Coverage does not equal health care

Massachusetts is a nice lab to see the effects of an Obama health plan. The proposals are fairly similar, with the exception that Obama does not mandate individuals to obtain insurance.

One consequence is a marked rise in emergency care, due to lack of primary care access.

Now a second shows that people still can’t afford health care, despite 97 percent of the state being covered with some sort of insurance:

Although far more Massachusetts residents have health insurance coverage than residents nationwide, a significant portion of Bay Staters are still struggling to pay for needed healthcare, a new survey shows.
Some are postponing treatments, and others are not filling prescriptions, because of high costs or an inability to pay bills from earlier procedures, according to the survey by The Boston Globe and the Blue Cross Blue Shield of Massachusetts Foundation.

Promising universal coverage scores easy political points, and helps one get elected, but it really does nothing to solve our health care woes.

Comments

The Happy Hospitalist
I am convinced, and I blogged about it yesterday, that before trying to fix access to care, we need to fix the cost of care. And that doesn’t mean simply paying less for services provided. Because paying less simply results in more volume of care. It means making the delivery of health care cheaper. Health care delivery is so straddled in inefficiencies that the cost of delivering care to the masses could be slashed if us docs weren’t so buried in rules and regulations. I could probably double or triple the number of patients I see if the documentation rules required for me to get paid went away. If I only documented what was necessary to care for the patient. Documenting the family history in an 80 year old septic patient is required for me to get paid. Not to care for the patient. Hospitals charge $10 for a Tylenol because they have horribly bloated costs structures mandated by the rules and regulations of our government. 10% of collections for most physicians goes straight to a billing company or staff required to submit claims and deal with the constant barrage of paperwork from third parties. Removing these obstacles would allow the delivery of more affordable care.
You can make health care affordable. And you do that by cutting the cost of delivering that care. Some like to believe that if we insure everyone, that disease will be caught earlier and costs will go down. I don’t believe it for a minute. What you will have is a bloated government funded program that will continue to pay for everything in all the wrong places. Stop paying for unnecessary care the we get in a fee for service model. I believe in the bundled care approach. You get X dollars to pay for Mrs Smith Crohns, or diabetes, or CAD. Now it’s up to you, doc and hospital, to find a way to make it work. Right now hospitals only make money if people get admitted. And they only make a lot of money if you dishcharge them as quick as possible. It’s a completely irrational system. Hospitals and doctors should get paid to keep patients out of the hospital as efficiently as possible. And until that happens, there is no incentive from patient, doctor or hospital to keep a healthy patient. The third party costs are simply passed on through tax payers and higher insurance premiums. Until one day, nobody can afford the price tag, including us docs.
Until we stop paying for everything, not simply paying less for everything, and figure out a way to encourage the patient the doctor and the hospital to spend less, we will continue our way into national bankruptcy. Spending less will never happen under the current fee for service system.
Health care providers depend on third party money to stay alive.

Coverage does not equal health care

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