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[Replaced_Texan]

Originally posted by Greedy,Greedy,Greedy
Right now, without the bill, there is a sense in which Massachusetts already has universal health coverage paid for with some combination of tax dollars and private money; this just rationalizes the system.

If someone is uncovered right now, they are still able to get free treatment (though not for all that ails them) at tax-exempt hospital facilities; to the extent the patient doesn't have funds to pay for the care, they go into an uncompensated care pool that is funded by levies on the more profitable hospitals and by tax money - that is, the uncompensated care adds to the cost of other people's healthcare and comes out of taxes.

The basic idea behind this bill was to get all the interested parties in a room to hash out how the uninsured were covered and to rationalize it, providing them with fuller coverage while cutting back on some of the costs. There's some new money coming from taxes, but much of that is spent on tax reduction for people who are covered. Most of the new money will come from the third party payors, but if it works there will be a long-term cost savings from the rationalization (less emergency healthcare, more preventative care = less total cost). There is a spirited debate right now, however, over whether the uninsured really do use ERs to a disproportionate extent, and if the traditional wisdom is wrong, there will be higher premiums partially offset by increased tax deductions.

Note that the bill is going to be signed by a Republican Governor currently running for President as a right-wing nutcase.

In light of the study suggesting that most people who go to the ER have insurance that came out last week, this is really interesting.

The researchers, led by Kelly A. Hunt of the Robert Wood Johnson Foundation, based their findings on a national survey that asked almost 60,000 adults about their emergency room use. The researchers defined a frequent patient as one who made four or more visits a year.

The issues of who goes to the emergency room and why have grown in importance as pressures on E.R. doctors have increased. From 1993 to 2003, the study said, emergency room visits went up about a quarter. In 2003, most emergency departments said they were at or over capacity at least half the time, the researchers said.

The study found that 84 percent of the frequent users had insurance and that 81 percent had regular health providers.

Although the study found that frequent emergency room visitors often had good reason to be there, it suggested that that there were better ways to take care of their needs.

"Clearly, having the patient be able to go to a primary care physician who knows them — that's the best kind of care," Dr. Weber said.

BTW, I *heart* the Robert Wood Johnson Foundation.