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Pay for care a new way, state is urged : Hospitals and doctors may be put on budget
Globe ^
| July 17, 2009
Posted on 07/17/2009 11:04:15 AM PDT by george76
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 Patricks 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.
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,
The plan would require significant restructuring of the healthcare system...to form so-called accountable care organizations. Insurers would pay the accountable care organization a flat yearly per-patient fee ...
(Excerpt) Read more at boston.com ...
TOPICS: Crime/Corruption; Culture/Society; Extended News; News/Current Events; US: Massachusetts
KEYWORDS: fascism; healthcare; heathencare; husseincare; obama; obamacare; rinoromney; romney; romney4dems; romneycare; socialismcommunism; socializedmedicine; universalhealthcare
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1
posted on
07/17/2009 11:04:15 AM PDT
by
george76
To: george76
EVERYTHING the liberals touch, they destroy. Bar none.
2
posted on
07/17/2009 11:05:43 AM PDT
by
EagleUSA
To: george76
Can we say Rationed ?
::::::
Socialism is running out of other people’s money. It always does.
3
posted on
07/17/2009 11:09:22 AM PDT
by
EagleUSA
To: george76
Payments to healthcare facilities have for years taken PP & E into account as part of the payment mix. Not only will we see a reduction in healthcare and procedures, the existing plant structure of healthcare facilities will deteriorate faster than our countries bridges. The whole system will collapse on itself.
4
posted on
07/17/2009 11:09:26 AM PDT
by
b4its2late
(Ignorance allows liberalism to prosper.)
To: george76
With univeral healthcare, doctors across this nation will be on more than a budget....they’ll be on the government payroll. They’ll be able to thank their “professional association” (AMA) for turning them into their Russian equivalents.
To: anniegetyourgun
With univeral healthcare, doctors across this nation will be on more than a budget....theyll be on the government payrollThe ones who are still working, you mean.
6
posted on
07/17/2009 11:13:02 AM PDT
by
Jim Noble
(I hope Sarah will start a 2nd party soon)
To: LucyT; neverdem
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
7
posted on
07/17/2009 11:13:05 AM PDT
by
george76
(Ward Churchill : Fake Indian, Fake Scholarship, and Fake Art)
To: Jim Noble
To: george76
The purpose of this system is to create a direct conflict of interest for your doctor.
If funds are running low after six months (guaranteed), then it's the doctor's salary and the salaries of the employees vs. your MRI or surgery.
It's that simple.
9
posted on
07/17/2009 11:15:10 AM PDT
by
Jim Noble
(I hope Sarah will start a 2nd party soon)
To: anniegetyourgun
The AMA is nowhere near a universal professional association. It is a group of politically active liberals, and despised by most of the physicians I know - even some of the libs.
10
posted on
07/17/2009 11:19:01 AM PDT
by
Mom MD
(Jesus is the Light of the world!)
To: george76
We have been told time and again how Romney-care and other forms of Universal Coverage are the answers in and of themselves and not step one on the road to government controlled socialized medicine.
This situation gives truth to the lie.
Waiting patiently for the Mitt fans to tell me how well his plan is working and why we should trust him as a small government conservative.
11
posted on
07/17/2009 11:20:22 AM PDT
by
BlueNgold
(... Feed the tree!)
To: george76
Mass. may be like Calif. - Mass exodus by doctors looking for a better life.
12
posted on
07/17/2009 11:20:40 AM PDT
by
4Speed
To: Jim Noble
The ones who are still working, you mean. Have you given consideration to a new career when the medical field becomes too odious to continue? I've had a few co-workers who left medicine for the software industry. It's amazing how much disposable income is available when you aren't paying exorbitant malpractice premiums and getting substandard payment for your services.
One of my co-workers spent significant time in OB/GYN. He is still having to remind himself that VB means Visual Basic in a software shop.
13
posted on
07/17/2009 11:23:23 AM PDT
by
Myrddin
To: anniegetyourgun
.theyll be on the government payroll.
And the government will decided the compensation the doctors receive. As they did in the UK,the gov mandated more and more services and offered less compensation in return.
14
posted on
07/17/2009 11:23:55 AM PDT
by
chainsaw
(If you think health care is expensive now, wait until you see what it costs when it's free! -- P.J..)
To: chainsaw
In Canada, when the budgets run out, the Hospitals close except for emergency services.
15
posted on
07/17/2009 11:29:10 AM PDT
by
massgopguy
(I owe everything to George Bailey)
To: george76
I think some guy named Lenin tried this.
Um, and what’s to keep the doctors from leaving the state?
16
posted on
07/17/2009 11:32:57 AM PDT
by
VeniVidiVici
(ABC-AP-MSNBC-All Obama, All the time.)
To: george76
REASON #4 - ROMNEY IS A FAILURE
: Romney never allowed the people of Massachusetts to vote on socialized medicine
Mitt Romney demonstrates his pervasive pattern of grandiosity (in fantasy or behavior),
and his need for admirationas the carpetbagger-socialist-dictator-hyperliberal shapeshifter
gleefully installs ROMNEYCARE-1 (wihtout a vote -- the ROMNEY-way(TM).
"Don't mimic the Massachusetts Way on health care reform [Romney Care is a failure]
In 2006, Massachusetts governor Mitt Romney was hailed as a visionary for signing one of the most expansive health reform bills in the country. "MassCare" aimed to expand health insurance, achieve universal coverage, and bring down costs through a complicated set of government controls and subsidies.
But implementing the MassCare model nationally would be a mistake. While the percentage of uninsured Bay Staters has dropped to 2.6 percent (from about 6 percent), the state has never adequately addressed what causes people to go without insurance in the first place: the cost of health care.
In fact, a substantial portion of Massachusetts' newly insured still can't afford to purchase even basic medical services, and are effectively no better off than before the law's passage. Meanwhile, government health spending is spiraling out of control, adding to the state's already massive public debt.
The numbers are staggering. In seven of the last eight years, per-capita health spending in Massachusetts has increased faster than the national average, according to Alan Sager, a professor of health policy at Boston University.
Overall health insurance costs in Massachusetts are almost a third higher than the national average, with a basic plan costing almost $17,000 for a typical family of four. Nearly 30 percent of Massachusetts residents report that their medical costs have increased since MassCare's implementation.
It's a similar story for government healthcare spending. Public health insurance expenditures are expected to be up 42 percent, to roughly $595 million, this year compared to 2006.
The centerpiece of Massachusetts' 2006 health reform bill is Commonwealth Care, a government program that provides free and subsidized insurance plans to low- and moderate-income patients. It's spending has doubled in the last two years, jumping from $630 million in 2007 to an estimated $1.3 billion in fiscal year 2009.
Last year, rising costs lead Commonwealth Care officials to approve a 12 percent rate increase, meaning that basic insurance costs will cut even deeper into the incomes of most participating patients. The national recession has brought added financial stress to MassCare. As State Treasurer Timothy P. Cahill recently put it, the system "was expensive, even in good times. In tough times, it just doesn't seem doable. We're all still waiting for the savings."
....Between 2005 and 2007, the number of ER visits increased seven percent, and total ER costs have gone up 17 percent over the last two years. Most disturbingly, patients on state-subsidized insurance use ER care 14 percent more than the average Bay Stater. Hospital officials have calculated that half of patients visiting the ER could have had their ailments addressed by a regular primary care doctor.
The bottom line is that expanding the Massachusetts model nationwide would be a disaster. It might reduce the number of Americans without insurance. But healthcare costs would become an even bigger problem, making medical care unaffordable for millions and resulting in denied care for many Americans."
"A Chicken in Every Pot and Healthcare for All (Welcome to the 0bamanation)
So now the federal government is taking a leaf out of Mitt Romney's Massachusetts book, with its intention to force citizens to obtain health insurance at the end of a gun. Many support this, too, with a poll last year showing that even 52 percent of Republicans find this kind of coercion palatable. .... But the point many seem to ignore is that this isn't a problem of the free market it's a problem of socialism. It arises when you force people to be responsible for the consequences of others' decisions.
Bear in mind that an MRI machine costs approximately $2 million to buy and $800,000 per year to run, and it costs the better part of $1 billion to research, develop, and bring a new medication to market. And what happens when you remove profit from the system?
Well, note that the whole nation of Canada, with its much touted socialized medicine, has fewer MRI machines than the city of Pittsburgh."
"Massachusetts Universal Healthcare System Breaking Down Already
When Governor Mitt Romney instituted a universal healthcare plan for Massachusetts in 2006 he proclaimed it a conservative idea.
But has it worked? Has it been successful?
For a time, many thought it might but cracks in the system are already being seen.
These cracks are instructive as a lesson on how Obamacare will crash and burn just like Romneycare is now in the process of doing.
One of the early claims that helped push Romneycare through to law was the insistence by its supporters that Emergency Room visits would fall as more and more citizens became covered under healthcare insurance.
Since ER care is far more expensive than a doctor's care, it was thought that more people with insurance would ease the overcrowding of ERs as well as lower the overall costs of healthcare.
However, a flaw in this logic has been seen throughout the state. As more people became insured, more people demanded the care of doctors. These doctors became overloaded with patients and waiting lists for doctors got longer and longer.
As a result, ERs in Massachusetts have not seen a downturn in visits. On the contrary, it seems that ER visits are actually on the upswing in the Bay State. In fact, in 2007 they were higher than the national average by 20 percent...
" Gov. Mitt Romney meets a medical marijuana patientOct. 6
Romneys treatment of this poor sick man is sickening...
"Hospital patients 'left in agony'"
"Patients were allegedly left screaming in pain and drinking from flower vases on a nightmare hospital ward.
Between 400 and 1,200 more people died than would have been expected at Mid Staffordshire NHS Foundation Trust over three years, a damning Healthcare Commission report said.
The watchdog's investigation found inadequately trained staff who were too few in number, junior doctors left alone in charge at night and patients left without food, drink or medication as their operations were repeatedly cancelled.
Patients were left in pain or forced to sit in soiled bedding for hours at a time and were not given their regular medication, the Commission heard.
Receptionists with no medical training were expected to assess patients coming in to A&E, some of whom needed urgent care.
Sir Bruce Keogh, medical director of the NHS, said there had been a "gross and terrible breach" of patients' trust and a "complete failure of leadership".
The Healthcare Commission's chairman Sir Ian Kennedy said the investigation followed concerns about a higher than normal death rate at the Trust, which senior managers could not explain.
He said: "The resulting report is a shocking story. Our report tells a story of appalling standards of care and chaotic systems for looking after patients. These are words I have not previously used in any report.
"There were inadequacies in almost every stage of caring for patients. There was no doubt that patients will have suffered and some of them will have died as a result."
Julie Bailey, 47, was so concerned about the care being given to her 86-year-old mother Bella at Stafford Hospital that she and her relatives slept in a chair at her bedside for eight weeks.
She said: "We saw patients drinking out of..."
"Paramedics told: 'Let accident victims die if they want to' in new row over patient rights (UK)"
Health Service paramedics have been told not to resuscitate terminally-ill patients who register on a controversial new database to say they want to die.
It has been set up by the ambulance service in London for hundreds of people who have only a few months to live so that they may register their 'death wishes' in advance.
It is believed to be the first in the country, but other trusts around the country are expected to follow suit to comply with Government guidelines which state that patients' wishes should be taken into account, even at the point of death.
Patients' groups and doctors have welcomed the scheme, but it has met opposition from pro-life groups who say it violates the sanctity of life.
The system would come into play if a cancer patient, for example, was in serious pain and rang 999 for help to alleviate the suffering.
But if the paramedics arrived and the patient was close to death, he or she would not be resuscitated if such a request was registered on the database.
This would also be the case if a patient on the database was being transferred between hospitals, and had a heart attack.
Dominica Roberts from the Pro-Life Alliance said: 'This is very sad and very dangerous. It's another step along the slippery slope, at the bottom of which is euthanasia as we see in Holland. 'Paramedics should be there to save lives. They should not be there to let patients die. The medical profession should not agree with someone's belief that their life is worthless.'"
"National Health Preview - The Massachusetts debacle, coming soon to your neighborhood."
"Three years ago, the former Massachusetts Governor had the inadvertent good sense to create the "universal" health-care program that the White House and Congress now want to inflict on the entire country.
It is proving to be instructive, as Mr. Romney's foresight previews what President Obama, Max Baucus, Ted Kennedy and Pete Stark are cooking up for everyone else.
In Massachusetts's latest crisis, Governor Deval Patrick and his Democratic colleagues are starting to move down the path that government health plans always follow when spending collides with reality -- i.e., price controls.
As costs continue to rise, the inevitable results are coverage restrictions and waiting periods. It was only a matter of time.
They're trying to manage the huge costs of the subsidized middle-class insurance program that is gradually swallowing the state budget.
The program provides low- or no-cost coverage to about 165,000 residents, or three-fifths of the newly insured, and is budgeted at $880 million for 2010, a 7.3% single-year increase that is likely to be optimistic.
The state's overall costs on health programs have increased by 42% (!) since 2006.
What really whipped along RomneyCare were claims that health care would be less expensive if everyone were covered.
But reducing costs while increasing access are irreconcilable issues.
Mr. Romney should have known better before signing on to this not-so-grand experiment, especially since the state's "free market" reforms that he boasts about have proven to be irrelevant when not fictional.
Only 21,000 people have used the "connector" that was supposed to link individuals to private insurers."
A Very Sick Health Plan; Bay States Grand Experiment Fails [RomneyCare]
"The Daily News Record, Harrisonburg, Va. - 2009-03-31 "
"For folks increasingly leery of President Obamas plan to radically overhaul Americas health-care system,
or 17 percent of the nations economy, all this could hardly have come at a better time
that is, fiscal troubles aplenty within Repubican Mitt Romneys brainchild, Massachusetts grand experiment in universal health care."
"Initiated on Mr. Romneys gubernatorial watch in 2006, this experiment has fallen on hard times, and predictably so.
Even though the Bay State commenced its program with a far smaller percentage of uninsured residents than exists nationwide,
RomneyCare is threatening to bankrupt the state. Budgeted for Fiscal Year 2010 at $880 million,
or 7.3 percent more than a year ago, this plan, aimed at providing low- or no-cost health coverage to roughly 165,000 residents,
has caused Massachusetts overall expenditures on all health-related programs to jump an astounding 42 percent since 2006.
So what does Mr. Romneys successor, Democratic Gov. Deval Patrick, propose as a remedy for these skyrocketing costs?
Well, whaddya think? The standard litany of prescriptions (no pun intended) price controls and spending caps, for a start, and then, again predictably, waiting periods and limitations on coverage.
As in Europe and Canada, so too in Massachusetts. And, we feel certain, everyone from Mr. Romney to Mr. Patrick said, It would never happen here.
But then, such things are inevitable when best-laid plans, with all their monstrous costs, run smack-dab into fiscal reality.
"Dem Congresswoman Admits Obama Health Care Plan Will Destroy Private Health Insurance Industry"
Thousands of patients with terminal cancer were dealt a blow last night after a decision was made to deny them life prolonging drugs.
The Government's rationing body said two drugs for advanced breast cancer and a rare form of stomach cancer were too expensive for the NHS.
The National Institute for Health and Clinical Excellence is expected to confirm guidance in the next few weeks that will effectively ban their use.
The move comes despite a pledge by Nice to be more flexible in giving life-extending drugs
to terminally-ill cancer patients after a public outcry last year over 'death sentence' decisions."
"Patients Forced To Wait Hours In Ambulances Parked Outside A&E Departments
"An investigation by The Sunday Telegraph has found that thousands of 999 patients are being left to wait in ambulances in car parks and holding bays, or in hospital corridors in some cases for more than five hours before they can even join the queue for urgent treatment.
Experts warn that hospitals are deliberately delaying when they accept patients or are diverting them to different sites
in order to meet Government targets to treat people within fours hours of admitting them."
"Cancer survivor confronts the health secretary on 62-day wait (UK Socialized Medicine)
WAITING times for cancer treatment need to be cut, the Scottish Government was told yesterday.
..Cancer experts later said that patients elsewhere in Europe would be "outraged" by having to wait two months to start treatment, with most being seen within two weeks.
The current target of 62 days from urgent referral by a doctor to starting treatment has still not been met in Scotland, despite that originally being the target figure for 2005."
"Hospital patient so shocked at dirty ward she climbed out of bed to clean it herself
After 12 years cleaning care homes and private houses, no one is better qualified than Tereza Tosbell to say whether a room is spotless.
So hospital bosses should take heed of her opinion after she spent four days on a 'filthy' ward.
The mother-of-one said during her stay there was a single, brief visit from a cleaner who left dusty curtains, dirty bedframes and a messy floor.
Disgusted at the conditions, she grabbed the antibacterial fluid dispenser at the end of her bed and some hand towels from the bathroom.
She then set about cleaning her four-bed ward, at one point dropping to her hands and knees to sanitise the floor as she dragged her drip trolley behind her.
'It was shameful to see how sloppy the cleaners were while I was there. I was not prepared to put up with such conditions,'
said Miss Tosbell, a 48-year-old divorcee who was admitted to Colchester General Hospital in Essex with an abscess in her neck.."
"Kidney cancer patients denied life-saving drugs by NHS rationing body NICE (UK Socialized Medicine)
Thousands of kidney cancer patients are likely to lose out on life-prolonging drugs.
The NHS rationing body, NICE, has confirmed a ban on three out of four new treatments.
.. 'Families will be denied time together and doctors will be unable to give patients the best treatment.'."
"Girl, 3, has heart operation cancelled three times because of bed shortage (UK Socialized Medicine)
A three-year-old girl awaiting heart surgery has had her operation cancelled three times this month because of a shortage of beds.
... A hospital spokesman said that procedures would be reviewed, but the case highlights a growing problem of cancelled operations in the NHS.
More than 57,000 surgeries were postponed for non-clinical reasons, including a lack of beds, last year 10 per cent more than the previous year."
17
posted on
07/17/2009 11:52:30 AM PDT
by
Diogenesis
("Those who go below the surface do so at their peril" - Oscar Wilde)
To: Diogenesis; LucyT; neverdem; jazusamo
18
posted on
07/17/2009 12:02:04 PM PDT
by
george76
(Ward Churchill : Fake Indian, Fake Scholarship, and Fake Art)
To: Jim Noble
uh...no one is touching my salary....
19
posted on
07/17/2009 12:11:55 PM PDT
by
cherry
To: long hard slogger; FormerACLUmember; Harrius Magnus; hocndoc; parousia; Hydroshock; skippermd; ...
Socialized Medicine aka Universal Health Care PING LIST
FReepmail me if you want to be added to or removed from this ping list.
**This is a high volume ping list! (sign of the times)**
20
posted on
07/17/2009 12:15:57 PM PDT
by
socialismisinsidious
( The socialist income tax system turns US citizens into beggars or quitters!)
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