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The politics of Healthcare need reform


From Greg Scandlen, Heartland, Jul 17, 2009

The results keep coming in from Massachusetts and they aren't pretty. The Wall Street Journal calls it "a mess." It reports, "the returns are rolling in, and a useful case study comes from the community-based health plan Harvard-Pilgrim. CEO Charlie Baker reports that his company has seen an 'astonishing' uptick in people buying coverage for a few months at a time, running up high medical bills, and then dumping the policy after treatment is completed and paid for." People can do that because of the guaranteed issue provision in the law that requires plans to sell coverage to anyone at any time with no denials or waiting periods. Yippee!

SOURCE: Wall Street Journal

The New York Times reports that, faced with a tight budget and high costs, Massachusetts is cutting people from the rolls. It writes, "The new state budget in Massachusetts eliminates health care coverage for some 30,000 legal immigrants to help close a growing deficit, reversing progress toward universal coverage just as Congress looks to the state as a model for overhauling the nation's health care system." The article goes on to report that the president of the Blue Cross Blue Shield Foundation, Phillip Johnston, thinks the solution is simple -- "an income tax surcharge on the wealthiest." There you go. Raise taxes and pass the money on to Blue Cross. Such a deal.

SOURCE: New York Times

The New York Times also reports that, "A high-level state commission recommended Thursday that Massachusetts seek to rein in health care costs by radically restructuring the way doctors and hospitals are paid." It would institute a super capitation scheme known as "global budgeting." That is, each institution would be rewarded a fixed amount of money.

This amounts to HMOs on steroids. The article says, "Global payments would reward health care providers for keeping their patients well rather than for merely treating their ailments. If the cost of treating a patient was less than the global payment, the provider networks, called accountable care organizations, would keep the difference as profit." That is exactly the same idea that fueled the HMO movement in the 1990s. It resulted in drastic under-treatment of patients and was roundly rejected by the American people. Tell me again what Einstein's definition of insanity was?

SOURCE: New York Times

Yet, the Times also reports on a hospital that is suing the state for underpayment. The article says, "The hospital, Boston Medical Center, faces a $38 million deficit for the fiscal year ending in September, its first loss in five years. The suit says the hospital will lose more than $100 million next year because the state has lowered Medicaid reimbursement rates and stopped paying Boston Medical 'reasonable costs' for treating other poor patients."

Perhaps you thought the Massachusetts reforms were supposed to fix all these problems. But, "According to the suit, Massachusetts is now reimbursing Boston Medical only 64 cents for every dollar it spends treating the poor. About 10 percent of the hospital's patients are uninsured -- down from about 20 percent before the law's passage in 2006. But many more are on Medicaid or Commonwealth Care, the state-subsidized insurance program for low-income residents."

Just imagine the suits to come if the state starts doing global budgets!

SOURCE: New York Times

In spite of all this chaos, Mitt Romney is still enthusiastic about what he wrought while he was governor. In a recent interview, he gives the program an A grade. I'll leave the conclusion to you. Which leaves me wondering. Is that man a fool, is he insane, or is he just another politician who will never admit when he has made a mistake?

SOURCE: The Boston Channel