Who benefits and who pays for the health reform?

As someone whose industry might be significantly altered by national health care reform, Peter Straley welcomes the effort — if it brings about the positive changes Massachusetts has already implemented.

Specifically, Straley, president and CEO of Health New England, praised the Commonwealth for pioneering a couple of concepts now being debated on the national level: barring insurers from turning away people with pre-existing conditions, and the individual mandate to buy coverage.

“The idea that, if you’re really sick, you might be denied insurance, or might have to pay a whole lot more for it if the presumption is that you’re going to use a lot of services, in Massachusetts, we got rid of that years ago,” he said in a lengthy, videotaped discussion of health reform posted at www.healthnewengland.com.

As for the individual mandate, “we say it’s the responsibility of every adult citizen to have comprehensive insurance,” Straley continued. “That’s a controversial issue because, in the United States, people don’t like to be told what to do, but let’s face it — we already do this with auto insurance.

“If you couple that with the idea that pre-existing conditions will not disqualify you, then you bring more people into the insurance pool, which should lower costs somewhat. These are things being discussed on the national level which we do in Massachusetts and have proven pretty effective.”

At the same time, he said the “prickly” issue of rising health costs hasn’t been fully addressed in the Commonwealth, although state officials are considering a restructuring of how providers are reimbursed. ~ Source: J. Bednar, HealthCareNews.com