Para nós brasileiros, acostumados com o conceito do SUS entender o Sistema de Saúde Americano é um desafio de lógica. Primeiro, porquê lá não existe um sistema público gratuito, mas sim o pagamento de seguro saúde em que o governo ou os cidadãos pagam a empresas privadas para cuidarem de sua saúde.

Com isso, quem não tem condições de pagar por esse seguro fica de fora do sistema e pode ter graves problemas financeiros em caso de doença, pois os gastos em saúe serão considerados dívida pessoal.

Para mudar esta situação, o Estado de Massachusetts proclamou uma lei enquanto Mitt Romney era governador, que obriga a todos contratarem seguro saúde ou pagarem uma multa, que equivale ao valor do plano mais básico. Com isso, a cobertura de planos de saúde no Estado de Massachusetts foi bastante ampliada.

Hoje, 99% dos residentes de Massachusetts têm seguro saúde e como houve um aumento significativo do número de usuários com a lei, os preços dos planos caíram, o que permitiu que muitos cidadãos que não tinham condições de pagar pelo seguro-saúde, passassem a poder pagá-lo.  Agora, o que se discute é aplicar uma lei semelhante a esta a nível nacional, mas não há consenso sobre seus benefícios, o que faz com que em Estados como o Texas cerca de 16% da população não tenha seguro-saúde.

Certamente, o SUS apresenta inúmeros desafios, mas a realidade americana é bem mais perversa do que a nossa, o que torna vital defendermos o nosso Sistema Único de Saúde para que ofereça um atendimento de qualidade a todos, um desafio monumental, mas um desejo básico de qualquer nação desenvolvida.

Atenciosamente,

Fernando Cembranelli

Equipe EmpreenderSaúde

The Success Of “RomneyCare” In Massachusetts

I have two young daughters. When they left Brazil in 2010, they had no U.S. health insurance. One has a mild case of childhood epilepsy. Lucky for my daughters, they live in Massachusetts.

The state’s  healthcare reform has no serious opposition. Individuals and businesses, by a large margin, agree that the program may not be perfect, but it has been successful as measured by the people, including many middle income families, who would not be able to afford health insurance otherwise.

On April 12, 2006, Massachusetts governor and now presidential candidate Mitt Romney happily signed the landmark Massachusetts Healthcare Reform Act into law at historic Faneuil Hall.  As a result, the state, known as a world class medical center, has the most affordable healthcare insurance in the country.  It’s healthcare costs are high, but that no longer impedes 99% of the state from having affordable coverage, according to the Blue Cross Blue Shield Foundation, the non profit independent foundation of private state insurance firm Blue Cross & Blue Shield.

Every resident is required by law to have insurance, or pay a fine. To date, 99% of the state’s residents have health insurance, up from around 90% before healthcare reform.  That number changes drastically depending on which segment of society you look at.  At least 24% of low income residents did not have health insurance prior to the 2006 law, according to the Urban Institute, a Washington DC non-partisan think tank.  Today, just 8% of low income adults do not have healthcare coverage.

Overall, the number of uninsured, which was estimated to be as high as 650,000, more than the population of the city of Boston, has been wiped out. People in Mass. are covered. By comparison, the national average in 2010 had 16% of the population without healthcare coverage.  It’s worse in some states. Texas has 16% of its population going without health insurance, according to the Kaiser Family Foundation.

According to the Urban Institute, higher income individuals, including the self employed who did not qualify for the state Medicaid program known as MassHealth, saw their uninsured numbers go from 5% in 2006 to under 1% three years later.

The program is largely seen as the textbook example of how mandatory, state-subsidized healthcare could work.

“I think it has been a huge success,” says Michael Widmer, president of the Massachusetts Taxpayers Foundation, an independent state watchdog that has a reputation as the “keeper of the keys” on the state budget numbers. “Romney should be proud of it. It has been one of the biggest policy achievements in this state over the last 25 years,” he says.

Although on the national level Republicans talk of overturning “ObamaCare”, no Republican is the Massachusetts government is serious about overturning its predecessor, “RomneyCare”. In fact, politicians in Massachusetts by and large don’t want to overturn RomneyCare; they want to make it better and bring costs down at the same time, rather than just bring costs down and let everyone fend for themselves in the meantime, stuck on thousand dollar a month premiums for healthcare coverage.

“The goal of Massachusetts Healthcare Reform was never to lower the cost of healthcare, it was to expand healthcare coverage, which it did as well as everybody expected,” says Sarah Iselin, president of the Blue Cross Foundation. She was part of the discussion at the Blue Cross Foundation that ultimately helped shaped the law when Romney was governor.

Employers are not up in arms over universal, affordable healthcare coverage either, says Widmer.  A two year old study from Urban Institute revealed that concerns over employers dropping coverage or scaling back benefits because of health reform have not been realized. That’s a claim many Washington Republicans have made about ObamCare, saying it would cause U.S. small businesses to hold back on hiring because of mandated insurance laws. In Massachusetts, companies were never mandated to provide health insurance.

“We fought hard against that. Romney was in our corner. The House was not. If the House got their way, an increase in the payroll tax would have definitely been punitive,” says Widmer. “I have not seen any evidence at all that healthcare reform has hurt state businesses.”

Access to employer coverage in Massachusetts has increased, as has the scope and quality of the coverage as assessed by workers in the Union Institute study. In Massachusetts, affordable healthcare is here to stay and business is contributing to the system despite it not being mandatory. In 2005, just 70% of the state’s employers offered health insurance. After “RomneyCare”, it went up to 77%.

“More employers are offering healthcare coverage to employees because of healthcare reform,” says Iselin, who notes that the number of people enrolled may be flat, but only because the economy has slowed and many employers have been laying off. She says no one has cited layoffs because of health insurance costs.

 From: Kenneth Rapoza, Forbes, 20/01/12