Health-care agency sick

Margery Eagan
The Boston Herald

Lauren and Nick Destito had a wonderful life in Plainville. They paid their bills and raised two sons in a lovely four-bedroom colonial that they were just eight years away from owning outright.

But the economy collapsed in 2008 and soon crushed the small tree and landscaping business the couple had run since 1984.

Now, the state of Massachusetts is grinding the Destitos into the dirt. The reason: the health insurance the Destitos bought, paid $750 monthly premiums on and repeatedly used at doctor visits apparently does not pass muster with the state’s mandatory universal health insurance law. Now the Destitos, both 50 and already on the brink of financial ruin, are facing a $3,000 state fine.

“The stress will kill me before anything else,” Lauren Destito joked nervously yesterday just before her appeal hearing with the state’s Health Connector. She was so worried she asked her state representative, Dan Winslow, to listen in on the conference call. With hearing officer Irene Herman’s knowledge, I listened in, too.

“I would just like to say that we did make the effort and purchased a plan,” Destito told Herman. “I don’t understand why we’re in this situation at all.”

Because, Herman explained, the state must establish if her family could afford other, better insurance, and that affordability is determined “not, unfortunately, from your perspective but from the state agency’s view.”

In other words, the state decides how much health insurance you can afford — not you…

The article continues at The Boston Herald.

RelatedMeanwhile, Back In Massachusetts…

The Times describes the effort in Massachusetts to rein in their spiraling health care costs.  The gist is to move away from a fee-for-service model and force service providers to act like insurers by accepting a flat fee for patients and then managing their care…

…As a matter of economics, this at least aligns the incentives of the people writing the checks with the people ordering the treatments…

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