those who are facing difficulties in paying for health insurance are also afforded an easier way of paying health insurance. The employers who do not have health insurance arrangement with their employees are also required by the law to contribute and this ensures that the population is benefiting fully from the policy (Sered, 2005). Financing This arrangement receives finances from various quarters. One of the important sources of funding for this arrangement is state contribution and tax revenues accrued from the taxes that the state and Federal Government derives from the residents and also the businesses in the state. Another source of funding is accrued from the policy requirement that everybody in the state must have health insurance of some sought and this has helped very much in the financing of the policy (Richard, 2005). Achievements and failures of the policy Massachusetts health care has improved and expanded with employer support health insurance providing the main source coverage for Massachusetts residents. It provides lower cost plans for small businesses and individuals and gives flexibility plans part-time and seasonal workers. It encourages dual participation of employers and workers in health care coverage. It promotes and creates standards and affordability for new states insurance plans. It provides and maintains health care to those uninsured people who cannot afford and those who are ineligible for health insurance. It creates a public program where unemployed people can access health care (Kowalcyzk, 2006). There are failures experienced in the implementation of the health plan, middle income earners are bitter on unsubsidized coverage between unaffordable premiums and inadequate plans that barely qualify as insurance. Many people argue that due to the rising costs, government, employers and uninsured would not be able to cope with the coverage expansion. According to a resident by name Libra, Massachusetts health plan looked ideal in first place by offering health care plan to people who didn't belong to mass pool and subsidizing costs for the poor plus fixing moral hazard problems. Libra problem comes due to high costs because law requires residents to purchase insurance from creditable providers who are expensive (Richard, 2005). Advantages and disadvantages of the policy and its privileges and oppression It has indeed very advantageous to the low income people and also those people who own small businesses in the state. In the same respect, it is deemed that these kinds of people are privileged by the policy. However, the upper class and middle upper class are highly oppressed and disadvantaged by the policy. This is because the policy's implementation have ensured that the low income earners and small business owners get most of their health insurance funds from the upper class and upper middle class citizens directly and indirectly. When these people are allowed to pay for their insurance through pre-tax income, the upper class and upper middle class feel the pinch indirectly (Kowalcyzk, 2006). Recommendations There are changes that are required to be addressed to get an ideal health care provision. The coverage should be universal, that is it should not be tied to one's occupation. It should be affordable to all individuals and families as well to society as whole. Last but not least the health care should of high quality to everyone. According to national association of social workers (NASW) code of ethics, social service should be provided to all people in need thus creating social justice in the society, social worker should also should show dignity and worthiness of a person thus a good health plan should strengthen relationships among people thus maintaining and enhancing wellbeing of individuals and social groups as whole. Although Massachusetts health care plan plays a good role of health coverage it should be fair to everyone without discrimination (Richard, 2005). REFERENCES Kowalcyzk, L. (2006). "State Health Plan Costs within Estimates." Boston Globe, Sept. 29, 2006, p.B2. Richard, W. (2005) The Complete Book of Insurance: Understand the Coverage You Really Need. Naperville, IL: Sphinx, pp. 368 - 382. Sered, S. S. (2005). Uninsured in America: Life and Death in the Land of Opportunity. Berkeley, CA: University of California Press, pp. 362 - 379. Read More