The vaunted Massachusetts “universal coverage” plan has let so many patients fall through the cracks that a key Boston health care system is going broke providing care to the uninsured. The Boston Globe reports that Cambridge Health Alliance is facing a “catastrophic” loss:
The alliance … says it is being hit hard by the state’s new healthcare reform law, which has left it responsible for providing free care for those without insurance while reducing the hospitals’ compensation for such services.
This system has historically treated a lot of uninsured patients and been compensated by the state for doing so. But when “reform” was enacted, funding for such care was slashed. No one panicked, though, because the plan was going to fix the uninsured problem. Oops!
Despite the state’s efforts to enroll all low-income residents in free or subsidized insurance programs, many still do not have coverage.
The result will be a $25 million loss for the Cambridge Health Alliance and a probable reduction in force affecting 300 jobs. And, the fantasies of “progressive” health care wonks notwithstanding, no hospital system can survive for long in the face of such losses.
How could this happen? The Massachusetts health care initiative was all about universal coverage. It even came with the kind of health insurance mandate that politicians and pundits keep telling us is the key to making reform work. So, what gives?
What gives is reality. The whole universal coverage movement is based on the myth that the uninsured problem is the primary challenge facing American health care and that government can fix it with some silver bullet (like mandates).
As I have said before, the uninsured problem is a symptom. Any reform effort that focuses on that issue without addressing the underlying disease (government interference in health care)  is doomed to failure. How many hospitals and doctors will be driven out of business before our “leaders” face this reality?
Comments 14
Interesting - no really. For if you read the whole story, whichIi guess you rely on people not doing, we find that this is a publically owned organisation with a big proportion of mental health and addiction patients.
We also find:
‘…Cambridge Health Alliance posted a surplus of $1.6 million in fiscal 2007 and is receiving “substantially” more public funding this year than last year.’
‘The Massachusetts Nurses Association … said the alliance’s financial problems are the result of poor management. “The introduction of the new health reform law was years in coming, and the changes in reimbursement rates and other factors have been well known and should have been anticipated,” the union said in a newsletter. “Our management built a budget that anticipated unachievable growth and set up this hospital for the failed situation it now faces.”‘
Posted 18 Mar 2008 at 8:54 am ¶$1.6 million isn’t enough to buy paper clips for a system that size.
And “more public funding” is no help if it is accompanied by so many new uninsured patients that the hospital goes further in the hole.
Posted 18 Mar 2008 at 9:19 am ¶‘And “more public fundingâ€? is no help if it is accompanied by so many new uninsured patients that the hospital goes further in the hole.’
I agree - and as this, interesting as I said, is a public organisation then it needs to be properly funded by public taxation. But it appears there may also be an element of poor management too.
Posted 18 Mar 2008 at 9:34 am ¶You’ve missed the point (again), Marc. Under “universal health care” there aren’t supposed to be any uninsured patients.
Posted 18 Mar 2008 at 9:42 am ¶The unanswered question is: “Who the heck are these uninsured?”
I suspect that they are illegal aliens, students, out of state transients coming for “free care,” and people who choose NOT to be insured.
Whoever these people are, there are a huge number of them and they use a lot of health care.
The OTHER issue is that obviously hospital reimbursements have been set penuriously low.
And so the socialization of Massachusetts begins, with a vast constriction in services available. Welcome to (medical) hell.
Posted 18 Mar 2008 at 10:53 am ¶I would have thought you free market junkies would be applauding the Mass reform - it is leading on consumer led choice of low cost plans. People in Mass now have a wide choice not available before. (And as a mandate - not a national/state insurance - system no one could expect it to offer universal coverage from day one.) So it looks to me like government intervention for consumer choice with a backstop for the poor. As for the uninsured, the figure in Mass has dropped hugely - by about 75% so far.
And here a question for Catron - would you have preferred that your government hadn’t intervened in Bear Stearns and interest rates? Isn’t this meddling with the free market?
Posted 18 Mar 2008 at 4:37 pm ¶“Would you have preferred that your government hadn’t intervened in Bear Stearns and interest rates?”
Yes.
“I would have thought you free market junkies would be applauding the Mass reform.”
Even you don’t believe this silly statement.
Posted 18 Mar 2008 at 8:25 pm ¶Goodness me - do you even agree with accounting rules for public companies?
As for Mass, surely the availability of more lower cost plans is at least on the way to the consumer choice you espouse.
Posted 19 Mar 2008 at 3:56 am ¶“People in Mass now have a wide choice not available before.”
And their liberty is trampled as a choice they DID have before is removed - the choice NOT to have a plan.
Once people are FORCED to have a plan, then they can be forced to do anything to abide by the rules of the plan, e.g. quit smoking or you will not have a plan. No plan - pay the penalty. Ahhh - the land of the free…
Posted 19 Mar 2008 at 7:12 am ¶Massachusetts is going to see a vast reduction in hospital services available every year, for many years to come. Many health care workers are going to lose their jobs. All that “universal” coverage will be meaningless as there will be no treatment will be there when it is needed.
I call this the “Ontario-ization” of Massachusetts. “Universal coverage” with much of the population with no PCPs. Doctor fees set less than Medicaid. No beds at the greatly shrunk hospitals. Third rate care even if you get admitted by greatly shrunk staff. Old out-of-date equipment. No options if you are desparately sick. No options. No choice. Passive aggressive bureaucratized second rate doctors who don’t give a darn.
This is the antithesis of a free market solution. Or perhaps the usual Orwellian definition of free market.
Posted 19 Mar 2008 at 8:12 am ¶‘And their liberty is trampled as a choice they DID have before is removed - the choice NOT to have a plan.’
That’s a grown up society for you.
‘Massachusetts is going to see a vast reduction in hospital services available every year, for many years to come.’
No, it’s not.
Posted 19 Mar 2008 at 4:36 pm ¶Is it too much to actually read the above post or the Boston Globe original article? To say “No its not” to the developing severe medical services contriction in Massachusetts is simply an absolute denial of reality.
From the very beginning of the Globe report:
“Cambridge Health Alliance, a key part of the Boston area’s healthcare network, is facing a potentially “catastrophic” loss this year and is looking to eliminate up to 300 jobs, or about 9 percent of its workforce, in an effort to stabilize finances.
The alliance, which includes Cambridge Hospital, Somerville Hospital, and Whidden Hospital in Everett, says it is being hit hard by the state’s new healthcare reform law, which has left it responsible for providing free care for those without insurance while reducing the hospitals’ compensation for such services.”
Posted 19 Mar 2008 at 6:38 pm ¶No worries, just send everybody to India! Med Care Cheep!
See:
http://www.businessweek.com/magazine/content/08_12/b4076036777780.htm
Posted 20 Mar 2008 at 8:54 am ¶‘No worries, just send everybody to India! Med Care Cheep!’
I’m surprised Catron allowed this - it exposes just how overpriced US medicine is.
‘Is it too much to actually read the above post or the Boston Globe original article?’
I read it all - as I said above, others think that the Alliance is poorly managed. Have a look at the link below, which is about a similar group that anticipated change. Also consider that Boston has some of the highest priced medicine in the world and wonder whether docs should perhaps earn less. And the head of the Cambridge Alliance makes about $630,000 a year.
http://www.wickedlocal.com/cambridge/news/x1775733049
‘But Boston Medical Center, which received much of the same funding for uninsured patients as the Cambridge Health Alliance before last year’s health insurance reform, isn’t reporting similar financial problems.’
Posted 20 Mar 2008 at 11:05 am ¶Post a Comment