Needs should guide reform
Healthcare reform is not about Salvatore F. DiMasi or Robert E. Travaglini. It is not only about the interests of Peter Meade, Jack Connors, and Michael Widmer.
It is a positive step that the House speaker and Senate president are moving toward providing coverage for some of the more than 500,000 uninsured in Massachusetts. It is encouraging that some business leaders are acknowledging their responsibility to share the cost. But could we hold the laurel wreaths? Where is the comprehensive plan to expand eligibility for MassHealth to those not now covered by the state's Medicaid program and to subsidize care for the working poor? Where is the plan to pay for it?
No reasonable person thinks access to healthcare can be expanded without requiring the participation of all of society's stakeholders -- taxpayers, businesses, and the individuals themselves. The $295 per worker that negotiators are said to have agreed to assess businesses with 10 or more employees that do not offer health insurance is not going to help Joseph and Gisele Landais of Dorchester, or tens of thousands like them who earn too much to qualify for MassHealth but too little to afford the insurance plan offered by their employers.
The Landais family knows something about the healthcare system. Joseph, 64, is a retired hospital janitor. Gisele works two jobs at area nursing homes. Even without the cost of health insurance, it is a struggle to provide for their three children.
For weeks, the preoccupation of players on Beacon Hill has been how to placate businesses that do not want to pay their share of expanding coverage to the uninsured. The sense of urgency has been driven, not by the moral imperative to provide a basic human need, but by the threat that the federal government might withhold Medicaid funds to penalize the state for failing to reduce the rolls of the uninsured.
The doomsday prophets at the Massachusetts High Technology Council who warned on Friday that requiring businesses to help shoulder the cost would inhibit job growth ignore the economic impact of doing nothing. Last month, the state Office of Health and Human Services reported that the government spent $213 million during the 2005 fiscal year in healthcare costs for 160,000 workers and their families through MassHealth and the free care provided by hospitals. Some of their employers offer health insurance, but at a price that is often prohibitive for low-wage earners, wage earners like Gisele Landais.
Is it any surprise that
Joseph and Gisele Landais were not invited behind closed doors on Beacon Hill to help hammer out a plan that might guarantee coverage for their family. The political and corporate insiders are understandably wary of those most in need; the poor generally do not share their reverence for incremental progress.
''I lost my health insurance when I retired," said Joseph, who did not need the coverage until last year when a triple hernia required surgery and he had to rely on the hospital's free care. ''All those years I worked, I never got sick." They don't know how they will pay for it, but the couple has decided Gisele must sign up for her employer's pricey health insurance plan, just for herself. ''What would we do if my wife got sick and she could not work?" asked Joseph.
It is a question that House and Senate conferees ought to keep at the forefront of their deliberations on healthcare reform.
Eileen McNamara is a Globe columnist. She can be reached at mcnamara@globe.com. 