RomneyCare: Does It Work?

  Stanley Feld M.D.,FACP,MACE

 In 2010, Massachusetts State Treasurer Timothy P. Cahill, an independent candidate for governor, offered a wide-ranging and scathing criticism of the state’s universal health care law (RomneyCare). “ It is bankrupting Massachusetts and will do the same nationally, if a similar plan is passed in Congress.”

I predicted this result when the RomneyCare was passed in 2006. Mitt Romney can deny the results of his plan all he wants. The results are the results and it is his plan. It was an ill-conceived plan. His plan was the model for Obamacare. The media forgets that the (CMS director) Dr. Don Berwick and his untested “idealism” was the architect of both plans.

“We haven’t done anything about driving down costs,” Cahill said. “We haven’t helped small business. We haven’t changed the way we pay for health care and the way we deliver it.”

“The real problem is the sucking sound of money that has been going in to pay for this health care reform,”

Timothy Cahill pointed out that the Obama administration had subsidized the state Of Massachusetts plan so it looked good. All of RomneyCare’s defects were camouflaged.

“And I would argue that we’re being propped up so that the federal government and the Obama administration can drive its healthcare reform plan through Congress.”

Commonwealth Connector, the independent state agency established to help residents find health insurance, has “totally failed” to create competition and connect people with affordable insurance. Cahill pointed out that 68% percent of the residents RomneyCare serves receives subsidies from the state.

Patients do not have ownership in and responsibility for their illness. The state of Massachusetts does. It is logical that there would be a rise in costs and overuse. Romneycare creates another uncontrolled entitlement.

The state's health care reform law dramatically reduced the number of uninsured individuals.  At the same time federal, local and state funding for safety-net hospitals was dramatically reduced. In Massachusetts, the thinking was the uninsured, now insured, would go to private facilities for their healthcare needs.

There would be less need for safety-net facilities. The state of Massachusetts could then save money by decreasing funding for these facilities.

Massachusetts’s survey data showed the opposite. The survey of data between 2005-009 found:

• The number of patients receiving care at Massachusetts Community Health Clinics (CHC) increased by 31.0%,
• The share of CHC patients who were uninsured fell from 35.5% to 19.9%.
• Nonemergency ambulatory care visits to clinics of safety-net hospitals grew twice as fast as visits to non–safety-net hospitals from 2006 to 2009.
• The number of inpatient admissions was comparable for safety-net and non–safety-net  hospitals.
• Most safety-net patients reported that they used these facilities because they were convenient (79.3%) and affordable (73.8%).
• Only 25.2% reported having had problems getting appointment elsewhere.

 Our findings indicate that, although health care reform substantially increased the number of people with health insurance in Massachusetts, the demand for services from safety-net facilities (CHCs and hospitals) also grew, particularly for ambulatory care. 

“CHCs have become an even more important source of primary care, perhaps because of increasing difficulty obtaining care from other primary care physicians' offices.”

 

Surveys are a tool of social science and are not necessarily scientific proofs. They have a tendency to miss important findings within the data.

 The state and federal governments have subsidized 68% of the uninsured. Private physicians’ offices in Massachusetts are overcrowded. The insured now have first dollar coverage. Patients overuse the system by seeking more medical attention raising the costs of care.

In Massachusetts patients have speculated with physicians’ appointment times. Physician appointment times have been sold on the secondary market.

In Massachusetts some insurance reimbursements are so low that physicians do not accept certain insurance policies. Patients then have to go to the safety-net hospitals.

Special reimbursement deals have been made with certain physician groups and hospital systems. The Boston Globe has published these deals in the past.

 The total money spent by the state has increased beyond affordability. The increase is the result of overuse of the healthcare system. Patients have no skin in the game.

 The losers have been patients, the state and small businesses. The winner is the healthcare insurance industry. 

Americans will see the same results with ObamaCare.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.