Cape Care and health care news from Cape Cod and Massachusetts
Cape Cod Times, February 22, 2006
STAFF WRITER
Residents this spring will have a chance to weigh in on a proposal to bring universal health care to Cape Cod.
Cape Care
So far, the resolution pressing for universal health care on Cape Cod is on town meeting warrants in Bourne, Chatham, Dennis, Eastham, Harwich, Yarmouth and Provincetown. Signatures are being collected in all other towns except Falmouth, where the warrant deadline has passed. Barnstable Town Council will also be asked to endorse the resolution. Proponents say the so-called Cape Care insurance plan would:
''Cape Care,'' a single-payer plan envisioned for Barnstable County by local human service groups and business people, will be floated at most town meetings this spring to gauge support for the proposal.
If the nonbinding question is approved, the county would spend the next year developing a plan for a single-payer health care program available to all on Cape Cod, said Dr. Brian O'Malley, a Provincetown internist who helped draft the resolution.
O'Malley and an informal group of health care, business and human services representatives have worked on the proposal for about two years, he said. The idea for a town meeting resolution grew out of one working group session.
''That's where we have historically gathered to talk about things of importance to our community,'' O'Malley said of town meetings.
All towns except Falmouth are expected to have the resolution on their annual warrant, according to Mary Zepernick, another member of the Cape Care group. Barnstable Town Council will also be asked to consider the resolution, she said.
As it stands now, Cape Care is short on details and long on concept. Generally, the proposal would assess all residents a fee based on income that would pay for a not-for-profit health insurance program that would cover everyone. The fee would be assessed regardless of a resident's choice to accept or reject the county insurance.
Cape Care is based on the premise that health care is a right and should be available to everyone, similar to municipal services such as schools, police and fire protection, Zepernick said.
Still to be worked out is how those on Medicare and Medicaid would fit into the system. Among the arrangements being considered are having the government programs earmark benefits to the Cape Care program, she said.
No calculations have been made yet about the average cost to residents.
The state has estimated that about 14,000 Cape Codders are uninsured. In its annual survey, the county finds the problem to be much bigger. County figures show that between 27,442 and 41,163 Cape residents have no health insurance.
If adopted, Cape Care would be one of the first such regional plans in the country, according to Alan Sager of the Boston University School of Public Health. Several states, including Massachusetts, and at least two counties in Michigan and Florida have looked into ways to cover the uninsured, but none has proposed blanket universal coverage, he said.
There are opportunities as well as challenges for Cape Codders with the Cape Care program, Sager said. Its well-defined geographic boundaries, higher than average number of uninsured people, and a relatively small health care provider base make it an attractive test ground for such a model, he said.
The challenge would be to pool Cape Care's money in a way that would ''squeeze out the fat and waste and capture the savings and recycle them to both cover everyone and preserve and protect hospitals, doctors, dentists, nursing homes, home health agencies, and other professionals,'' Sager said.
A single-payer plan would eliminate the hours of paperwork doctors and their clerks spend on the various billing requirements from different insurance plans, he said. Health care providers who were assured of prompt payment and who would be consulting with other providers in the system would presumably have less incentive to order unnecessary tests and procedures, he added.
''Caregivers could focus on what's clinically appropriate and not on what makes money,'' Sager said.
If town meetings approve the Cape Care resolution, it will likely fall to the county's human services department to develop the program and bring it back to voters for consideration, said department director Len Stewart. He has been involved with the group working on the Cape Care plan for the past couple years and believes it could work.
''It's a manageable thing,'' he said.
''We are pretty self-defined, not only geographically, but as a health care delivery region.''
Stewart said the biggest obstacle may be residents' attitudes. In his discussions with residents from all over the Cape, he has found most people feel the health care issue is too complicated to solve.
''I want to get residents empowered to think maybe we can,'' he said.
Robin Lord can be reached at rlord@capecodonline.com.
(Published: February 22, 2006)
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Universal health care proposed for the Cape
By ROBIN LORDSTAFF WRITER
Residents this spring will have a chance to weigh in on a proposal to bring universal health care to Cape Cod.
Cape Care
So far, the resolution pressing for universal health care on Cape Cod is on town meeting warrants in Bourne, Chatham, Dennis, Eastham, Harwich, Yarmouth and Provincetown. Signatures are being collected in all other towns except Falmouth, where the warrant deadline has passed. Barnstable Town Council will also be asked to endorse the resolution. Proponents say the so-called Cape Care insurance plan would:
- Provide health care coverage for all residents.
- Control health care cost by reducing excessive administrative expenses.
- Shape health care delivery through a representative policy-making board.
- Strengthen the ability of the existing health care network to provide high-quality care by assuring adequate funding for services.
''Cape Care,'' a single-payer plan envisioned for Barnstable County by local human service groups and business people, will be floated at most town meetings this spring to gauge support for the proposal.
If the nonbinding question is approved, the county would spend the next year developing a plan for a single-payer health care program available to all on Cape Cod, said Dr. Brian O'Malley, a Provincetown internist who helped draft the resolution.
O'Malley and an informal group of health care, business and human services representatives have worked on the proposal for about two years, he said. The idea for a town meeting resolution grew out of one working group session.
''That's where we have historically gathered to talk about things of importance to our community,'' O'Malley said of town meetings.
All towns except Falmouth are expected to have the resolution on their annual warrant, according to Mary Zepernick, another member of the Cape Care group. Barnstable Town Council will also be asked to consider the resolution, she said.
As it stands now, Cape Care is short on details and long on concept. Generally, the proposal would assess all residents a fee based on income that would pay for a not-for-profit health insurance program that would cover everyone. The fee would be assessed regardless of a resident's choice to accept or reject the county insurance.
Cape Care is based on the premise that health care is a right and should be available to everyone, similar to municipal services such as schools, police and fire protection, Zepernick said.
Still to be worked out is how those on Medicare and Medicaid would fit into the system. Among the arrangements being considered are having the government programs earmark benefits to the Cape Care program, she said.
No calculations have been made yet about the average cost to residents.
The state has estimated that about 14,000 Cape Codders are uninsured. In its annual survey, the county finds the problem to be much bigger. County figures show that between 27,442 and 41,163 Cape residents have no health insurance.
If adopted, Cape Care would be one of the first such regional plans in the country, according to Alan Sager of the Boston University School of Public Health. Several states, including Massachusetts, and at least two counties in Michigan and Florida have looked into ways to cover the uninsured, but none has proposed blanket universal coverage, he said.
There are opportunities as well as challenges for Cape Codders with the Cape Care program, Sager said. Its well-defined geographic boundaries, higher than average number of uninsured people, and a relatively small health care provider base make it an attractive test ground for such a model, he said.
The challenge would be to pool Cape Care's money in a way that would ''squeeze out the fat and waste and capture the savings and recycle them to both cover everyone and preserve and protect hospitals, doctors, dentists, nursing homes, home health agencies, and other professionals,'' Sager said.
A single-payer plan would eliminate the hours of paperwork doctors and their clerks spend on the various billing requirements from different insurance plans, he said. Health care providers who were assured of prompt payment and who would be consulting with other providers in the system would presumably have less incentive to order unnecessary tests and procedures, he added.
''Caregivers could focus on what's clinically appropriate and not on what makes money,'' Sager said.
If town meetings approve the Cape Care resolution, it will likely fall to the county's human services department to develop the program and bring it back to voters for consideration, said department director Len Stewart. He has been involved with the group working on the Cape Care plan for the past couple years and believes it could work.
''It's a manageable thing,'' he said.
''We are pretty self-defined, not only geographically, but as a health care delivery region.''
Stewart said the biggest obstacle may be residents' attitudes. In his discussions with residents from all over the Cape, he has found most people feel the health care issue is too complicated to solve.
''I want to get residents empowered to think maybe we can,'' he said.
Robin Lord can be reached at rlord@capecodonline.com.
(Published: February 22, 2006)
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