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Sharon K. Long, On The Road To Universal Coverage: Impacts Of Reform In Massachusetts At One Year, Health Affairs Web Exclusive, June 3, 2008 [Abstract] [PDF] [Reprints & Permissions]

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Concerns

Leonard L. Howell   ( 11 June 2008 )

Concerns 11 June 2008
Leonard L. Howell, R.N. Public Health Service Send comment to journal: Re: Concerns llhowell{at}bop.gov Leonard L. Howell	My initial concern is the costs are already higher than anticipated, and this is just the first year! What will this look like in 5-10-20 years? Especially as scams, loopholes, and irresponsiblity for one's health come with less cost. I am concerned that basing responsibility to pay premiums on income to gain access to insurance provides an incentive to decrease, or hide, income. I am also concerned that employers are penalized when they too struggle for profits. That to avoid the penalties, they may either decrease employees or go out of business, which leads to unemployment. Health care costs are driven up by paying for excessive procedures that are ordered just to limit liability, and lawyers defend against frivilous malpractice cases with outrageous awards by ill-informed juries. I would rather see incentives that reward taking personal responsiblity for maintaining one's health and preventive health (tax incentives to lose weight or run/walk a mile in less than 15 minutes?). How about tax deductions for annual physicals? Obesity and substance abuse should be treated like smoking by insurance companies -- if you play, you pay. Health insurance companies like groups that share costs over the group. These groups are primarily formed by employers. Why not enourage insurance companies to make up groups based on other criteria (Social Security number, last names, etc.), which would open up insurance group rates to self-employed and part-time employees? These are some of my concerns, as paying for an increasingly morbidly obese population that will depend on a broken health care system that has inflated costs will bankrupt any plan to pay for it.