Tuesday, June 22, 2010

Mission Accomplished!

In 2006 the residents of Massachusetts passed their own version of Obamacare (Patient Protection and Unaffordable Health Care Act) which has been dubbed "RomneyCare" by many of the states citizenry. We have been given a report from the Robert Wood Johnson Foundation that is a somewhat glowing endorsement on the success of RomneyCare.

The 4 page report is an easy read and does a good job of providing fluff in an attempt to say that RomneyCare has accomplished the goals it set out to do with minimal downside. In promoting the so-called success of RomneyCare the folks at RWJF seem to be saying Obamacare should also be an improvement over status quo.

I beg to differ.

More People Insured

Some of the accomplishments of RomneyCare include 96% (or more) of the states residents now have some form of health insurance. This is above the national average of 85% insured.

Only 1% of the states residents were assessed a penalty for non-compliance with the state mandate that everyone have health insurance. Sounds to me like there are some Libertarians in this blue state.

The report claims gains in coverage for low income individuals and minorities.

It also acknowledges some areas that need improvement such as a need for more PCP's (primary care providers) and a way to control the overall cost of health care.

Doc Shortages and Rising Health Care Costs

The PCP shortage is attributed to doctors who are unwilling to take new patients or the provider does not accept their type of insurance. Almost all doc's limit the number of Medicare and Medicaid patients due to the low reimbursement levels. Given that RomneyCare expanded the number of people on Medicaid it is not surprising that docs would limit or refuse new patients.

The states proposed solution for the doctor shortage is to expand medical school enrollment for those willing to go into primary care by providing incentives (including loan forgiveness) for new enrollment.

Of course you can't produce a doc over night so don't expect the number of providers to increase any time soon. Even if they do graduate more PCP's where is the guarantee they will be willing to load up on Medicaid patients?

Higher Taxes for all and Reduced Income for Medical Providers

And where will these incentives come from? The state doesn't do anything to generate income independent of collecting taxes. So the incentives will come from the most productive residents who are already paying a hefty amount in taxes.

As for the other concern, rising health care costs, they have a somewhat novel idea. Their solution is to change the way providers are paid and shift to a single payer system that will dictate how much providers will be reimbursed for services.

I am sure the docs and hospitals won't have any trouble at all accepting that move.

The state does admit they can't do this alone and would rely on "strong federal leadership on health care payment reform". Yeah, that's it. Make the feds institute cost controls.

They do acknowledge it will mean less income for some providers and there will be fewer choices for consumers, but in the end the best thing is for everyone to bite the bullet and take one for the team.

And the folks in DC feel this is a good thing.

You're doing a helluva job there Barry.
blog comments powered by Disqus