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in 2009 there is no bigger issue

What previous case is relevant in predicting what Obamacare will cause in the healthcare industry?

What will matter, as it did when we began this debate, is cost reduction. If one does not use competition to drive down costs, then policies must be used, even if brow beating and public shaming is applied. Massachusetts is the case that bears watching, for the costs have sky rocketed, earmarks continue to be added (as the politicians add politically popular treatments to the insurance mandated coverage. So in this article some other aspects of this care are alarming.


Your Massachusetts Future

The Senate Finance Committee approves its version of ObamaCare.  WSJ, Oct 14, 2009

These are the days of miracles and wonders, as the Senate Finance Committee approved its version of ObamaCare yesterday on 14 to 9 vote, including Maine Republican Olympia Snowe.  Now their health-care marvel—a new entitlement that will supposedly "reduce the costs of health care," as the President put it in his congratulatory message—will move to the Senate floor, and perhaps then to a doctor or hospital near you.

Meanwhile, Massachusetts is offering a preview of where all this will end up.  The state passed a prototype for ObamaCare in 2006 on the same cost-control theory as Senate Finance, only to see spending explode.  So now Beacon Hill is contemplating far more drastic spending-control measures, such as a plan to "require residents to give up their nearly unlimited freedom to go to any hospital and specialist they want," as the Boston Globe reported on Sunday.  Paul Levy, the CEO of Beth Israel Deaconess Medical Center, told the Globe that "You can't reap these savings without limiting patients' choices in some way."

A 10-member commission is trying to impose a new "global payment" system on the top-notch Massachusetts health system.  Doctors and hospitals would be forced to join large networks and be paid a set rate for each patient.  The idea is to make providers live within a fixed budget and cut down on expensive treatments.  But if patients are allowed to receive care outside of whatever network they end up in, this new jerry-rigged cost-control would break down, or not produce the desired "savings."  You know who wins when the interests of government conflict with those of patients to choose a doctor or treatment.

We'll have more to say about such "accountable care organizations" in the coming days, as they're also a major element in the Senate Finance bill and the direction that Washington wants to move U.S. medicine. Yet anyone following yesterday's vote should understand what it will mean—because the Senators clearly don't.