Healthcare Market and Insurance in Boston - Essay Example

The Boston community Healthcare economics This paper focuses on the Boston community. The health insurance and the healthcare market in Boston play a major role in assisting individuals gain access to quality health care services. Following the Massachusetts’s 2006land –mark healthcare reforms, many employer, insures, providers and consumers have been forced to adjust to the new reforms that embraced universal health insurance cover (Corrigan 13). Political support for this health reform has equally remained overwhelming even as many reform opponents greatly oppose the move. According to the Boston healthcare plans, adults are supposed to gain health coverage and employees too must have this nature of coverage. Similarly, the reform witnessed the merging of the individual health insurance markets and small groups of other related healthcare providers. Through this move, the number of uninsured persons dropped significantly from 8.2 % to 2.7% by the year 2009. It is also worth noting that the recession that occurred did not have a great influence on the healthcare reforms that were passed in the year 2006. According to the reforms, the law required every Massachusetts resident to have a state regulated healthcare insurance protection. Also, the reform bill recommended provision of free insurance healthcare for citizens that earned less than 150% of the state federal poverty level. The people that did not take the state healthcare insurance cover took Medicaid which also played a similar role in insurance. This move largely affected the market and changed several trends in the insurance market. Through the amendment, there was development of independent public authority that was formed to foresee the activities of the healthcare insurance, the connector (Minkler 19). It is through this that the citizens getting free healthcare insurance cover signed up for their insurance in the events that they applied and got turned down by the Medicaid. The connector took the place of insurance brokers and it offered private insurance to individuals. Since the enactment of the healthcare insurance reform, a number of changes have taken place in the marketing hence triggering a series of changes in the Boston healthcare market. Most of the key players in the healthcare industries suffered diminish of their businesses and as a result, they opposed the bill. The state healthcare bill had several effects on a number of people who were operating in the market. Several parts of the reformed insurance plan were changed with the political transformations that took place. For instance, the Romney’s care legislation had tax penalties that were given to residents who did not obtain the insurance plan. Such penalties were also levied on employers that did not offer insurance plan to them especially, those that had more than 10 employees. In 2013 however, the state legislature repealed the legislation and anticipated for a same but a more flexible mandate in PPACA. Similarly, the Obama administration waived off the PPACA mandates as the national employer. The individual penalties that were initially instituted by state were replaced with the provisions of the PPACA. The shape of the health insurance market has greatly changed in Boston with a number of key players dominating the market. After the entry of the government into the insurance plans, many insurance firms had to change their approaches to delivery of customer services. Thus, they offer more lucrative benefits within their covers to ensure adequate competition in the market. From the above, it is evident that various key market players are currently competing for the insurance tasks of the community. Most of these wage conflicts against the government that is implementing policies that would benefit the citizens but silently hurt the various market players. The major insurers in the Boston market include the Medicaid, Medicare and the state owned PPACA. All these are major players that are currently competing for the insurance needs in the market. The competitors have made the competition stiffer by including a number of appealing elements in their insurance plans so as to woe many people. For instance, the Medicaid insurance introduced an insurance program called MassHealth which was targeting low and medium income residents in the Massachusetts community. This insurance care covered even children. Depending on an individuals’ coverage, the MassHealth program may cater for all or part of the medical bill depending on the nature of cover. Other players in the market like Medicare are currently offering services to people of 65 years and above. This type of insurance offers various covers; for instance, there is the hospital insurance which caters for inpatient and skilled nursing care as well as home healthcare provisions. The other part of this medical insurance cover caters for medical test, doctor fees among others. These are just some of the few lucrative offers that have been issued by the various insurance covers. Over time, the common wealth insurance plans have faced a number of challenges that would probably make people change their opinions regarding it. For instance many people have had insurance cancellations a factor that has greatly made them to shop out for much better healthcare plans. The president, Obama, during one of his recent visit in Boston urged the community residents to seek for much better insurance plans in case they experience state insurance cancellation. The healthcare market is currently facing a myriad of challenges that will probably bring more in depth changes to the community’s health insurance plans. In addition, the Massachusetts healthcare system witnessed a medical bankruptcy. Most of these were brought about by the unpaid medical bills as well as illnesses that that led to complete loss of income. Hence the cases of medical bankruptcy increased relatively by more than one third. About 60% f the bankruptcy was contributed by medical costs and illnesses (Wholey et al 27). The medical bankruptcy may have been triggered by the financial crisis that began in 2008. Despite the health care reforms in the Boston community, still the cost of healthcare services got higher and higher. Economic implications With the market taking a different shape since the 2006 landmark healthcare reforms, there are various economic implications that have been experienced in Boston. Most of these relate to the manner in which the various healthcare services are given to the people. Making a comparison of the health safety Net expenditures within the years 2007 and 2009, there is a drop in expenditure since more people were insured hence did not require more health funds supports. Significantly, the health safety net expenditures increased by 7 percent in the year 2011. During the same year, their demand percentage increased by 10 percent. The demand in this case represents the total amount that the providers would need to be paid in case there were no funding short falls. Since the health safety net demand exceeded their expected funding, the hospital healthcare providers had a $ 38 shortfall (Felland 7). One of the most anticipated notions was that through the formation of commonwealth, the amount of charity given by healthcare institutions would significantly reduce hence leading to improved healthcare services. This however never came to be, the commonwealth care had a short term deficit of $ 100. With the increased number of people having insurance covers, many health institutions were overwhelmed and could not function effectively. Most hospitals had an increased number of visitors and the resources that initially were used in healthcare provision have become insufficient. The quality of healthcare has reduced to considerable levels a factor that is of great concern in the healthcare industry. At the same time, access to healthcare has increasingly become a bit difficult with many people having their health insurance plans getting cancelled. Upon such a cancellation, it is not easy to get an immediate insurance cover; one must wait for a given period before acquiring the other. This has greatly affected many people since they are forced meet the expenses of the ever-increasing cost of healthcare services. The introduction of the commonwealth insurance led to a distinction in the social classes of the people-needing healthcare. One of the classes is the group that registered for the commonwealth medical insurance. The other consists of people that did not comply with this rule and faced the penalty of the law. Such people waited for a time when they were in need of a crucial healthcare need that is when they resort to get insurance covers. Such suffered the consequences of the law provision and faced the penalty (White 4). Moreover, the insurance cover that they took differentiated the consumers. Some took the commonwealth insurance plans while others opted for Medicaid and Medicare insurances. Most of these dropped their insurance coverage and opted for some much better insurance choices. Consequently, pricing of medical services and insurance raised significantly, the 2006 insurance reforms led to increased demand for health insurance cover. The law made it compulsory to have an insurance cover; hence leading to the rise in the number of insured persons in the community. This in turn increased access to various healthcare institutions. With the increased access to medical insurance covers, many people were better placed to gain access to various health institutions. The increase in number of people accessing the medical facilities ubstantively led to increase in cost of medical services. Most hospitals had to raise their costs since many people were coming and they had inadequate resources. The financial crisis that occurred in 2008 also led to an increase in the cost of medical health care (Dowling et al 14). Consequently, the financial crisis did not leave out the insurance companies. They were affected, and thus, had to increase their rates periodically. Such changes compelled many people to search for the most appropriate insurance cover (Tu 23). Overall, despite the program benefiting many people, others were greatly hurt and had to incur losses in order to sustain themselves in the economy. Despite all these, Boston remains to be the state with the highest number of insurance cover with employees covering 65.1, Medicare 16.4 and commonwealth plan taking the 16.6 percent. Works Cited Corrigan, Janet M. Corrigan. "Center for Studying Health System Change." Case Study. Version 1. Washngton DC, 4 June 2009. Web. 4 Dec. 2013. . Dowling, Marisa K., Laurie E. Felland, Paul B. Ginsburg, and Ralph C. Mayrell. "Center for Studying Health System Change." Community Report No. 1. Version 1. Health Systems change, 1 Sept. 2010. Web. 4 Dec. 2013. Felland, Laurie E. . "Ascension Health's Community Efforts to Foster Safety Net Collaboration." Improving Health Care Access for Low-Income People: Lessons from Ascension Health's Community Collaboratives 30.7 (2011): 1-12. Print. Tu, Ha T. . "Boston Community Report." Center for studying health system change. Version 2. Washngton DC, 4 Oct. 2008. Web. 4 Dec. 2013. . White, Chapin . "Kaiser Family Foundation Report." Medicare Spending Limits: Issues and Implications 1.1 (2013): 7. Print. Wholey, Douglas R. , Jon B. Christianson, Debra A. Draper, Cara S. Lesser, and Lawton R. Burns. "Community Responses to National Healthcare Firms." Center for studying Health System Change 1.45 (2007): 118-135. Print. Minkler, Meredith. Community Organizing and Community Building for Health and Welfare. New Brunswick, N.J: Rutgers University Press, 2012. Print. Read More