This Is One of Those Times and Issues When It's Not So Great to Be 'Mr. Chairman'

Thursday, June 7, 2012

Would you like to be Steve Walsh or Dick Moore, the House and Senate chairs of the legislature’s Joint Committee on Health Care Financing?  I wouldn’t.

More than any other members of the legislature, they had to come up with the answers over the last year on how to put the brakes on health care costs and thereby save the state’s unique system of universal health care, which most people, at least in Massachusetts, seem to see the beauty of. That was a $67 billion challenge.


That’s the total amount spent on health care in one year here.

To try to put that number in perspective, the entire state budget for the next fiscal year (FY 2013) is going to be somewhere north of $32 billion.

According to conservative estimates, of the $67 billion spent annually on health care, about 20% goes to unnecessary treatments, excessive administration, the after-effects of preventable medical errors, and readmissions to hospitals that could have been avoided through higher-quality care and better medical decision-making.

Twenty percent of $67 billion is $13.4 billion dollars.


How would you like to figure out how to squeeze even 10% out of that $13.4 billion?  If I had that assignment, I’d find myself hopelessly lost after one week of wandering about in our bewilderingly complex, densely interwoven, multi-layered health care system.

And how would you like to face all the folks who have a strong interest in the health care status quo -- all the big hospital systems with deep-pocketed board members, all the Top Gun/Top Dollar physician specialists, all the medical entrepreneurs with free-standing, “state-of-the-art” diagnostic labs and surgical centers -- and basically tell them, “My duty is to make sure you don’t make as much money next year.”

If you’re Representative Walsh or Senator Moore, that’s what you have to do.

Then you have to listen respectfully to the status quo folks as they warn you not to push this health-care-payment-reform thing too far or you’ll wind up killing a lot of good-paying jobs in our state’s job-rich health care sector, the “Golden Goose,” as ex-Partners board chairman Jack Connors and others call it, which is in fact the case. 

Squeezing money out of our health care system, the most costly in the nation and world on a per capita basis, inevitably means jobs will be lost and fewer new jobs will be created. 

If you’re a member of the legislature, it’s a sure bet you didn’t run for office to vote for something that puts people on Unemployment, and you didn’t run to make more people jobless at a time when Massachusetts is continuing its slow-mo recovery from the Great Recession, the worst economic times since the Great Depression.

Your constituents, the folks you see every day at the coffee shop, the post office, the Little League game, etc., they elected you with the idea that, maybe someday when they were in a pinch, you’d help them or someone in their family find a job, not lose one.

The alternative to squeezing money out is allowing health care to eat up more of everyone’s budget year after year-- every company’s, every community’s and every household’s budget.

As Rick Lord, chief executive of the Associated Industries of Massachusetts, said in a March 26 blog post, “Doctors, hospitals and other health-care providers argue that reductions in medical spending will harm a sector that represents 13 percent of the gross state product in Massachusetts.  Fair enough.  But why should the employers who make up the other 87 percent of the state overpay to support the 13 percent?”  See  http://blog.aimnet/org/AIM-IssueConnect/bid/76364/Rising-Health-Costs-Mean-Real-Mon

If you’re Representative Walsh or Senator Moore, you ’re damned if you do cut the rate of increase in health care spending, which is what differing versions of health care payment reform legislation passed recently by the House and Senate would do, as opposed to actually cutting the total amount of current health care expenditures.  And you’re damned if you don’t cut the rate of increase.  You have to do something.

If you do nothing, our system of health care, which does so much good, could well turn into something bad, a monster that slowly devours every other collective and individual priority in sight.

Yikes.  Steve Walsh and Dick Moore, you have to stop that thing!

No comments:

Post a Comment