Massachusetts: The Canary in the Coal Mine for ObamaCare
Like in Massachusetts, the Obama administration plans on controlling rising medical costs nationwide through a system of “bundled payments” to “Accountable Care Organizations” that would essentially reward doctors and hospitals for limiting care. Although the buzzwords may be new, one patient astutely observed to New York Times medical writer Dr. Pauline Chen, “Whatever that care plan is called, it still sounds like an H.M.O. to me.”
Hence, it is no surprise that many doctors are increasingly seeking to opt out of government programs such as Medicare. Others are moving towards “concierge practices” that allow them to practice according to their best medical conscience free from the restrictions of the government-controlled insurance system. And just as many fed-up Massachusetts doctors are leaving that state, some fed-up American doctors may start taking a closer look at overseas “medical tourism” practice opportunities.
In a recent Washington Post piece, Dr. Manoj Jain reported on his visit to a medical tourism facility in Bangalore, India. This facility catered to Americans by offering surgeries of comparable quality to American hospitals, in a clean, modern, high-tech setting — but at one-tenth the price. Similar facilities will be opening soon in the Cayman Islands, a mere hour’s flight from Miami.
Of course, under ObamaCare not every American doctor will relocate to another country. But as government controls increase, those doctors who most value their freedom to practice according to their best independent judgment will be least willing to be compelled to practice according to government “clinical guidelines.”
America may thus experience a combined internal and external exodus of the best, most independent, most conscientious doctors out of the government-controlled system — akin to how the best scientists, musicians, and artists fled the Eastern Bloc countries for the West during the Cold War. The remaining doctors will be the ones more willing to abdicate their professional responsibility to offer their patients their best independent expertise and instead practice “cookie cutter” medicine as dictated by bureaucrats in Washington, D.C. Is this the kind of doctor you will want caring for you five years from now when you are seriously ill?
Fortunately, it’s not too late for the rest of America to learn from Massachusetts. Instead of adopting that failed system at the national level, Americans should demand that Congress “defund” and repeal ObamaCare — and adopt genuine free-market health care reforms like those advocated by Tea Party physician-activist Dr. Milton Wolf and Whole Foods CEO John Mackey. Such reforms include fixing the tax code to put employer-provided health insurance and individually-owned health insurance on a level playing field, repealing costly mandates specifying which benefits insurers must offer, allowing individuals to purchase health insurance across state lines, and eliminating monopolistic medical licensing requirements that prevent doctors from practicing across state lines. These reforms would lower costs and improve access to quality medical care, while respecting the individual rights of patients, doctors, and insurers.
The ongoing failure of the “universal health care” plan in Massachusetts serves as a clear warning to the rest of America. The only question is whether we’ll heed it.
And yet, Mitt Romney expects us to vote for him. As if! =^[.]^=
I live in the Socialist utopia called Massachusetts, have all my life. If i could find comparable work in NH I would be there tomorrow. And 50% of that reasoning comes from Romney Care and the mentality that created it.
It is the biggest piece of garbage ever jammed up the the citizens of Massachusetts collective back sides! But the liberal fools here still seem to believe that things are great and getting better, even when they are shown the numbers over and over. I am beginning to see that the Liberals treat their “political morality” as a religious belief. So much so that no amount of proof can change their minds.
I’m willing to bet that “the liberal fools” you speak of are full of themselves that they support a program put forth by a Republican.
Meanwhile, if we put this guy on the ticket in 2012, there is NO WAY that they would vote for him.
ANYONE BUT OBAMA in 2012!
Go read today’s Los Angeles Times piece on Romneycare. One would swear an insurance company wrote it, but it is too full of gushing liberal self-congratulation and delusions. Truly, that paper is the most Obama-deluded in the country.
But at least they don’t call Obama/Romneycare “socialist,” I’ll give them that credit.
As a resident of MA, I can tell you this has been a disaster. The rates go up every year and they are not cheap. We now wait on average 55 days to see a doctor.
Solutions;
Let us buy insurance across state lines.
Have a high risk poll just for existing conditions.
HIGH DEDUCTIBLES in exchange for lower rates.
Solution–stop voting for the socialists.
How many years did you all vote for Ted “want to make a sandwich, Chris?” Kennedy. Now that mentality is infecting the rest of the country.
Boston is the San Fransisco of the the East Coast. What do you expect?
“The access problems have gotten so bad that the state legislature even considered forcing doctors to accept government-controlled insurance rates as a condition of retaining their state medical licenses (regardless of whether or not the doctors lost money on each patient). As Massachusetts-based health policy analyst Jared Rhoads describes it, this would be responding to the failures created by the government’s insurance mandate by imposing a new “physician mandate.”
Doctors will simply leave the state or stop practicing medicine. And if the doctors really think their license is at risk simply because they don’t want to be employees of the state, then they really will leave. What will the governor do then when all or most of the doctors leave? You can’t pull doctors out of thin air. So what is going to happen then? This is a disaster that’s going to play out on the national level as well when Obamacare really kicks in. Hopefully, it will be declared unconstitutional by the Supreme Court and that will end this folly.
“What will the governor do then when all or most of the doctors leave? You can’t pull doctors out of thin air. So what is going to happen then?”
What will happen is we will end up with the “dregs” of the medical world and “fresh out of school” just skimming by “doctors” because that is all that will be dumb enough to become a slave of the state.
It happens in businesses a lot, especially when “management” thinks that technical people or high skill people can be had on every corner. They micro manage them out the door with less money and worse working conditions, then sit back and wonder what happened after the doors close.
And the plight of medical staff will be exactly the same here but on a state wide level in the next 5 years. Nationally it will take a little longer to landslide but when it does nothing will stop it!
Medical schools are already choosing admissions not based on scientific excellence, but on “social conscience” and other irrelevant nonsense. In the 1970′s there was a so-called doctor shortage that resulted in the importation of large numbers of foreign medical graduates (FMGs), only some of which were competent. Expect that to happen again, as the best and brightest elect not to enter the medical profession. And don’t forget:
What do you call someone who graduates last in their medical school class?
“Doctor”.
I wonder what the trend is for Harvard medical students staying in Mass to practice. Harvard is still one of the top medical schools in the nation, but I bet less and less of their grads are sticking around. It would be interesting to see the actual numbers.
Austrian economics tells us that the more government intrudes in private economic exchanges, the more it distorts the outcome, and then the more it must later intrude in order to mitigate the effects of its previous intrusion.
More important, Austrian economics tells us that the ONLY solution to this mess is for as many people as possible to pay their own bills. And even when a person is not required to pay their full cost, they must pay something.
Socialist schemes like ObamaCare ™ avoid the essential discussion we must be willing to have: who in our society is “indigent” and worthy of our help and who is expected to carry their own weight. Just like ever-expanding salaries and pensions of government workers, we have allowed politicians to expand the “benefits” we offer to people, so that our “poor” now include people at the low end of the middle class, people who should really carry their own weight.
Sadly, you’re absolutely right. The lower-middle class types blame everyone else but themselves for their situation. I’ve witnessed the finger pointing within my own family.
Not to mention St. Louis ‘activists’ are ‘proposing’ (demanding.. same thing for the activist. Right Obama?) sub-prime loans (yikes!) for ‘minorities’ (what the hell is a ‘minority’ in this day and age anyway?) and poor.
Common sense, personal responsibility, investing in one’s future and overcoming their own ghosts, problems is so alien to the illiberal mind it’s frightening.
Socialist? Tiresome. It is corporatist, or fascist if you like.
“Austrian economics?” How about this: if you force every one to buy insurance, insurance companies do not have to compete to attract uninsureds to buy policies.
Simple economics. But the Obamacare corporatists believe individual mandates with reduce costs and premiums. Simply stupid.
It is becoming apparent that the Socialist from Chicago really only set this whole mess up to increase control of more of the economy and the patronage jobs and the union dues that would bring. The group with almost no real experience in the private business sector has set up a soviet command and control system to handle the health care of 310 million people. Clearly an impossible task to anyone who has even glanced at the various socialized systems that have tried to centralize like this in the past. We have corrupt morons in our Congress and in our White House and if we don’t take them out of control of our lives in 2012 we are all going to be paying much much more for much much less. Vote out every liberal Progressive before it is too late to late.
“The American people will never knowingly adopt socialism. But, under the name of ‘liberalism,’ they will adopt every fragment of the socialist program, until one day America will be a socialist nation, without knowing how it happened.” Norman Thomas
Please allow me to add that when we do decide who is entitled by their circumstances to enjoy no-cost or low-cost health care, we must account for and show respect to the money we must take from others in order to fund this activity.
When we extract money from a person who would otherwise have invested it in a new business, we will never see the jobs or wealth that business might have created. We only see the effects of the government program. And we have allowed too many pols to make a play for class warfare and exploitation of different demographics and social strata.
Lastly, in each of the last several years, Americans donated almost $300 billion to charities. So, there is plenty of money to fund a lot of social spending and without taxes, coercion or compulsion. All we need is a correctly packaged appeal, and a correctly structured tax system to allow social spending to be privately funded. But this option offers no juice for the cynical pol to exploit so it never gets mentioned.
As much as I would like to vote for Romney, his RomneyCare ™ shows his utter lack of understanding about the nature of socialism and the nature of the free market. Socialism destroys wealth and liberty. It can only exist when government is willing to employ coercion and compulsion.
Further, Romney recently signed a ban on so-called “assault weapons”. So, again by his actions, he shows me how much he understands liberty.
Romney is just a supporter of big government in a conservative suit.
We have a right to the Doctors lives and brains – and they have a right to work for us!
From each slave according to his ability,
to each master according to his need.
Too little too late – the mere fact that at one time Romney thought Romneycare was a good idea is fatal in my estimation. He can renounce it all he wants now, but he can’t change the fact that he supported it and only years later decided it was not a good idea. So rather than vote for a ticket that includes Romney in either slot, I will stay home just like I did in 2008.
Not to vote against Obama is to vote for Obama, or any liberal for that matter. There is such a thing as “the lesser of two evils”.
Sorry, but after having fiscally profligate Republicans like both Bushes screw me over and after watching McCain sell out on various matters to the Democrats, I decided that I’m better off not voting than perpetuating the political lives of such people. My hope is that by killing off their future political life (you notice how McCain gets hardly any press anymore), the Republican party might finally return to its fiscally conservative roots. I refuse to vote for Democratic light.
i agree
much better to elect real conservatives wherever we can
electing a rino just gives the statists cover
obama, in a twisted sense, is a “better” president than mccain would have been
obama has succeeded in making the issues more lucid; he has made a clear line in the sand where it is easy to be on this side or that; now, the real battle of persuasion for the ideals of freedom versus collectivism can happen
and we are getting to the fight while there is still time to change course
rinos, on the other hand, blur and blunt conservatism
they create a “fictitious” middle of the road when compromising with the other side
and they tend, because they are politicians first, to cater to those that are loudest and have the deepest pockets and their loyalties know no ideology
Over50
Have you ever noticed that the “press” is there for John McGoofy McCain when the dimocrats need a spoiler? Now that his job has been secured by the Fox News Team for another six years, he no longer needs the “press”. Maybe they should promote his candidacy for president again. Chris Matthews and his ilk are waiting in the wings to carry his water.
That would surely stop the Mormon Cultist, No? Hate seems to spring eternal as evidenced by the many one note commenters here. Even if you have your eyes wide open in a tunnel, you will probably still see a tunnel.
Maybe Huckleberry the Huckster will make it this time and they can all rejoice in the knowledge that the Marxist will be reelected.
It all depends on your perspective.
To a marxist, this is nirvana.
You can bet the political capos have instant access to the top medical professionals at rock bottom prices. Indeed, if you have that, it’s proof positive that YOU are a politial capo, or a favored constituent of one.
Liberals only know how to move in one direction. When their laws result in increased costs and increased wait times they keep pushing for even greater government control. The same thing happened in housing. Romney let the camel’s nose under the tent and now it is pissing and shytting everywhere.
Romney seems to be positioning himself to get all the votes of a nonexistent sector of the voting public. Such obtuseness is simply amazing.
Government has enough problems building roads, that is, laying asphalt. You think creating and managing a complicated, heavily used industry is something the boobs,& failed lawyers can do? Leftist trash want this precisely because it is destructive. Romney runs, the media chews him up, retardo Obama follows and picks up the pieces. Funny thing is, the media will stress the problems and get away with it. Morons don’t notice things like that.
According to liberal doctrine, the failure of Massachussetts’ Romney-care is simply remedied. Implement and enforce Obama-care nationwide as fast as possible. Then those evil, capitalist doctors who feed their own greed based upon the workers’ misfortune will then have no place to run to.
The most important thing for the liberal is not the quality of healthcare, but the equality of all—-even if equality necessarily results in no healthcare.
We may soon be singing a new version of the Peter, Paul, and Mary standard.
Where have all the doctors gone?
Long time passing.
Where have all the doctors gone?
Long time ago.
Where have all the doctors gone?
Driven out of business every one.
When will we ever learn?
When will we ever learn?
haha exactly
if there is a problem government needs to spend more; if there is still a problem government isnt spending enough
Instead of medical tourism in far-away places, how about cruise-ship medicine. Cruise ship medical centers can be set up to pick up patients at ports and go 3+ miles offshore to perform medical services in international waters. No need to worry about government interference, rich liberals will be the first customers. Once again, free market capitalism to the rescue. Is this a great country or what????
Jimbo
But wouldn’t that require permission from the United Nations? Maybe you should run the idea by Eric Holder.
Dr. Rich at The Covert Rationing Blog has already suggested Indian Reservations as another alternative due to their treaty rights as sovereign nations. Done right, could be way more profitable than casinos. Fortunately for me, I live 10 miles away from a fairly economically adept tribe likely to be an early adopter.
A very informational piece. It’s clear to me that the Massachusetts system failed because it violated the rights of both doctors and patients. No wonder, they shrugged!
The exodus is happening not only for the doctors, but also for patients. I recently met a lady (in California) who has gotten quick sick. She cannot see a specialist without long life-threatening wait times, despite the fact that she is medically insured. It wasn’t long until she and her husband decided to return to their country of birth. They are leaving their jobs, and taking their kid along.
I have had my life saved by a doctor in California and the wait time was about 10 minutes for the ambulance and maybe 15 in emergency until I want upstairs. altho there was nurse immediately there.
I have heard it can be much worse. Doctor was originally from a foreign country. I cringed when I read about wait times in Ma for MRI. MRI can find things an xray can’t.
Why be a doctor when it takes 6 to 10 years of grad training, only to be paid the same as an engineer with just a BS degree. My wife was a Kidney Specialist and I earned more nearly every year as she did.
Why be a doctor to receive calls at 2 AM, but not be allowed to bill for that 1/2 hour of lost sleep.
Why support charities that advocate for more of this Government, I have really stopped doing it especially since I get no tax break anymore.
Why invest or take risk when the government makes it so hard to do so, why hire someone when Obamacare may make it impossible to lay off or fire them without paying their O’premium for years.
If the One is relected, it will be time to just go underground.
Same thing happens in Canada… except until now the doctors all ran to the US. It’s virtually impossible to get a family doctor in Canada. Why? Because get paid basically a fixed salary. It’s low, so the doctors that don’t go to the US go to the hospitals where they can make more doing the same thing.
Emergency MRIs = 3 weeks. And they brag that that’s a vast improvement.
Oh and then there is the fact that by 2020 100% of all government budgets will go to healthcare… it’s already over 70% of all taxation is for healthcare, and it will be > 100% in the next 9 years!
When the US was expanding westward, there was a phrase, “Gone to Texas.” Because of the lack of roads and communications, you were likely never going to hear from that person again. They might as well have died.
Since tort reform was implemented in Texas, premiums have gone down 27%. Now doctors are flooding the place. Small towns have doctors. Docs leaving MA? Gone to Texas has a new meaning… Going Galt.
Humorous cartoon on this at http://drawfortruth.wordpress.com/2010/12/27/obamacare-paying-doctors/
A hard core conservative with the one hypocrisy of wanting poor people to have health care. There are worse things to my mind.
Health care if you are truly sick approximates an inelastic demand doesn’t it? You will pay any price to stay alive, when it gets down to it, except perhaps to deprive someone else of life.
I live as frugally as I can but I am happy to pay my health insurance premiums.
Well put. Beneath the agendas of the libs to extend health care to all and the agenda of the right to defend unencumbered profits for all of the providers is the 800 lb gorilla of so many expensive new procedures and drugs that if we really paid for the procedures and drugs we “need,” especially once we get to middle age, we might devote half (or more) of our income to such things. So, if we can afford it, we buy health insurance and let the insurance companies figure out how they will pay for it all. Then they just keep raising their rates and fast.
If more people gain access to health care, of course there will be longer waits for doctor’s visits. It is not the end of the world to consult with a nurse practitioner; I do it regularly in my HMO, as I can get an appointment with her within a week or two, whereas the doctor is a month or three. Anything which is serious, they will usually have me come in right away and squeeze me in to see someone. Oh, the injustice of it all!
While there are many problems in Massachusetts from which one can cherry-pick a meme of “failure,” especially given the loss of tax revenues because of the downturn which is nailing all state services, the Mass. system is NOT the unmitigated disaster one would gather from reading here. It is the direction in which we are inevitably heading.
In general, I think that larger co-pays are needed for those who can afford them. My HMO was in serious financial trouble ten years ago, but they tightened their belts, raised the yearly payments and co-pays and chugged on. In the mean time my wife and I have hit them up for two knee replacements, an appendectomy, a hernia operation, a gall bladder operation, and five colonoscopies. Throw in drugs which would probably cost $300-$500 a month, which we get for $5 per prescription. All in Massachusetts.
You have a HMO not the “State Run Option” or on Mass Health so your not in the exact situation that this story is about …..Ask some one who has Mass health and see how much the wait times have gone up and even worse how hard it is to find specialists that will even take on a patient with the Mass health card or the “State Insurance”.
To boot several Hospitals have had to sue the state for back pay for services rendered.
And doctors are leaving the state faster and faster because they are smart enough to see where this train is headed.
Glad you have gotten the services you needed from your HMO and doctors, but your on the plus side trust me.
Well who has Mass. Health? It stands to reason that the basic state system is going to get swamped. How could it not? If people have options to pay for HMO’s or Mass. Health, those who have the bucks can buy what they want. Those who can’t, have to deal with Mass Health. What’s wrong with that?
It’s like my brother who was on West German welfare before the wall came down, resented the influx of all the East Germans who got a piece of what he had. But the damned Germans, to give them credit make their system work (sort of.) From the moans here, you’d think that if we moved toward the European system that the world was coming to an end. If one has a few bucks, they can pay for the health care they want (even if health insurance in general seems like a Ponzi scheme to me, given the demographics); if people don’t have that money, then they are afraid that people even poorer than they are will get part of what they have.
Then they can grumble about death panels.
How appropriate! http://www.typobounty.com/Funny/Health_Care_Reform2.htm
The Tort Reform Act in Texas, used as a legal weapon against Texans, isn’t much better.
When there are laws on the books preventing the common man from getting accountability, the laws need to be eliminated.
http://www.youtube.com/watch?v=JT7rxa21_Xo
or, just Google Cleveland Mark Mitchell, then click on youtube.
Everytime Romney opens his mouth about health care I want to gag. Socialized medicine is immoral no matter where it is. And he wants to run for President?
Once again we see the benefits of Federalism. Try things in one state and see if they work before extending an experiment out to all states.