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I was talking about a similar issue on my blog recently (http://www.bernardfarrell.com/blog/2007/02/talking-about-chronic-illness) [apologies if you've got Firefox, this won't display properly]. Are there any Massachusetts legislators who are seriously considering mandating coverage for preventive/chronic illness coverage?

Why does it require legislation for insurers to realize that they can save money by treating chronic illnesses properly? The argument I hear is that as people change insurers they would lose money. But if ALL insurance companies did this, in the end they'd all benefit.

I, for one, would change insurance companies if I could find one that fully covered the types of treatment I need to properly maintain control of my Type 1 diabetes.

Its worth mentioning that with less fanfare, Pennsylvania has also proposed a very similar step in terms of universal coverage. Building upon the Massachusetts program that began this year which likens health insurance to car insurance, making it a requirement for everyone. Within the last month, governors, legislative leaders and various commissions have also declared universal coverage an attainable goal in Iowa, Kansas, Minnesota, New Mexico, Oregon, Washington state and Wisconsin. Massachusetts and Vermont are expected to put their programs into effect this year, while Maine is tweaking its existing system. Many more states are also considering significant expansions.

But the Massachusetts' program is already being lampooned by its critics as being more costly than originally proposed by the former governor, and today, the Boston Globe is reporting that more than 200,000 people who already have health insurance would be forced to buy additional coverage in order to meet the proposed minimum standards under the state's new law, according to a count completed by insurers. California's plan is not as far along, but it seems safe to say that legislators in Sacramento are watching what happens in Boston very carefully.

The bottom line is that while universal coverage is long overdue and has been ignored in Washington for the past 8 years, the states are ultimately going to push the legislative envelope here. But anyone expecting it to be a smooth ride is not living in reality. There will be many bumps on this road, and until these bumps are paved over, I would not expect to see prevention to become to take really take precedence over care.

I am hopeful that day can come soon, just don't expect it tomorrow ... in Massachusetts, California, Pennsylvania or anywhere else in the U.S.

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