rev80

Last active
2 years, 7 months ago
  • Why isn’t the White House using MA as the example of how ObamaCare works? Because it turns out that RomneyCare really doesn’t work that well.

    The Administration has been hitting the “it will end medical bankruptcy” talking point recently. It turns out RomneyCare really hasn’t made much of a difference: http://www.pnhp.org/sites/default/files/docs/2011/AJM_Mass-Reform-hasnt-stopped-med-bankruptcies.pdf

    Then there is the whole it will save money by taking away the need to get expensive ER care. Well that hasn’t really happened in MA either: http://www.nejm.org/doi/full/10.1056/NEJMp1109273

    Of course no one thinks about the impact of ObamaCare’s insurance based approach effect on already high administrative costs. It looks like RomneyCare has driven up costs in MA while holding down the employment of direct care providers: https://www.dartmouth.edu/~dstaiger/Papers/2011/staiger%20auerbach%20buerhaus%20nejm%202011.pdf

    When several peer reviewed studies contradict your talking points you stay away from it.

  • That means very little when the health insurance companies will simply reclassify administrative expenses as medical expenses.

    Or classify patient care related expenses as administrative and cut them.

    As a provider I can tell you it can takes days or weeks of work to get a diagnostic test approved by an insurer. A procedure can take up to a month especially with some of the big insurers. By cutting the insurance company staff that deal with pre-approval and appeals they can delay care and in some cases allow the patient to die while waiting. It also will cut their employee costs. It is a win-win for them

  • Accountable care Organizations “are just rebranded 1990’s style HMO’s.

    Here in MA Gov. Deval Patrick, one of Obama’s friends, it trying to push the entire state towards these things as a way to save RomneyCare. He essentially wants to allow the insurance industry to pass all the risk to the providers. Your Dr will get the blame for denying care and the insurance industry gets to sit back and feed on the system.

    This has spurred an explosion in for-profit health care in MA which has been free of this disease until recently. The hedge fund Cerberus bought a hospital group from the Catholic Church and has gone on a buying spree exclusively in the suburbs with the express goal of forming an ACO. It looks like they want to harvest the healthier, more affluent suburban population. They will dump the sicker, poor, urban population on the non-profit hospitals. The ACO model is easily exploited for profit.

    Managed Care with capitation (known Patrick/ Obama newspeak as ACOs with global payments) is not new. It was tried and failed miserably in the 90’s. We live with its legacy today. It is the parent of the shortest hospital stays in the developed world. Hospitals downsized to the point where they can’t respond to minimal health emergencies (That is why you spend so long in the back hall of the ER waiting for a bed). Experienced trained healthcare professionals were replaced with barely trained ancillary staff.

    I used to be a patient of a large group practice in MA that essentially functions as an ACO. Primary care was OK but specialty care was a nightmare. After a 3 month wait for a specialist appointment I ended up in the hospital before I saw him. After I was discharged I still only saw a PA and never the physician.

    The ACO is just another way to keep the current corporate health care structure alive. They will divert money from patient care to feed the beast. Single payer will have to eventually come it is only a question of how many will get hurt on the way.