Stanley Feld M.D.,FACP,MACE
Never the less, President Obama’s healthcare team is modeling his universal healthcare plan after the Massachusetts plan. It is possible the President’s healthcare team knows this plan will fail. They will then conclude the only remaining option will be a single party payer system run by the government.
However, the government presently outsources Medicare’s administrative services to the healthcare insurance industry. The healthcare insurance industry controls the healthcare dollars and therefore controls the costs and the coverage. A single party payer system will also fail just as Medicare is failing unless the structure of the Medicare system is changed.
The solution is to change the control of the healthcare dollar from the healthcare insurance industry to the consumer.
In the meantime President Obama’s healthcare team will destroy the healthcare system piece by piece.
“The $28 billion spending plan also freezes Medicaid reimbursement rates for doctors and hospitals who care for poor patients, after steep cuts made in October.”
Massachusetts’ physicians seem to be the most tolerant physicians in the nation. They tolerate continued reimbursement freezes and cuts even though their overhead rises but they are losing their tolerance rapidly.
"We have a state that has been visionary in pioneering health reform and universal coverage," said Dr. Bruce Auerbach, president of the Massachusetts Medical Society and head of emergency care at Sturdy Memorial Hospital in Attleboro. "Anything we do that reduces the ability of physicians to care for Medicaid patients is going to negatively impact our pursuit of true healthcare reform."
You bet it will. Politicians will conclude, as they have in California, is the only way to pull this out of the ditch is to increase taxes. They do not realize that if they increase taxes they could drive business out of the state. The result would ultimately be the reduction of state tax revenue.
The governor's tax proposal also touched on public health: He is seeking new levies on alcohol, candy, and sweetened beverages among other increases in taxes.
This tax idea is not a bad idea. It could encourage lifestyle change and even decrease obesity and alcoholism. The result could be to decrease chronic disease and its complications thereby decreasing healthcare costs.
According to administration estimates, those new tariffs would generate $121.5 million for public health initiatives, if the Legislature goes along with them.
In order to save face the mandated universal healthcare plan was not cut except for one critical element. Eliminating a program that helps the insured enroll will generate more uninsured citizens as unemployment rises during this recession.
“The state's closely observed health insurance initiative, which requires most adults to have coverage, emerged largely, but not entirely, untouched in the budget blueprint. A program that helps the uninsured enroll for health coverage was eliminated, just as thousands of Bay State residents are losing their jobs.”
This is occurring after the federal government has provided Massachusetts with 8 billion dollars in state bailout money. Someday a healthcare plan that aligns all the stakeholder incentives and solves the problem of the complications of chronic disease will be proposed by a governmental body. It would help to ask patients and practicing physicians what they think the solution is. That day does not seem to be on the horizon.