"Drugs or No Drugs, That's the Question" by Celia Wcislo

Many of us working on the implementation of health insurance expansion know that several things must happen for this law to result in universal participation.

The healthcare coverage we develop must have real value to the patient: that is, it must cover the basic expenses someone incurs when getting sick today. That’s why the Connector board included preventative doctor visits before any deductible in our coverage standard. You should be able to see a doctor to avoid getting sicker.

We cannot create comprehensive health insurance coverage without including drug coverage. That’s like building a bike that has no wheels. That’s why the Connector board will, today, include drug coverage as a requirement for all plans in Massachusetts. Prescription drugs are a primary method of treatment for many diseases, such as high blood pressure and diabetes. And when used in tandem with managed care, they can be a very effective method – both for the patient and the healthcare provider. What we surely know is that without affordable drug coverage, many patients simply do not fill a prescription and do not follow their physician’s plan of treatment.

It’s not the intent of the law that only some individuals have health insurance or partial health insurance. It’s the intent that the health insurance options we create to execute this law have real value in the face of real illness.

Coming up quickly after that the Connector vote on prescription drug coverage, is the issue of mandating individuals to buy insurance. Most members of the Connector Board understand and believe that every Massachusetts resident needs to become a part of the healthcare system, by enrolling in the most affordable plan for them. We need to help them find such plans, and when none are affordable, we need to help subsidize plans so everyone can afford it.

I understand that getting to universal participation in our healthcare system might require a phased-in approach for both businesses and individuals. We can’t go too fast, because neither business nor individuals will be able to afford a sharp hit on their budget.

All of us have a responsibility to make access universal, and to help pay for it. Business has a responsibility to provide quality, affordable coverage that includes drugs and preventative care. Government has the responsibility to help set up the system, and provide subsidies for those with limited income. And individuals have a responsibility to help pay for a fair and reasonable amount of the cost of their care.

Celia Wcislo
Assistant Director, Massachusetts Division
1199SEIU United Healthcare Workers East
and Connector Board member