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I don't understand! I listened in on the Tsongas town hall phone call tonight and she said everything was pissa and it (HC) was going to be cheaper and better! LOL!!
Massachusetts health meltdown is your future
Massachusetts health meltdown is your future
Mass. health meltdown is your future
By SALLY PIPES
Last Updated: 12:54 AM, May 25, 2010
Posted: 12:26 AM, May 25, 2010
The future of US medicine under ObamaCare is already on display in Massachusetts. The top four health insurers there just posted first-quarter losses of more than $150 million. Most of them blamed the state's decision to keep premiums at last year's levels for individual and small-business policies, when they'd proposed double-digit hikes to match the soaring costs they've seen under the state's universal-coverage law.
The companies have gone to court to challenge the state's action -- it apparently had no basis for its ruling beyond the political needs of Gov. Deval Patrick. If they win, Bay State health premiums will continue their rapid rise; if they lose, they'll eventually have to stop doing business in Massachusetts -- and the state will be that much closer to a "single payer" system of socialized medicine.
The Massachusetts "health reform" disease means more than just bureaucrats setting prices. It also includes rising government spending and taxes; politicians demonizing doctors, hospitals and insurers -- and patients getting lectured that the restrictions of managed care are good medicine.
It's what's in store for all of America. The Bay State's structure provided the base for ObamaCare. "Basically, it's the same thing," says MIT economist Jonathan Gruber, who was a health adviser to GOP Gov. Mitt Romney and President Obama.
Like ObamaCare, RomneyCare includes a government-run exchange (the "Commonwealth Connector"), mandates and fines on individuals and fines on businesses. It expanded coverage mainly by expanding Medicaid. Of the 176,766 insured through the Connector, more than 152,000 are on subsidized plans, most paying nothing.
ObamaCare will follow suit. Richard Foster, chief actuary at the Centers for Medicare and Medicaid, reports that the law will add $310 billion over 10 years to federal spending and put 18 million more Americans on Medicaid.
Another similarity: RomneyCare offered no real means to control and ultimately reduce costs. Its backers made airy promises of redirecting monies from state-sponsored charity care to insurance premiums, claiming that an insured population would be healthier and save money. In fact, the state has begged Washington year after year for money to plug the system's gaps. In the program's first three years, the feds will have spent $21.2 billion -- $3,000 per Massachusetts resident.
Actually, ObamaCare's cost-control promises are even more fantastic -- from supposed slashing of Medicare payment rates to politically impossible "Cadillac" taxes. The only real cost control in either plan will be the brute force of government.
A Boston Globe story from earlier in the dispute over rate hikes says it all: "Two of the state's big health insurers face stiff fines after they submitted to the state revised premium rates for individuals and small businesses that differed from what regulators ordered."
There's no such thing as a market where bureaucrats set the price. Yet that's what health care has become in Massachusetts under its reform.
"I don't know how much clearer we could have been with them," complained Massachusetts Insurance Commissioner Jack Murphy. He told the Globe: "We communicated four times what rates we expected. We're considering all options. At minimum, both will face significant fines and potentially other penalties."
When insurers then complained that they'd post losses, the Patrick administration lambasted them as "outrageous," "uninterested in alleviating escalating health-care costs" and "in love with the status quo."
Government finally caring about the little guy? Hold your cheers -- because the inevitable next step is rationing at the point of consumption. Massachusetts state Senate President Therese Murray has proposed putting an end to "fee for service" medicine in the next five years and moving to a system of capitated managed care, where doctors receive a flat fee for each assigned patient.
This "HMOs for all" approach is designed to lead to soft rationing -- which, in medical terms, means people will have a hard time finding doctors or seeing the ones they have. It's already started. In Massachusetts, one doctor in two is not accepting new patients. Waits for treatment in Boston are the highest in the nation.
And Medicare's chief actuary predicts the same fate under ObamaCare. "It is reasonable to expect that a significant portion of the increased demand for Medicaid would be difficult to meet," Richard Foster wrote in a recent report.
Get ready, America: If nothing else, ObamaCare will put the patience back in being a patient.
Sally Pipes, president & CEO of the Pacific Research Institute, is the author of "The Top Ten Myths of American Health Care."
I don't understand! I listened in on the Tsongas town hall phone call tonight and she said everything was pissa and it (HC) was going to be cheaper and better! LOL!!
My personal experience over the last ten years that medical personnel and pharmaceutical companies engage in sale of Snake Oil cures.
Among the pseudo diseases, that are sold as being life threatening, are high cholesterol levels, sleep apnea, salt intake,.....
High cholesterol levels:
In 2007, the median total cholesterol level of people that died from heart attacks was 198. Reaction of the medical community was to lower the total cholesterol level threshold to 130 and to use a high accuracy C Reactive protein test to determine inflammation of the arterial walls. Visit the Lipitor site and browse the data and you will find a term "Numbers Needed to Treat" of 41. The # 41 means that 41 people will have to be treated with Lipitor over a period of 10 years to prevent one death from a heart attack. Lipitor like all statins works by preventing the liver from producing cholesterol with some serious side effects that can kill you. Check out the statin, Baycol, to see the type and number of adverse impacts before a drug is pulled of the market. Two blood tests AST and ALT need to be monitored and the statin protocol stopped or modified if the test results are outside the 95% test range boundaries. The German and Australian Health agencies have posted many studies on statins that would make most people wonder whether the so called benefits derived from statins outweigh the serious impact that they can have on your liver and kidneys.
Sleep Apnea:
The latest Snake Oil scam that is being sold to the public. There may be some people that suffer from sleep apnea and there are several solutions ranging from a mouth piece, septum reconstruction, and positive airflow device. The medical gurus claim that one must have 8 hours of sleep at night to be able to function. This factoid flies against the protocols use in space flight, naval sea duty and military crew duty guidelines which were derived in the 60s and 70s in support of manned space flight.
I was admitted to Emerson hospital for an auto immune illness and within 4 hours of being admitted, I was being asked by a floor nurse if I had ever had a sleep apnea test. I informed the inquisitive nurse that I had in fact had had two sleep apnea tests both of which had come back negative. i.e. I did not suffer from sleep apnea. About an hour later, the Hospitalist (A Dr. who roams the wards), asked me if I ever had had a Sleep Apnea test. I asked him "Is there a sale on Sleep Apnea tests?" Dr. Hospitalist replied "Emerson just built a state of the art Sleep Center." I thanked him for the information and told him "I have been up for 20 hours and I am in pain, I would like to sleep. Goodnight" I then did a six hour sleeping tour and was awaken at 5:30 am so the orderly could draw my blood. That night, I asked Inquisitive Nurse if she had had a sleep apnea test. She replied that indeed she had had a sleep apnea test and she was using the positive airflow device. I asked her about her experience with the positive airflow device and she replied "I can only wear it for a maximum of 4 hours."
Salt Intake:
The latest crusade by the medical profession is the reduction of salt intake by the American consumer. There has never been a cause and effect test that can show that the reduction of salt intake levels by healthy individuals will save one life. In fact up until two years ago, the only governmental requirement on salt content of drinking water supplies was that if the sodium concentration exceeded 10,000 parts per million then the source had to be labeled brackish.(BTW the level quote is a 1% salt solution.) There are people that will retain water (fluids) and there are people who will see an increase in blood pressure when consuming salt (sodium). These individuals compose less than 2% of the population and they are usually suffering from some form of heart disease. So to protect a small sample of the population, who are very likely to be on a salt (sodium) restricted diet, the US government and the medical gurus will launch a campaign in the very near future that "Salt Kills" at a cost of several hundreds of billion of dollars to food consumers.
I wonder how Capt. Horatio Hornblower was able to cruise the seven seas with his primary source of food was salted meat, wormy biscuits and grogs of rum. It must have been the rum.
Last edited by Tony1941; 05-25-2010 at 11:55 PM.
Healthcare costs are Govts fault?
The article makes it seem that exponentially growing healthcare costs are romneycare's fault. Yes, romneycare didn't do much to try and bend the cost curve, but everything that obamacare is trying to do to bend the cost curve is lambasted as a government takeover.
If we are serious about decreasing healthcare costs, we would do everything possible to take the profit motive out of healthcare and use government spending to promote innovation (the same as is done in the scientific and R&D industries). Until then, why wouldn't a company spend ridiculous amounts of money to create medical treatments for silly conditions and then spend ridiculous amounts of money on marketing and sales promotions because those treatments have fantastic gross margins?
If neither the government or insurance companies would cover or pay the ridiculous cost for the silly conditions, the overall cost of medical treatment would decrease. Would you believe that $22 for two aspirins is considered a valid charge by Met Life. Why? Met Life collects a % of the expenditures and the employee does not care since it does not come out of his/her pocket.Originally Posted by ggreenma
In June 1986, I had cataract surgery at Nashoba Community hospital with a total cost for surgeon and hospital costs under $2,300. That Fall, the Globe published an article comparing comparing various surgeries and their cost at different facilities. Mass Eye and Ear would have charged over $8,700 for the care that I received at Nashoba. Since my surgeon at Nashoba also practiced out of Mass Eye and Ear, the next time that I saw him, I asked him "Why the difference in the costs between Nashoba and Mass Eye and Ear ." He replied "Professional courtesy. I suggest to my Boston area patients to come out to Nashoba so I can charge the lower rates."
So price fixing seems to be well established in the Massachusetts hospitals where some hospitals are reimbursed at 4 or more times the rate of other hospitals, by the insurance companies. Better results do not seem to be the cause for the difference in reimbursement.
I am halfway through reading the book quoted by Amber. My view is that the author is applying Libertarian principles to justify the current system.
i.e. Screw You Jack, I am covered by an insurance program that will pay for anything that my doctors deem necessary. For example foreigners come to the US to be treated by US doctors. These individuals are paying out of their bank accounts so they can shop around the world for their care. It may be an expression of snobbery. Moi, you expect moi to wait 7 days to see a renowned physician for my in-grown toenail. You dolt, I am entitled.
It's the "soft rationing" which bugs me. A shortage of physicians - especially internal medicine - means much longer wait times. We already see that with Autism, where a proper feeding clinic, neuropsych eval, and SLP eval with ongoing treatment all are on 9-month to over a year waiting periods. My family care physician has a relatively small practice and is no longer taking new patients. I prefer the option of the whole family going to one doctor because the doctor knows the whole family dynamic (plus I can't stand Pediatrics West).
If it becomes more lucrative to practice other areas of medicine or pick a different path entirely, how will we serve the insured masses? School districts already pay for therapeutic services which should be reimbursed by insurance companies but aren't. It may cost $22 for two aspirin but then pediatricians aren't reimbursed properly for immunizations, either. Dr. Beck, the best family medicine doctor I had in my lifetime, moved out of Mass because it became too expensive to practice. In his letter to patients when he left, he explained how he paid out more for his wife's root canal than an insurance company reimbursed him to follow a woman through her entire pregnancy, including labor and delivery. That's crazy. The current system punishes practicing physicians and consumers while benefiting pharmaceutical companies and inscos.
Most doctors I have spoken with are torn between one of two solutions - a true single payer system or consumer-driven, free-market system - but all agree on the need for tort reform to cut the cost of malpractice insurance.
Both initial options cut managed care inscos out of the picture completely. I prefer the second option. Let people buy a catastrophic care plan just like they do house and car insurance, and leave the day-to-day repair and maintenance costs to the consumer. We're (by and large) not considered too stupid to shop around for our own gas, oil changes, and new tires. So why does everyone think we're not smart enough to shop around the same way for well-child visits, immunizations, and annual check-ups?
Last edited by Amber; 05-27-2010 at 03:16 PM.
Another option
I don't see how we put the entire insurance industry out of business, but here are two thoughts...
1) Provide tax breaks to insurance companies that turn themselves into non-profits and agree to meet a very high standard for medical loss ratio (percent of dollars spent on healthcare rather then on marketing/admin)
2) Set up a commission consisting of dr's, insurance companies, consumers and regulators that negotiate pricing for all common health expenses and again, provide incentives to healthcare providers to use these prices. This would eliminate crazy prices like $22/aspirin.
Maybe the insurance companies wouldn't be going out of business if they started to question some of the outrageous fees they pay routinely and started to go after excessive charging organizations.
Dr. Beck should have billed the pregnancy as a root canal or conversely have the patient go to an ObGyn doctor. If Dr. Beck was delivering babies. his insurance premiums would be astronomical.
Nationalization of the health system is the only solution to the problem. Malpractice suits would be prohibited with criminal charges substituting in their place.
Information on cost and/or quality of everyday items are readily available. Cost on medical services and supplies are generally not available to the averege consumer.
The more I pay out the higher premiums I can justify. If I pay out 1 billion on a given year and make $50 million, my profit is 5%.
If I pay out 10 billion and make 500 million my profit is still 5%.
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