Dear Dr. Bones,
Make a memorandumb of this one, please. I think on the whole I will not trouble the Blue Blazers with more than about my first two-and-a-quarter knock-down arguments.
| Health care: Cultural shift charley-on-the-mta | Tue, May 29, 2012 12:10 PM EST A civil and useful conversation between Health Care for All’s Brian Rosman and Pioneer Institute’s Joshua Archambault. I prefer Josh asking these very pertinent and well-based questions (rather than trying to provide the answers himself, which tend to be right-wing boilerplate). And Rosman properly admits that we don’t know how well these measures will work at the scale that the legislature is dealing with. Will the Mass. payment reform proposals help control health care costs? – YouTube. (( snip crutch for the prose-challenged )) Bottom line: * We know that fee-for-service leads to tremendous waste and bad care — and takes money out of the hands of employers and individuals, suffocating other areas of the economy. * We know that especially in Massachusetts, the big providers (ie. Partners) use their market power to charge high prices. * We do not know that Accountable Care Organizations will hit the sweet spot of quality care and controlled costs. * That is why it matters that the legislature sets a reasonably tough target for health care cost growth. (The House’s target is tougher — dare I give kudos to DeLeo??) More on the shifting alliances of health care costs in the Globe today: GBIO + AIM = luv? Wow. |
| Getting to the nitty gritty... This video shows the faux esoterics in coming to a solution. Anyone who looks at the economics of the health care industry realizes it is a people industry. Unless you are willing to pay people less or frankly lay them off, no real savings is possible. Adding extra services and leaving traditional centers of care only increases cost. A hospital is not going to shut down since it is still necessary and if they have a budget to support they will increase their UNIT PRICES to keep above water. Some sort of uniform coverage that reduces administrative costs is where the paydirt is. If some care is found unnecessary something more needed will take its place. However if charges and payments are the same for the same services billing departments and contract departments can shrink. It has been estimated this savings amounts to $400 billion a year. oetkb @ Tue 29 May 12:31 PM === Next Steps Thanks for promoting the video. If the points raised are concerning, will readers on Blue Mass Group contact Legislators and ask them to pause and slow down before adversely impacting 18% of our state economy? joshatpioneer @ Tue 29 May 1:15 PM |
Ad quos Patricius:
| I do not believe in "unit prices" (( fold here )) for the following reasons: (1) The day Ch. D. Baker began running for Governor, he said the only memorable thing Paddy McTammany ever heard from that direction, namely that once he had become acquainted with the internal organs of H*rv*rd Vulture Health Care, he discovered that these "unit prices" of which Mr. Poster speaks blithely do not exist. With medical stuff, pricing entirely depends on who is profiteering from whom. (2) Moreover, about every other month the Globe or somebody runs what seems to be always the same story about how Partners HealthCare gets at least twice as much from the Wicked State as, say, my own slum does for pretty well the whole menu of goods and services. (3) Paddy’s anecdotal evidence is not strictly relevant, not since Dr. Alzheimer put me on Medicare. Nevertheless (( truncate approximately here )) I am as sure as one can be without actual evidence that those who get sick strictly in the Secret Sector do not get bills that are LESS mystifying than my own. Probably rather more so, considering that out there the patient or victim is generally expected to cough up a much larger percentage of the one-time-only "unit price." The closer mostvolks come to understanding a hospital bill, the more likely they are to dispute it--and ¿What would become of "18% of our state economy" [*] if everybody started doing THAT? ¡I ask you! Happy days. _____ [*] joshatpioneer @ Tue 29 May 1:15 PM (in this thread) AD HOMUNCULUM. The honourable and telegenic gentleman plainly likes these things the way they are, a good indication of which side his stethoscope is buttered on. I suspect he is worried on his Institute's Funders' behalf needlessly: should the General Court actually do anything noticeable, the chances that what they do will simplify the existing ‘system’ are low. Extremely low. Come what may, there ought to be plenty of nooks and crannies and bogs and gulches left for The Entrepreneurial Spirit™ to hide out in. The stalwart Pioneers are in a bit of a pickle on this one. As a general rule, they and their Venerable Funders want the Evil State to cost a whole lot less than what Comrade Commissar Patrick and the Demoncrats lavish upon it, but in this case, at least, almost every penny saved would also (¿would it not?) be a penny that the EighteenPercenters never get their hands on. So perhaps we shall soon learn whether their freelordships consider it more important to damage their Class enemies or to succour their Classmates. Master Joshua’s dynamic-kinetic plan of nolite quieta movere, "pause and slow down before adversely impacting"--betcha a thousand romneys he means "lest you adversely impact"--inclines to the defensive or ideobuddy-helpin’ end of the spectrum. Considering, however, that the Pioneers are but one small drop of reaction in the bucket of America's Otherparty, it may not be wise to specuvest too many chips on this comparatively mild-mannered attitude prevailin' forever. Or even for long. Under a POTUS known to like firin’ volks, "¡Scrooge thine enemy before she scrooges thee!" could take over rapidly.  Or, to call the same rose by another name, "¡Damn the ‘adverse impact’, full speed to the rear!" |
Happy days.
--JHM
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