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Medical Professionals, Citizens Seek Health Care Solutions

What Health Care Plan Would Do For Uninsured

POSTED: 2:01 pm EDT April 4, 2005
UPDATED: 2:02 pm EDT April 5, 2005

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For the past couple of weeks, WCVB has been profiling some of the state's uninsured residents, in particular some of the 350,000 Bay State residents who have a job but do not have health benefits.

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This week, we take a look at the proposed solutions. We start with the first plan to be thrown on the table, which is authored by a coalition of legislators, business and labor leaders, and health care providers.

NewsCenter 5 medical editor Dr. Timothy Johnson reported Phil Edmundson started his insurance company in a tiny Boston apartment 20 years ago. Today, he runs the largest independent insurance broker in New England. While Edmundson has never sold health insurance, he deals with it every day for his 170 employees.

"It's the one major expense item we have that goes up in the double-digits category every year and has for many years. It's a serious expense," Edmundson said.

Now, the expense equals more than $1 million a year. Still, Edmunson said all employers should offer health insurance just as they are required to provide unemployment and workers compensation policies.

"That inconsistency just seems so wrong in providing a basic decency for people," Edmundson said.

He feels so strongly, Edmundson joined Health Care for All, a nonprofit group that has come up with its own reform plan. Called the Health Access and Affordability Act, it works around the current system of private insurers and state Medicaid.

"We don't think we should hold the needs of nearly 500,000 uninsured [people] hostage while we negotiate and try to navigate all those difficult issues," said John McDonough of Health Care For All.

"It's a lottery each month, what bill we pay," said Veronica Greico.

A few weeks ago we introduced you to Veronica and Ernie Greico. Ernie is disabled and needs expensive medication. Veronica works as a parking attendant. While she is offered insurance, she can't afford it. The couple used to qualify for Mass Health, but a slight increase in Ernie's Social Security check put them over the eligibility limit and they were cut off.

"I don't know where to turn, what bridge to jump off of. You go to reach for a rope and it's gone," Greico said.

Under this new proposal, the Greicos would get their coverage back.

It raises the eligibility threshold on Mass Health -- covering children under 19 whose families make under 300 percent of the poverty level ($56,000 for a family of four) and adults with incomes less than 200 percent of the poverty level (less than $38,000 per year for a family of four).

"I fell into an insurance hole," Coleen Craven said.

Craven works part-time for a hospital. She is not offered medical benefits, but under this plan, she most likely would be offered insurance. The plan will require employers to offer uninsured employees -- including part time workers -- coverage. If they do not they will pay a fee, based on their payroll, to the state.

Also helping raise money for the program -- a 50-cent increase in the tobacco tax. And lowering cost in other areas, the plan would convene a panel that will meet regularly to set specific goals.

"For instance, we know that if every hospital in Massachusetts had computerized prescription order entry, that could save the system about a quarter billion dollars per year and yet right now, we have them in seven of our 67 acute hospitals. What's our plan to get there?" McDonough said.

Edmunson said while the plan would put pressure on businesses, it will help in the long run by evening out the playing field -- everyone will need to provide coverage or pay up.

"I think a lot of small and medium-sized businesses have thrown their hands up in the air. But I think they're getting tired of it. I think it's rising up to their agenda too," he said.

That agenda could include better health care for every Massachusetts resident.

The proponents of this bill said if the plan were adopted, it would cover 80 percent of those who are currently uninsured within five years, giving Massachusetts, by far, the lowest rate of uninsured in the nation.

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