News outlets report on a proposal in Massachusetts to require colleges and universities to insure students, an insurer in Massachusetts that is expected to try to alter the "fee for service" model and a plan in Hawaii to opt out of the national health care overhaul. The Associated Press/Boston Globe
: "Lawmakers are weighing a bill to require every full and part-time college student in Massachusetts to have at least the basic level of health insurance required under the state's landmark 2006 health care law. Under the proposal, any public or private institution of higher learning that fails to insure its students would face fines of $1 per student for every day the student remains uninsured" (11/29). The Wall Street Journal
on Friday reported on the expected announcement of a deal that would cover "60,000 members of the Caritas Christi Health Care system, marking one of the country's largest experiments in fundamentally changing the way doctors and hospitals are paid. In most of the U.S. health-care system, doctors and hospitals generally earn money when people get sick, under a reimbursement system known as 'fee for service.' But Blue Cross is trying to change the payment model to a system in which doctors and hospitals earn more by keeping patients healthy and out of doctors' offices and hospitals. If successful, the approach offers a potential model for the rest of the U.S. Legislation to overhaul the health-care system pending in the Senate calls for Medicare to set up small experiments to change reimbursement in ways similar to what Blue Cross is attempting" (Martinez, 11/27). NPR
: "Hawaii wants out of the national health care overhaul because it already has one of the lowest uninsured rates in the country, thanks to its 35-year-old employer mandate system. Hawaii's congressional delegation inserted language into both House and Senate health care bills that provides explicit protection for the landmark Hawaii Prepaid Health Care Act of 1974. It's apparently the only state looking for such an exemption from major health care overhaul (Markus, 11/27).