Evidence-Based Health Care Reform? Lessons From Massachusetts

In Massachusetts, where 97% of us have health insurance by mandate since 2006, we have learned a few things about health care reform.

We have learned that universal coverage does not mean universal access to a doctor.  The Massachusetts Medical Society reports that there is a critical shortage of family physicians and severe shortage of internal medicine doctors.  Seven physician specialties are also operating in critical or severe physician labor markets.

A recent study by the Robert Wood Johnson Foundation showed that 75% of non-emergency ER visits occurred because a regular physician was not available after hours, and half of these visits occurred because a timely appointment was unavailable.  With more than half of all the doctors trained in Massachusetts leaving the state, citing the practice environment and low salary levels, and one out of every four currently practicing doctors considering a career change, it does not appear that access issues are going to improve soon.

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Tags: Commonwealth Care, defensive medicine, emergency room visits, evidence based medicine, family physicians
Posted Jan 19th 2010 at 7:31 am in Healthcare, Politics, State Politics | 61686125 Commentshttp://biggovernment.com/lschratz/2010/01/19/evidence-based-health-care-reform-lessons-from-massachusetts/Evidence-Based+Health+Care+Reform%3F+Lessons+From+Massachusetts2010-01-19+15%3A31%3A17Dr.+Lorraine+M.+Schratz

Senator J. Wellington Wimpy’s Health Care Bill

Pollsters like to say their surveys are like a snapshot, limited to the time and the picture frame in which they are taken. What we are seeing in polling on the takeover of health care by the federal government is a consistent opposition by the American people. No major poll shows the people supporting the House or Senate bill.

The poll most often cited by conservative talk show hosts is that of CNN/Opinion Research. This is the poll that shows the widest gap between those in favor and those opposed—25 points. Rasmussen reports a milder ratio of 16% between those opposed and those in favor. Gallup shows it a near-tossup: 46% in favor, 48% opposed.

What all these polls fail to show, however, is intensity. Intensity in politics is everything.

Those who know the most, who tell pollsters they are following the debate most closely—especially seniors—tend to be most opposed.

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Tags: Abraham Lincoln, Civil Rights, CNN/Opinion Research, delayed benefits, Emancipation Proclamation
Posted Dec 20th 2009 at 5:34 am in Congress, Featured Story, Healthcare, Politics | 4963062 Commentshttp://biggovernment.com/kblackwell/2009/12/20/senator-j-wellington-wimpys-health-care-bill/Senator+J.+Wellington+Wimpy%E2%80%99s+Health+Care+Bill2009-12-20+13%3A34%3A19Ken+Blackwell

A White House Power Grab that Congress and America Doesn’t See

To achieve the goal of a universal, single-payer health system, the White House must secure the power it needs by amending the Social Security Act to transfer pivotal controls from Congress to the executive branch.  This transfer of power would ultimately give the President and the majority party, in this case the radical left Obama White House and Pelosi-Reid led progressive Democrats, the authority to frame and manipulate new policy, coverage options, and reimbursements, ultimately reshaping the future US health care system into a something unrecognizable in this country.

The deliberate setup for the White House power grab is built into the each of the health care bills and, if they fail, little-known twin bills called “MedPAC Reform of 2009” are waiting in the wings.  The bills, S.B. 1110 and H.R. 2718, craftily amend the Social Security Act and transfer the Medicare guideline and rule setting processes, from the legislative branch to the executive branch.  These bills offer cover to one another in case one doesn’t pass the House or Senate, respectively.  Remember, Democrats need to gain executive branch authority by amending the Social Security Act over Medicare regulations and physician fee schedules to transform the health care system in a single-payer, socialized system.

More importantly, Medicare’s regulations and physician fee schedules are the keystone to developing payer systems and reimbursement models across the entire health care industry.  And where Medicare goes, insurers follow.

To underscore the far-reaching power, a bulk of the states already reference or utilize the Medicare guidelines and fee schedules in determining policy, coverage, and payment, which impacts certain state-specific plans, including, but not limited to, self-funded plans, automobile insurance payers, and state workers’ compensation funds and plans – affecting even Big Labor.   For the executive branch to have such authority over Medicare regulations with little oversight is alarming.  This raises further issues of the powerful impact these federal mandates could potentially have on the states in stripping them of their own management of their respective insurance industries.

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Tags: Centers for Medicare and Medicaid Services, government health care, government rationing, government takeover, Health Care Financing Administration
Posted Dec 8th 2009 at 6:31 pm in Big Labor, Congress, Healthcare, News, Obama, Politics | 43214146 Commentshttp://biggovernment.com/sahiller/2009/12/08/a-white-house-power-grab-that-congress-and-america-doesnt-see/A+White+House+Power+Grab+that+Congress+and+America+Doesn%27t+See2009-12-09+01%3A31%3A38SusanAnne+++Hiller

Reid’s Health Care Bill by the Numbers

Let’s take a quick look at numbers behind the Senate health care bill introduced by Senate Majority Leader Harry Reid.

Reid claims his bill will cover 94 percent of the population at a cost of $849 billion over 10 years.

The population of the country is roughly 300 million.

At this point you need to understand one thing – there are two vastly different numbers used for the uninsured. The first number consists of all the people uninsured at some point in a given year, whether they are citizens or here illegally. The second number is the chronically uninsured, those who have spent an extended period of time (years) without insurance. The number for the former, the one I like to call the “kitchen sink” number, is one with which you are undoubtedly familiar: 47-49 million. The number for the latter, the chronically uninsured, is one you may not have heard before: 12-15 million.

How these differing numbers come to be is a story for another day, but let’s analyze both of them for the sake of argument.

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Tags: chronically uninsured, employer provided coverage, government health care, Government spending, Harry Reid
Posted Dec 6th 2009 at 6:51 pm in Healthcare | 3395042 Commentshttp://biggovernment.com/dhunter/2009/12/06/reids-health-care-bill-by-the-numbers/Reid%27s+Health+Care+Bill+by+the+Numbers2009-12-07+01%3A51%3A01Derek+Hunter

HHS Chief Actuary on ObamaCare: Total Health Care Spending Will Go Up, Not Down

Richard Foster, Chief Actuary for the Department of Health and Human Services’ Centers for Medicare and Medicaid Services, released this week to several Congressional offices a financial analysis of HR 3200, the House version of ObamaCare. He reached some inconvenient conclusions for President Obama and Congressional Leadership:

-“Total national health expenditures under this bill would increase by an estimated 2.7 percent in 2019…”

 -“The additional demand for health services could be difficult to meet initially with existing health provider resources and could lead to price increases, cost-shifting, and/or changes in providers’ willingness to treat patients with low-reimbursement health coverage.”

-More than half of the expansion in coverage (18 million out of 34 million) would be from increased Medicaid coverage.

-12 million people would lose employer-sponsored coverage.

-The productivity adjustments to Medicare are “unrealistic” and providers “might end their participation” because the cuts would make serving Medicare beneficiaries unprofitable.

-Medicare Advantage enrollment would decrease by 64 percent (from a projected level of 13.2 million to 4.7 million under the proposal).

As of today, HHS still hadn’t published the analysis on their website, even though it was written by its own staff. We have a feeling it may never find a home there. So, we’ve brought it to you directly. Full financial analysis below.  

CMS OACT – Memo on Financial Impact of H R 3200 09-10-21 –

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Tags: actuary, Centers for Medicare and Medicaid Services, employer converage, health care spending, HHS
Posted Oct 23rd 2009 at 1:31 pm in Exclusives, Healthcare, News, Obama, Politics | 2028236 Commentshttp://biggovernment.com/capitolconfidential/2009/10/23/hhs-chief-actuary-on-obamacare-total-health-care-spending-will-go-up-not-down/HHS+Chief+Actuary+on+ObamaCare%3A+Total+Health+Care+Spending+Will+Go+Up%2C+Not+Down2009-10-23+20%3A31%3A49Capitol++Confidential

An ObamaCare Alternative from the States

Earlier today Minnesota Governor Tim Pawlenty explained to BigGovernment.com readers how the Baucus health care plan is a prescription for higher taxes and higher premiums.

In keeping with the theme that good perspectives and ideas often come from the states, 33 state-based think tanks came together this morning to announce a health care reform alternative to ObamaCare.

“President Obama and other supporters of government-run health care like to proclaim that there’s no alternative to their plans,” said John Tillman, CEO of the Illinois Policy Institute. “Our patient-centered reform package offers a clear alternative that puts patients, not bureaucrats, first.  It protects the doctor-patient relationship, offers viable solutions for the uninsured, and keeps medical care affordable for all Americans.”

Patient-centered health care reform:

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Tags: Gov. Tim Pawlenty, health care mandates, Health Savings Accounts, Illinois Policy Institute, mandated coverage
Posted Oct 13th 2009 at 3:21 pm in Congress, Healthcare, Obama, Politics, State Politics | 1603861 Commentshttp://biggovernment.com/krasmussen/2009/10/13/an-obamacare-alternative-from-the-states/An+ObamaCare+Alternative+from+the+States2009-10-13+22%3A21%3A51Kristina+Rasmussen