Has Massachusetts Finally 'Cracked the Code' On Health Care Costs?

[ralph]

oh boy, more bureaucracy. Why, that's bound to help!

C'mon now,everybody knows more govt, is better! How's the saying go?We're from the Govt, and we're here to help!!

[NWPilgrim]

Government regulation to "control costs" leads to:
- Less service, longer wait times for care
- Fewer doctors and nurses, and degradation of qualifications (smart people will go elsewhere to make money with their talents and skills)
- an ever increasing percentage of "health care" dollars spent going to compliance rather than care
- Ever more bureaucracy to "fix" the previous regulations, rinse and repeat

You cannot provide unlimited, ever more complicated and long lasting care on a finite budget. There is not enough money in the world to provide everyone a high level of the most advanced treatment and care. Face it, our bodies are not perfect and are programmed to degrade and eventually quit functioning, and most have some level of physiological defects. Each family should be responsible for deciding how much of their home budget is allocated to their own health care and then providing for it.

As soon as someone realizes that someone else is picking up the tab (taxpayers) their "need" for services will have no limit. Govt meddling only complicates the industry and adds ever more overhead costs. A symptom of how sick the industry has become is that most physicians either cannot, or will not, give you proactive cost estimates and discuss options based on affordability. If they are fee for service then they don;t want you to know, just get treated and bear the financial burden later. If they are flat fee plan then they don;t want you to know what could be done, only what they are willing to provide within their cost/profit structure.

Why does anyone think that government regulated or operated healthcare is any less stupid than govt regulated and operated education, or revenue collection, or postal service, or motor vehicle and driver licensing (biggest source of fake ID data in Oregon for meth heads has got to be our own DMV via corrupt workers selling it)?

The more the govt is involved, the more of your money will go to govt and industry bureaucrats and the less of it to doctors and nurses.

[Belmont31R]

Government creates problem...leads to more problems...government solves those problems....leads to more problems...government solves those and we have single payer under Pelosi's control.

[armakraut]

Building a house would be very expensive too if the government mandated that all contractors had to hold doctorates in engineering and only employees with a masters in hammering assistance could bang nails in.

[WillBrink]

Building a house would be very expensive too if the government mandated that all contractors had to hold doctorates in engineering and only employees with a masters in hammering assistance could bang nails in.

In MA they do!

[Caeser25]

The easy way to control costs would be less coverage by insurance plans. Covering only needed surgeries and and inpatient stays. Regular office visits, physical therapy, etc paid directly from your pocket would cut costs because there's no employees needed to cut through all the buerocracy of the paperwork for billing to insurance company x, y and z.

[Sensei]

But isn't that what insurers are doing right now, with an ongoing battle between the insurer's utilization review staff and providers?

To some extent, yes. But, there is a big difference between private insurers negotiating with healthcare providers, and Big Sis (Center for Medicare Services) setting the rules of the game and the prizes.

http://www.forbes.com/sites/aroy/201...ganizations/2/

On a different note, it may be a little premature to blame all of Massachusetts' problems with cost containment on Romneycare. The merger between Brigham and Mass General (2 Harvard flagships) did not help.

http://www.forbes.com/sites/aroy/201...y-talks-about/

Don't get me wrong, I'm not a fan of Romneycare - I just want a full accounting if the facts.

[uwe1]

Found this article:

Seriously? Doctors say they're underpaid.
http://thechart.blogs.cnn.com/2012/0...yre-underpaid/

From halfway down the comments section posted by a someone screen-named "ERDoc":

As a senior ER resident I make about $50k. In a year, I'll make significantly more. On a normal shift I work about 10 hours, during which time I rarely eat, drink, or use the bathroom and I see somewhere between 12-20 patients with an unlimited number of complaints. I work between 20-23 shifts a month, not including administrative time, studying, and academic projects that I am required to complete. I can agree that healthcare costs have ballooned., but doctors are not making the vast majority of this money. What we pay for, as a society, is maintenance of our hospitals and technology. You come to an ER with "the worst headache ever" and you're gonna get a CT scan and an interpretation of your findings. Now you get to pay for the hospital, the CT scanner maintenance, the physical space, the nurses, the EMR fees, radiology technician, transportation services, environmental services, registration, and of course your ER doc and radiologist. There's also static costs like the water bill, electricity, air conditioning etc. I will likely never see the huge salaries that are mentioned here, and even if I did the money would be heavily taxed and much of what is left (at least early in my career) will go to my $200k in student loans and the $95K I owe on my 840sq/ft condo. I will almost certainly drive my Sentra well into this decade and my ailing water heater will ensure that I take lukewarm showers for the rest of residency because I have neither the time nor money to invest in repairing it. Do most people spend too much at the doctor? Yes. Do I get paid enough for what I do? No. Do I love my job? Absolutely. I do my job because I love what I do, not to get rich. All I really want is adequate reimbursement for my time and effort, and a little bit of respect ... and even the respect is negotiable. If I ever struggle to make ends meet as a physician, I will simply change careers to a consultant or administrative position and the US will be down another clinician. Please, stop this nonsense about blaming doctors for the woes of society. The problem is all of ours, not doctors alone.

I know nothing about the inner workings of an ER. Lanesmith (err... Sensei) does what was written make sense to you?

[khc3]

Purely as anecdote, but I recently paid an orthopedic surgeon significantly less for the same procedure I had done, at the same facility, 6 years ago.

The hospital charges, however, had nearly doubled.

[Sensei]

Found this article:

Seriously? Doctors say they're underpaid.
http://thechart.blogs.cnn.com/2012/0...yre-underpaid/

From halfway down the comments section posted by a someone screen-named "ERDoc":


I know nothing about the inner workings of an ER. Lanesmith (err... Sensei) does what was written make sense to you?

Most of what he says is technically accurate. The salaries of physicians who are in training (i.e. residency) is between $40-60k and funded in part by the govt. The work hours in residency were once insane with some rotations averaging 110-120 hrs/week. However, they have recently been limited to no more than 80 hrs / week by regulatory authorities. Once a physician completes residency, things generally improve significantly. How much so depends greatly on the speciality. Surgeons in my region generally work about 60 hrs per week (including overnight call 1 day per week) and bring home about $250K per year with the possibility of added healthcare benefits, 401K, profit sharing etc. While this may seem like a lot of cash, keep in mind that surgeons completed 4 years of undergrad, 4 years of med school, and at least 5 year of residency where most of the hours were >100/week.

Board certified ER docs make similar money, but we work fewer total hours due to the large number of night, weekend, and Holiday shifts. If I had to put a number on it, ER docs in my region make about $125 / hr plus benefits (healthcare, business expense, malpractice, etc.)

We are not starving, but we probably make a little less than we could if the govt would extricate itself from healthcare and allow the market to dictate prices and salaries.

FWIW, I'm leaving clinical practice in a few months to pursue a totally different career in govt service. It's a big pay cut, but I'll get to work with a good group of people. I'll do just enough medicine on the side to keep my credentials so that I can supplement my salary and have a backup plan.