Here we are in late July and the question is being asked with greater urgency, “Is health care reform going to be successful?” I believe the short answer is “yes.” The only folks I hear saying that it is not working are from other states, and tend to be opponents of the model agreed to by all the stakeholders in Massachusetts. I am confident that in a few years’ time, we will look back with pride on what was accomplished when we all came together to support life changing public policy. But as this is a process that is happening in real time, it will continue to evolve and be affected by both politics and the marketplace.
A perfect example of proposed legislation that could have profound implications on health care reform is Senate Bill 697, which calls for standardized coding, a numerical method used by health plans to define medical treatments for billing purposes. At first glance, this certainly appears reasonable. Who wouldn’t support a national coding system that is already used by hospitals for Medicare?
However, the reality is that this is much more complex than a quick glance would indicate, with major ramifications on payment policy and premiums. In brief, the scope of technology changes necessary would require the resource investment of tens, possibly hundreds, of millions of dollars to support either reconfiguring existing technology systems or purchasing new systems.
While Massachusetts’ not-for-profit health plans currently have the lowest administrative costs in the nation, it is no leap to assume that if S.697 passed in its current form, health care costs would increase, and ultimately undermine the goals of health care reform by raising premiums for all consumers, including those who are just now benefiting from coverage. My colleague, Eric Schultz, president and chief executive officer of Fallon Community Health Plan, told the State House News Service that the bill would “do a lot of harm in dismantling health care processes.” He was not overstating the issue.
It wasn’t that long ago when hospitals and health plans were brought together by the Massachusetts Health Data Consortium to discuss the technical solutions necessary for the Health Insurance Portability and Accountability Act of 1996. The outcome of that collaboration is simplified administrative processes, which translate into reduced costs for health plans, providers, and members.
But there is always room for improvement. To that end, it is my recommendation, which has the support of the Massachusetts Association of Health Plans, that hospitals and health plans reconvene with the Massachusetts Health Data Consortium to find common ground on this complicated and expensive, though well-intentioned bill. No one wants to see the gains we’ve recently achieved with health care reform become once again out of reach.
James Roosevelt, Jr. is the President and CEO of Tufts Health Plan
Forgot one “stakeholder” in your power grab in Massachusetts… the people of Massachusetts. Put the health care law to a vote. Until then it has all the legitimacy of our corrupt and unrepresentative legislature. Perhaps next time you should have a real public debate before you buy off the legislature to pass a law.
Mr. Roosevelt,
The fact that you think only “out-of-staters” are critical or expect this law to fail shows that either you have not read the comments on this blog or you are totally delusional! Chapter 58 is a a horror show. It takes food out of my daughter’s mouth to enrich the coffers of health insurers. The no frills (by which I mean “no care” plans) offered via the Connector are useless products that will force people to pay thousands of dollars for fifty bucks worth of care. Since the law contains no cost controls and sets no limits on insurer profits, the whole system will implode within the next few years. The individual mandate is tyrannical and will cause untold pain for hundreds of thousands of Massachusetts families. The “free” market lead us into this morass, and has no potential to get us out of it. Single payer, now!
With all the Insurance companies, HMO’s (total failures in furnishing good health care) the “sell out” by the legislators how can we taxpayers “get real”. DON’T ASK FOR MY SUPPORT ON THIS FLAWED BILL!
“The “free” market lead us into this morass, and has no potential to get us out of it. Single payer, now!”
Ron, I wouldn’t exactly call either what we had before or what Chapter 58 does a “free market”.
A free market doesn’t threaten you with punishments and fines if you don’t purchase an inferior product. Might as well have a Yugo law, where everyone is forced to buy a Yugo or else pay a fine that subsidizes Cadillacs for the poor. Or by buying that Yugo, a portion of the sales price subsidizes Cadillacs for the rich. That isn’t a free market. That is being fleeced.
Government has been meddling in so many ways in the last 50 years in effect mandating more and more middlemen get between us and health care.
I am not saying that a free market is the solution to the inequalities of health care, but to blame the free market is to miss all the corruption and distortions in the last 50 years. And free choice of health care providers must be part of the solution at least so we can choose which doctors, nurses and hospitals we go to.
Everyone is on the take, and the more I hear this self congratulatory hold the course rhetoric, the more I know that they are starting to feel the pressure.
The Massachusetts Health Reform Tracking Survey was clear, once exposed to the details of what people are being forced to pay and what they get, 58% thought the premiums were “unreasonable”, 62% thought people would still be “vulnerable” to high medical bills and 62% thought it was “unfair” to require a person to sign up to a plan like the ones offered. These were 1003 Massachusetts residents and not some outsiders.
Go ahead, James Roosevelt, Jr., blame outsiders for the pressure you are feeling. After all you got all the “stakeholders” behind closed doors in secret meetings to work out this law. Blame irresponsible young people. Blame whomever else makes you feel better about what you have done to undermine freedom and democracy in this State in the name of your fear mongering.
Because we blame you.
Pat,
You are absolutely right, that’s why I put the free in quotes. There is considerable collusion among insurers that virtually eliminates any real competition. Now that these lousy products are compulsory, where is any hope to be found that things will get better?
This law is nothing more than corporate welfare that perpetuates and expands a failed system. Simple logic dictates that the best deal to be had in any transaction is gotten by eliminating the number of middlemen in the bargain. Insurers do not provide care, and they have done a dismal job of financing the health delivery system and assuring access. A fragmented conglomeration of private insurance represents the most inefficient means possible of delivering care. Backbreaking health insurance costs are a major reason that jobs are being outsourced, and they account for a high proportion of individuals’ property taxes,as well. This law isn’t good for anyone other than Mr. Roosevelt and his compadres. We can can do better, we just need an informed populace, that demands their elected officials do their jobs, and the political will.
I’ve been sitting on the sidelines in recent days because I felt like I had had my say, but I couldn’t let this self-congratulatory nonsense go unaddressed.
Thank you to the above commentors who have taken the time and effort to write out their thoughts, thoughts that so many of us are having about this fake reform law.
To learn more, to see national critiques on the MA law, and to take action and re-chart the course for health reform, please visit http://www.defendhealth.org