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Statement by Senator Moore on the Senate Health Care Plan |
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November 9, 2005 - Massachusetts has made significant progress in the past twenty years in incrementally expanding health insurance coverage to a position that is the envy of other states. We have managed to expand coverage to all, but about 7% of our population. Yet this position is at risk as those who are insured face double digit premium increases and as employers seek relief from rising costs to stay competitive by shifting more burden to their employees – forcing some to drop their coverage. We must take action or we’ll see the number of uninsured continue to rise. But this debate is not just about our good ranking among states and our reputation as a caring Commonwealth. Expanding health insurance coverage is good because it provides regular access to care rather than waiting as a health problem grows more serious and, ultimately, lands us in the emergency room, or worse…in a funeral home. Expanding health insurance coverage for the uninsured is good because it eases the cost shifting of health care that is driving up the cost of health insurance for those whose employer provides coverage and eases the strain on those who can afford their share as an employee. Expanding health insurance coverage is good for the economy. We need to take action because if you have insurance, your more productive as an employee, have less absenteeism due to illness, and spend less time worrying about how you’ll care for your family if sickness hits. Too many of our constituents are just one illness, one family crisis, one pink slip away from sliding into the deadly trap of ill health, medical debts, and marginal employability. Too often the consequence of being uninsured involves unnecessary death or disability because of untreated disease, inadequate care for chronic illness, and medical debt and bankruptcy. Some of our citizens turn to alcohol as their method of pain management. Last December, and repeatedly in the months that followed, the Senate President sounded the call for greater progress in the effort to expand health care access to all of our Commonwealth’s residents. Without his leadership, and the enthusiastic embrace of this issue by every member of the Senate, this issue would not be the priority that it has become with the entire legislature, or with the Governor. We can be proud of the fact that all of the critical support has come together to declare our goal, as a caring Commonwealth, of achieving universal coverage in the foreseeable future. We applaud our House colleagues for taking action and we want to continue to work with them to develop the best plan – the most responsible plan - for achieving universal coverage. We even applaud the Governor for entering into the debate – he even shook my hand in front of Natalie Jacobsen to promise that we’d achieve real health care reform in this legislative session. We can all see the goal of universal health coverage in sight, but there are major chasms to cross before we get there, and we must not jump blindly across these chasms without knowing that we can reach the other side. The Institute of Medicine has told us repeatedly of the “quality chasm.” We have made great progress in Massachusetts in improving patient safety and medical quality, but we still have a long way to go. It won’t do us much good to make more people eligible for care if that care is unsafe or substandard. The bill before the Senate today takes some major steps to improve quality and safety in our health system. There is a chasm of resources with several major unknowns waiting to devour us if we slip into that chasm – the uncertainties of the state and national economy only beginning to improve that could be sent into another free fall if unsustainable increases in energy costs and rising interest rates bring harm to both public and private sectors, the uncertainties of federal support – not simply the concerns about loss of help for our safety net system with the 1115 waiver that faces us by next July, but with Congress taking back Medicare and Medicaid funding to try to stem the flow of red ink in the federal treasury, the uncertainties of a flu pandemic that would overwhelm our health care system and our economy. We must make progress toward universal coverage, but we must be responsible and wise in making our choices of how to get to that goal. We can adopt more sweeping plans and find, as we did in 1988, that the impact of a broad employer tax for health care in a time of economic crisis threatened our fiscal health and ended the “Massachusetts Miracle” of economic success. We made promises then that we were unable to keep and those promises had to be rescinded. Late in the 1996 we made progress again, but on a more modest scale, and it has served us very well. That’s the course that experience suggests is the wisest course for us today. Everyone in this Chamber would like to follow the easy, popular course and vote for full coverage immediately rather than the more prudent course of incremental progress toward a goal we all share in this building. We can’t take the old political route of promising, promising, promising and then – because of problems beyond our control – again pulling the plug on health care life supports by failing to deliver on that promise. We cannot be like the snake oil salesman of old promising the cure all elixir that is only sweetened water and that we pay much more than the product is worth. The approach in the Senate bill is the best treatment that is prescribed. The Senate Health Care Reform Plan – Builds toward full coverage in a rational, sensible, affordable manner.
We do all this without new taxes, without broad employer mandates that could threaten the economy at this point in time and we do it without mandating individual coverage. However, we don’t take any of these options totally off the table because we may need to rely on some or all of these in order to reach full coverage by the end of this decade when the economy, we hope and believe will be stronger. We want to study the idea of an individual mandate because there are too many unknowns in this direction – we need to know how it will work, whether affordable insurance product can indeed be developed with co-pays or deductibles that are so high that they keep people from seeking needed care, we want to have a better understanding of who among our constituents this new, uncharted course might affect, and we need to educate the population on the desirability of this course, if we decide it’s one we should follow. The Senate Bill:
The bill is accompanied by a separate appropriations bill that restores and expands funding to a number of critical public health programs. We believe bills would result in an investment in the health of our people of $178 million including $114 million state dollars in this fiscal year, and is funded almost entirely with revenues from the state's rainy day, or stabilization fund. Throughout the day, we will considered, and adopted, other good ideas proposed by our Senate colleagues. With the unanimous vote of the Senate we go into conference with the House with a strong vote of confidence. |
