Patrick To Doctors: I See Your Winks And Nods

Call me a muckraker, but I thought Gov. Deval Patrick sounded a bit peevish at one point today when he spoke to more than 200 doctors who’d come to the State House to lobby their legislators.

He’d just laid out his determination to proceed with the next, cost-containing stage of health care reform, despite the great complexity of the challenge. (He phrased it much as he did at Harvard recently – here’s that text.) Then he told the doctors that he saw them exchanging looks across their tables, “the furtive glances you’re casting, winks and nods. Let me tell you, we are going here, to integrate accountable care organizations, we are going there together.”

The video is above. He concludes:

“We have got to deliver on what is ultimately a values statement, and that is that health is a public good, and everyone in this commonwealth deserves access to adequate, cost-effective care.”

The Massachusetts Medical Society, which organized the doctors’ visit to the State House today, is arguing for a dozen main elements in Patrick’s proposed payment reform, as expressed in talking points that the society distributed to the visiting doctors today. They include:

-Physician directed authority: Physicians will make most of the clinical decisions under a new health care model, so it’s only logical that they are at the center of decision-making, both at the public policy level and the clinical level.
-One size will not fit all: One single payment model will not be successful in all types of practice setting. Many physician groups will have a great deal of difficulty making a transition, due to their geographic location, patient mix, specialty, technical and organizational readiness, and other factors.

There are 11 more, including what I would call the “carrots only” provision: “The incentives to transition to a new model must be predominantly positive.”

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