Monday, August 6, 2012

More Massachusetts Medical Controls

The 8/6/2012 Wall Street Journal has published an update on health care in Massachusetts, "RomneyCare 2.0".

They make two key take home points:

* Costs keep spiralling out of control
Health costs -- Medicaid, RomneyCare's subsidies, public-employee compensation -- will consume some 54% of the state budget in 2012, up from about 24% in 2001. Over the same period state health spending in real terms has jumped by 59%, while education has fallen 15%, police and firemen by 11% and roads and bridges by 23%.
* In response, the state will impose more overt controls over how doctors can practice medicine
[A]ll Massachusetts doctors, hospitals and other providers must register with a new state bureaucracy as a condition of licensure -- that is, permission to practice. They'll be required to track and report their financial performance, price and cost trends, state-sanctioned quality measures, market share and other metrics.
As the WSJ notes, this new "Health Policy Commission" will have the power to "to ensure that total Massachusetts health spending, public and private, grows no more than projected gross state product through 2017".  (Emphasis theirs)

Basically, if a doctor or hospital spends too much on a patient's care, they could be punished.

How hard will your doctor fight for your medical interests, if his medical license and his very livelihood are endangered whenever he spends more money than the government considers appropriate? Will he still be willing to order the MRI you need or prescribes the stronger (but more expensive) antibiotic to stop your life-threatening infection?

Of course the government will claim: "'We're not telling the doctors how to practice medicine -- that's still the physician's job. We're only establishing global economic guidelines. The doctor still makes the day-to-day medical decisions on his or her patients".

But in reality, the government will be using the power of the purse and the power of licensure to co-opt doctors into becoming its proxy agents of rationing.

As always, trends in Massachusetts under RomneyCare will foreshadow what will happen to the rest of the country under ObamaCare.  In particular, get used to hearing the term, "Accountable Care Organization".

(Read the full text of "RomneyCare 2.0".)