January 21, 2009

Just So Will Healthcare Fall

Justin Katz

It amazes me that we can watch these things, which should have been entirely foreseeable, and never return to our initial premises:

Some of the big-name Boston teaching hospitals that have managed to extract higher insurance payments include Children's Hospital and the members of Partners HealthCare, a group including Massachusetts General and Brigham and Women's. As a result, they may be paid two or three times more than a community hospital for the same procedure. ...

In addition to helping raise the average Massachusetts family's premiums by 78 percent since 2000, the 800-pound-gorilla hospitals are using their enhanced profits to expand into the suburbs and take business from smaller hospitals. For example, Partners has built a $43 million outpatient clinic in Foxboro, not far from Caritas Norwood Hospital. The objective is to drain day-surgery patients from Caritas, which because of its lower insurance reimbursements, is $4 million in debt. Caritas asserts that were it paid the same rate for delivering babies as the Partners hospitals, it would have lost no money in the third quarter.

Ensure funding for anything, and prices will go up. Increase the distance between the customer and the payment, and advantaged suppliers and middlemen will leverage their power for even greater dominance. And then comes the predictable reaction:

In response to these revelations, Governor Patrick has proposed having state insurance regulators stop excessive premiums. And he has convened a panel to embark on cost-containment steps in Massachusetts, something that is long overdue.

So now prices will ultimately be determined by a government whose interest is more directly in the payments than the service provided, conducted by a panel whose power is appointed, overseen by politicians whose underlying job is to raise money and be reelected.

What do you suppose will happen next?

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"Cost containment" and "cost effective" are phrases that, in several contexts, cause horripilation. In medicine it may be especially menacing.

Especially when government micro-manages. While Britain's NHS does a pretty good job, note refusals to treat patients who smoke, are overweight, need pharmaceuticals costing over a certain amount, etc. Or, to conform to rules limiting the amount of time before a patient must be seen by a doctor - with monetary penalties - having incoming patients wait hours in ambulances (which are not then available for their job, ie transport). Political/insurance decisions, not medical.

Posted by: teqjack at January 21, 2009 5:40 PM

This is a well-trod road:
1. The government dictates a price private companies can't profit from.
2. The privates withdraw from the state.
3. The state then takes over the whole industry.
Amtrak, Beacon Mutual, RIPTA, Fannie Mae, etc. Same tune, different song.

Posted by: Mike at January 21, 2009 7:38 PM

And cost continually goes up as quality continually goes down.

But we gain a unionized workforce guaranteed to vote Democrat and a large portion of whose mandatory dues will be enriching the union bosses and recycled into campaign contributions to Democrats - in effect using those workers as a middleman to forcibly extract money from taxpayers and funnel to the politicians dedicated to extracting even more money from the taxpayers inclined to vote against them.

So, for Democrats, this is "change we can believe in."

You really didn't believe that this was about concern for the "uninsured" and the superiority of "universal health care" now did you? Follow the money.

Posted by: Tom W at January 21, 2009 9:53 PM

I have very close and dear friends in Switzerland whom I see several times a year here in RI. (Please remember that Switzerland is a fairly conservative country (some, but not many, looney leftists and progressives there!) Here's what my friends tell me about health insurance there: It's mandatory! Essentially, everyone in Switzerland must have health insurance. Sorry, no excuses! You buy health insurance coverage from private insurance companies. It is not socialized medicine...the Swiss government does not run the health care system (with minor exceptions); Here's the thing: My friends tell me that it costs about what it costs here in the US, maybe $800-$900 per month for a family plan; there is no Medicare when you turn 65; you must maintain your private health insurance. Insurance companies are prohibited by law from making a profit off of basic coverage. Where they can make a profit is from offering optional extras, such as, say, private rooms, etc. Also, those who can't afford the full premium are subsidized by the Government.

Would such a system work in the US?

I don't know, but I am interested in hearing your opinions!

Posted by: bam at January 22, 2009 12:02 AM

Swiss system won't work here with our open borders duopoly. Swiss, and most Europeans for that matter, have elected anti-immigrant (not anti-illegal immigrant, anti-immigrant) governments.
The US has more illegals than Switzerland has PEOPLE. Chew on that for a minute. Now ponder the tens of millions of Anchor Babies we treat as citizens (and no it is NOT in the 14th Amendment). In Europe, there is no such animal as an Anchor Baby. A child of a non-citizen is a non-citizen. Period.

Posted by: Mike at January 22, 2009 8:05 AM


The concept sounds nice, but the Democrats will never go for it.

They want government run healthcare. Period.

Initially there may be the pretense of private insurance, they'll regulate and cost-contain it so much that it'll intentionally be destroyed (similar to what they're doing now with regulations and "cost-shifting" from Medicare / Medicaid onto the "private market").

They want "Medicare for All" as some of them put it.

Posted by: Tom W at January 22, 2009 8:51 AM

By way of elaboration, it's no use discussing with Democrats what would work best as a system for healthcare.

They'll use the language, but only to further their ends. Their single focus is "single payer" - their euphemism for socialized medicine.

And to that end they'll not engage in good faith debate regarding the merits of alternatives, though they might appear to for public consumption. They have their eye on the ball, and have learned from HillaryCare - they will mask their ultimate intentions, and will impose it piecemeal if necessary, but are unwavering in their ultimate goal.

That goal is socialized medicine, making virtually all citizens "dependent" upon a government program (look at seniors' attitudes toward Social Security and Medicare), and have it staffed by a workforce of unionized government (or de facto) government employees.

That it will be inefficient, costly and of low quality doesn't matter.

If it did, they'd be up in arms about the present public education system. Rather, they fight tooth and nail to protect the status quo on behalf of the teachers unions, while putting their own children in private schools.

It will be the same with healthcare. We'll end up with the high taxes and poor quality of Canada and Great Britain, while they'll go to private clinics (here or overseas) and enroll their children in private schools.

They are like the pigs in Animal Farm that moved into the farmer's house. Do not assume good faith or reason with them - if they win, we lose. It's that simple.

Posted by: Tom W at January 22, 2009 10:17 AM
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