nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Monday, December 13, 2010

Massachusetts Health Care Reform Costs Continue To Spiral Up After 4 Years

If you promise to cover everybody and lower cost, what do you do when cost goes up even faster? Claim victory while pointing fingers and considering desperate measures.

Four years experience of reform in MA has caused costs to rise even faster.  Overdrawn, and running out of options, the state is considering more draconian measures.

Like Obamacare, MA requires everyone to buy insurance.  But people are avoiding enrollment until they need something big, like surgery.  Then they join, get the care, pay premiums until they recover, and disenroll.

This transfers the costs of the freeloaders to the law-abiding patients who enroll and stay enrolled.

The state has been increasingly overbudget every year, has gotten waivers for Medicaid from an accomodating Administration, and sees only a deepening crisis ahead.  On top of this, health care usage (how often people see the doctor, go to the ER, etc) is on the rise.  The number of doctors and hospitals is unchanged.  Result: delays, reduced quality.

So what do you do?  According to
spokesman Richard Powers ...[with] 97 percent of Massachusetts taxpayers insured, the program so far has been an overwhelming success. Officials are now trying to lower health-care costs. “If the rest of the nation is as lucky as Massachusetts, the entire country will be better off,” he said. (Boston Herald, Nov 19)
The view from La-La Land.  The state admits that it is gearing up to sue citizens who don't enroll.  Big Brother must have your dough to keep the system from collapsing.

Critics like Michael Cannon, of the Cato Institute claim
“It was sold as a way to cover uninsured and then reduce cost of health care. It has covered some previously uncovered people, but not as many as the commonwealth claims they have covered, and the cost of health care is rising, by every measure, while the quality is falling.” (same link)

Supporters' big hope now is "Payment Reform,"  which means doctors and hospitals won't get paid for what they do, they'll get paid for the result.  It will be interesting to see what payment reform does when an overweight alcoholic does poorly and the clinic doesn't qualify for the excess cost of taking care of this patient.  The usual remedy has been for the taxpayer to pick up the tab; I don't see insurance regulators denying payment for services rendered.

Even the state Attorney General says that payment reform, if it works, won't be enough.

Recall that the Massachusetts program was a "ground breaking" effort that Obamacare patterned itself after.

Uh...that means the rest of us get stuck with it next?

Doc D

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