The Wall Street Journal did a recent review of what is going on in Massachusetts.   You may not be able to see the link unless you have a subscription.  Let me review:

  • 79% of the newly insured are on public programs.
  • Health costs will consume some 54% of the state budget in 2012 up from about 24% in 2001.
  • Over the same period state health spending in real terms has jumped by 59%, while education has fallen 15%, police and firemen by 11% and roads and bridges by 23%.
  • Massachusetts spends more per capita on health care than any other state and therefore more than anywhere else in the industrialized world. Costs are 27% higher than the U.S. average, 15% higher when adjusted for the state’s higher wages and its concentration of academic medical centers and specialists.

Maybe you can call this political spin. Maybe the WSJ somehow cherry picked the statistics they wanted.  It doesn’t matter because this wasn’t the most upsetting part to me.  This was:

Under the plan, all Massachusetts doctors, hospitals and other providers must register with a new state bureaucracy as a condition of licensure—that is, permission to practice. They’ll be required to track and report their financial performance, price and cost trends, state-sanctioned quality measures, market share and other metrics.

I have said this over and over again.  The quality movement is unproven and bad for healthcare and now Massachusetts is putting it in play and using our licensure as hostage!!!

Want some more? Here:

But Massachusetts takes 360-degree surveillance and converts it into a panopticon prison. An 11-member board known as the Health Policy Commission will use the data to set and enforce rules to ensure that total Massachusetts health spending, public and private, grows no more than projected gross state product through 2017, and 0.5 percentage points lower thereafter. (And Paul Ryan’s Medicare projections are unrealistic?)

No registered provider is allowed to make “any material change to its operations or governance structure,” the bill says, without the commission’s approval. The commission can also rewrite the terms of provider contracts with insurers and payment levels and methods if they are “deemed to be excessive.”

As the commission polices the market, it can decide to supervise the behavior of any provider that exceeds some to-be-specified individual benchmark—that is, doctors and hospitals that are spending too much on patient care. These delinquents must submit a “performance improvement plan” that the commission must endorse.

I told you this was coming.   And yet the AAFP and AMA walk right into it……..asses first….with a bottle of vaseline to make it easier.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]

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8 Responses

  1. Judy says:

    agree with Pat comment on Aug 9 — right out of ‘Atlas Shrugged’. Dr. F: your ability to paint such amazing ‘mind pictures’ is beyond compare! Vaseline should pay you dividends….

  2. regnad kcin says:

    So, when does the stampede for New Hampshire begin?

  3. Scott Miller, MD says:

    We’re smart, but we don’t cooperate. Instead we compete with each other. That’s what got us into and through medical training. Now other groups who can cooperate have found ways to get into our pockets, to control us, to, in effect, be parasites upon us, because we can’t cooperate. Unite or Die as someone once said. Not “unite” like the AMA or similar fat cat groups, but actually take the lead, to control cost, to cut out waste, to serve, and to toss out the parasites. The nurses support each other better than we do, but they don’t have the knowledge to step into our shoes and I think they won’t like what they have stepped into if they ever succeed in doing it.

    I said it.

  4. Kurt says:

    The message to med students, “STAY AWAY FROM PRIMARY CARE.”
    They are getting that message with 43% of 1st year FP residencies filled by foreign graduates.

    People who get “free or near free care” are going to continue to smoke and eat crap with careless abandon no matter how much I scream at them. It’s time to hit them in the pocketbook. If people know it’s going to cost ’em more in the future, they just might start listening to us and making positive health changes now so the future would be a little more positive.

  5. gc says:

    Still to hear comments in the same direction regarding fines given to hospitals where re-admission rates are “unacceptable”. Interrestingly according to WSJ, Yale who raised the issue is one of the prime targets of this new process.
    Same ? : how do you prevent re-admission in patients who don’t want to / forget to take their prescription medications, How do you help those who refuse to follow suggestions regarding eating habits, smoking, drinking, and taking drugs…

  6. Charles Davant, MD says:

    Keep out of the sample closet? Hell, there’s nothing good for anything in there anymore. Had to get my partner to call a script for Ambien for my wife before a flight to Italy. She needed two. Got a patient with a fracture–forget giving them something in the office. Need something for a runny nose? Good luck.

  7. Theodore Bacharach says:

    Depending on your inclination you can refer to “Affordable Health Care”, “Obama Care” and “Romney care”. Take your pick

  8. Pat says:

    Before some of you ostentatiously compassionate types get on me as a shrill reactionary, stop – this is literally right out of the old Soviet model. This scenario could come right out of “Atlas Shrugged”, wherein special Unification Boards would set price, productivity quotas, work obligations/restrictions, and have unlimited power over every previously private entity. Physicians have betrayed the very freedom that allowed us our previously noble work.

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