Healthcare: As Goes Massachusetts ...

This can't be welcome news for Washington as Obama continues to try and sell healthcare reform in his Saturday address. There's very little to like as far as healthcare news coming out of Massachusetts. today. Details of steps being considered to salvage previous reform become fiasco appear to confirm many of the concerns critics have over Obama's not so grand healthcare reform plan.

Consumer advocates said patients are going to have to be educated about the new system. Patients could find it harder to get procedures they want but are of questionable benefit if doctors are operating within a budget. And they might find it more difficult to get care wherever they want, if primary doctors push to keep patients within their accountable care organization.

Implementing this “is going to be a very long haul,’’ said state Representative Harriett Stanley, Democrat of West Newbury, a commission member, and cochairwoman of the Joint Committee on Health Care Financing.

Many of the details are chilling, or should be. Budgeting doctors and hospitals at a single rate per patient up front will ultimately produce the very thing people fear most - rationing. And take a look at this immediately below. The harder you've worked in life, the less care you will likely get because the poor  need and consequently deserve more? Thanks, I'll pass.

Lynn Nicholas, president of the Massachusetts Hospital Association and a commission member, said payments must also be adjusted for socioeconomic factors, because“someone who lives in Brockton and doesn’t speak English’’ might require more intense care than “someone who lives in Newton or Wellesley with a lot of other resources around them.’’

But, relax. It's all going to be made up with efficiency. How may times have we read how that's mysteriously going to solve every dollar problem in every system, only to watch as it doesn't produce good results? Keyword: could!

Lastly, I guess Romney won't be touting his mastery of healthcare issues on the stump in 2012. He has more explaining to do on his now dismally failed efforts than he's managed so far. He should have simply fought it then, just as many are now. It's one reason why I do fear he's a government can solve it guy like other not so conservative Republicans in the end. The best approach might be to get government more out of the way and open up more genuine competition and choices to see the results we want and need.

A state commission recommended yesterday that Massachusetts dramatically change how doctors and hospitals are paid, essentially putting providers on a budget as a way to control exploding healthcare costs and improve the quality of care.

Instead, the group wants private insurers and the state and federal Medicaid program to pay providers a set payment for each patient that covers all that person’s care for an entire year and to make the radical shift within five years. Providers would have to work within a predetermined budget, forcing them to better coordinate patients’ care, which could improve quality and reduce costs.

Comments

[Lala]

My French friend tells me that's how it works in France. In her area there are two doctors. One doctor was so busy that she was working 6 days a week (pre the 35 hour per week law), the other doctor, who almost no one liked, sat in his office alone. The busy doctor exceeded her budget by seeing too many patients and was then required to give the excess payments back to the government. She then cut her hours, stayed within the budget, rationed care.

[AWW]

Valid point about Romney. Maybe just a coincidence that as Romney begins to be touted as the GOP frontrunner for 2012 his record as MA governor starts getting trashed. On the MA healthcare situation he is going to need to come up with a plausible story as to why it didn't work and what he would do differently at the national level.

[Ray]

If health care passes, a doctor would be wise to set up a clinic in the Caribbean with the help of venture capital. Use the Canada model, if in trouble go to to the US. One plus, they won't have to go on vacation to go to the islands. It would also be a great boost to the economies of the islands.

[Rich K]

Like we knew the mess in MASS wasnt going to happen. And romney was a front runner to mcCain no less.
And its 5,6,7 open up the pearly gates, I got no time to wonder why,WOOPIE were all gonna Die!

[mark l.]

"Like we knew the mess in MASS wasnt going to happen."

it isn't as if there weren't people telling them that the negative consequences would not occur.

romney aside, it remains that if you can't make a healthcare system work within a state, you can't make it work within a nation. the whole problem for the obamacare is that he doesn't have a working model of how to run healthcare.

this is like scribbling a new car design on a napkin, and giving it to every car munufacturer with the intent of having them mass produce the car within a year. no testing for flaws.

it would be one thing if obama were taking all the country's available resources and betting on a red or black, but he has gone so far as to bet on a single number. still a 1 in 37 chance is actually better odds than this healthcare system has of working.

[Rich K]

Mark, We would Have better odds of parking a Prius in front of a moving locomotive and surviving.

[WBestPresidentEver]

I feel sorry for us as a people as we are all going to get older as time goes on. The older generation if you get sick and need healthcare will cease to exist. You will just be sent to a hospice home to die. Our government will love that as they want have to pay you Social Security then. I am sure they have it all figured out. They will only help high wage earners to keep that tax money flowing in and anyone that is retired and no longer pays into the system will be left out in the cold.
I cannot believe this is happening in this country. I cannot believe that we watching our country go down the tubes at the hands of a runaway congress and a hostile leader.
Help us someone.

[expat]

Romney has also said that states should be the venue for trying out different health care ideas to see what works. He was against a nationwide experiment that risks our entire healthcare system. Let's take him at his word. Examine what Massachusetts did. Build on any good points, and avoid the disasters. I don't believe Romney is ideologically committed to a failing idea. Instead of distancing ourselves from him, ask him to contribute his analytic powers to the results in the Massachusetts system. If he acknowledges the failed concepts, it will have more resonance with voters than simply dissing him and any kind of health care reform. People are very skeptical now about thousnd-page unread legislation. Challenge Romney to be the grown-up who reads the fine print and explains its implications.