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Obamacare Preview: MA Medical Commission Wants Providers On A Budget

Like with all things Obama, just look to MA for a preview of coming attractions.  Under the leadership of Obama’s Mini-Me, Gov. Deval Patrick, the state is broke, taxes are going through the roof, services have been cut, and now a state commission is recommending that doctors and hospitals be put on a budget.  Can you spell r-a-t-i-o-n-i-n-g?  The Boston Globe reported the commission’s recommendations yesterday.

A state commission recommended yesterday that Massachusetts dramatically change how doctors and hospitals are paid, essentially putting providers on a budget as a way to control exploding healthcare costs and improve the quality of care.

The 10-member commission, which includes key legislators and members of Governor Deval Patrick’s administration, voted unanimously to largely scrap the current system, in which insurers typically pay doctors and hospitals a negotiated fee for each individual procedure or visit. That arrangement is widely seen as leading to unneeded tests and procedures.

Instead, the group wants private insurers and the state and federal Medicaid program to pay providers a set payment for each patient that covers all that person’s care for an entire year and to make the radical shift within five years. Providers would have to work within a predetermined budget, forcing them to better coordinate patients’ care, which could improve quality and reduce costs.

Massachusetts would be the first state to adopt such a broad “global payment’’ system, and commission members are acutely aware that Congress and the Obama administration are watching how the state moves forward as the federal government overhauls healthcare nationally.

“This is an historic moment, an extraordinary moment in healthcare in Massachusetts,’’ Andrew Dreyfus, senior vice president of Blue Cross and Blue Shield of Massachusetts and a commission member, said after the panel’s vote. “I urge the Legislature and the administration to take this up quickly.’’

Commission members stressed that failing to control medical spending – which is growing by more than 8 percent annually in Massachusetts, driven largely by the high price and heavy use of hospitals – could threaten the state’s model health insurance law and bankrupt employers and patients.

Still, while commission members who represent doctors and hospitals endorsed the change, they have serious reservations. They are afraid that a new payment system could create serious financial problems for providers if the yearly fees are too low and if they are not adjusted upward for patients who are very sick or at risk of serious disease and require more care. Low payments were one reason for the downfall of a similar payment system (called capitation) tried in the 1990s, providers said.

Providers want to know that if they have a lot of very sick patients, “they won’t be penalized for that,’’ said Dr. Alice Coombs, an anesthesiologist and commission member.

If this plan gives you a Chris Matthews type thrill, wait until you see what the Federal plan proposed by Obama looks like. Michelle Malkin points out one key element of that plan.

If you think government is too big and too costly, wait until Obamacare kicks in. The Congressional Budget Office put the price tag of the House Democrats’ health care takeover plans at $1.5 trillion over 10 years. But the CBO’s fine print included a tell-tale caveat:

“We have not yet estimated the administrative costs to the federal government of implementing the specified policies, nor have we accounted for all of the proposal’s likely effects on spending for other federal programs.”

July 17, 2009  Tags: Barack Obama, Democrats, Health Care, Health Insurance, National Healthcare, Obamacare, Socialism  Posted in: Economy, Politics

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