Re: Does Massachusetts need more cost control?
posted at 7/31/2012 8:45 PM EDT
Gotta love appdev for attacking me with no facts at the same time casting aspersions at others for fact collecting, while he exercises no real fact on his side. I mean, statistical analysis is what you put in FAR more than what you get out. That I learned 30 years ago in statisics. Far more studies using statistics are concluded before the data is even looked at, than the opposite.
Oops I forgot to mention that Ronald Reagan basically banned the tax free shelter for donations to Hospitals in his 1985 raise the tax act that reversed his republican creedo. No longer were people with money able to shelter significant taxes from wills and familial tranfers at death with tens of millions to public hospitals. And just about that time came the for profit large hospitals. Coincidence? Not really just bad tax policy hurting the poor and benefiting the few.
As to the notion that all is lost in medical cost control and there is no good plan and no one has ever done anything useful? I say it depends very strictly on the model. Fourty years ago the cost model included a totally different source of federal funds and cost for running hospitals and cost of fuel, electricity.... It is a very demanding task to compare cost measures from different decades. In the 70's plastic was cheap, I mean REALLY cheap compared to today even with inflation. How do I know? Because I was an assistant for cost accounting at a plastic molding company.
The numbers on medicaid vs medicare were very different. The state portion of these costs was VERY different being that many states ran their own public healthcare clinics without federal dollars from medicaid. Then the block grant time period for public health and so many different funding environments that appdev pushing his singular cost expansion model is just fantasy over the previous four decades.
As to offices that refuse Medicare patients. This has always been the case even fourty years ago. It has been complained about in newspapers and other outlets every year. The heart wrenching stories. Year in and year out and twice as much in an election year. But really the doctors that I have contact with in mass get paid faster with less paperwork from Medicare than ANY insurance company. Just talk to the office staff. While a cheap payback the office spends far less effort. AND that is a big boost to the doctors practice, compared to the private ins. co's.
In Response to Does Massachusetts need more cost control?
[QUOTE]Although history-challenged Globe reporters seem unaware, Massachusetts has set up and sometimes abandoned one medical cost-control effort after another over the past 40 years. The early 1970s "certificate of need" requirements aimed to hold down proliferation of new hospital progams. They were soon exploited by bigger hospitals seeking to protect themselves from smaller competition. [A.E. Reider, J.R. Mason and L.H. Glantz, Certificate of need: the Massachusetts experience, American Journal of Law and Medicine 1(1):13-40, 1975] Hospital rate-setting in the late 1970s disintegrated as emergency rooms started churning patients and hospitals laid off nursing staffs. HMO capitation in the 1980s became another failed experiment, producing massive rejection by health-care insurance subscribers. At one time or another, the state has experimented with almost every popular medical cost-control notion except the one that might work, single-payer care. Gov. Patrick, his foolish advisers and a State House contingent bereft of insight are now embarked on a high risk, low return project to rein in costs of medical care. Unlike Congress, trying fitfully to restrain the growing cost of Medicare, they lack effective leverage. If the state tries to squeeze payments any more for Medicaid, a/k/a Commonwealth Care, the high proportion of state physicians who already refuse new Medicaid patients will skyrocket, and there will be hardly any physicians caring for low-income people. In her latest press-release article on the mess, Liz Kowalczyk does not even mention powers that the state has available to enforce cost goals. Quite possibly that is because, despite her years of attention to this development, she really does not understand. If she did, it might be embarassing to describe a slipshod effort driven entirely by personal ambitions and public relations. [ Liz Kowalczyk, Legislative leaders reach compromise plan to control health care spending, Boston Globe, July 30, 2012, at http://www.boston.com/whitecoatnotes/2012/07/30/legislative-leaders-reach-compromise-plan-control-health-care-spending/9SREL4mSlDKKD1LbN3MmdI/story.html
Posted by AppDev[/QUOTE]