The Globe reports that GBIO is calling for a delay in the individual mandate. No surprise since no one can afford to pay the prices insurers can offer.
The Connector has to drive tougher health care bargains for the people of Massachusetts. The Globe congratulates the Connector for not being a price taker. Fair enough. But the state has to to stop paying for the substandard care that all too many of our providers deliver. The hot topic these days is paying them more to do the right thing!
The Legislature and the Governor have to listen much harder to their 6.3 million constituents than they do to the whining and grousing of the medical industrial complex. Since there is no alternative to seeking care from the health care industrial complex it’s time to start cracking down on waste.
This decades long failure is killing patients, bankrupting working families and making our economy uncompetitive in a time of globalization.
We could all use our share of that $16 billion in savings.
Barbara Waters Roop, PhD, JD
Committee for Health Care For Mass
617-413-1622
Yikes! I thought that it was in the 20s, but that might just be overhead added by the the payer – perhaps 40% is payer + payee admin costs.
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Do you have a reference for 40%?
In 2001 the Legislature spent $250,000 to hire LECG and Mercer Associates to provide options for streamlining and consolidating our health care system.
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Step one: a baseline study to find out where the money goes. Among other things they found that 39% of every health care dollar in Massachusetts goes to administration. That’s $24 billion last year alone.
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They looked at three options for getting to universal coverage. Priced them out. Presented the final report just before Christmas in 2002 and it was filed with the House Clerk on December 31, 2002.
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The taxpayers’ dollars that purchased that report were almost entirely wasted. If 100 people know the report ever existed I’d be surprised. It was certainly never used as the basis for any legislative initiatives. I suspect there is a copy of it in the State Library, however.
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I was a member of the commission that oversaw the production of the LECG Report and the enthusiasm with which the Legislature wasted the taxpayers money by ignoring its recommendations was one of the reasons I decided to go forward with the health care constitutional amendment. It was designed as a tool to make them address a problem that they had been ignoring for decades – the waste of the medical industrial complex.
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I’d be happy to email you a copy if you like or by Monday I can post it on our website and send you a link. Let me know your preference.
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Barbara Roop
Look no further than the money that is “supposedly ” spent on the disabled.
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I alone can give a dozen places where things, services and fees are so far out of the ball park, Fenway might as well be on the moon!
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Case in point my current situation. Well, anyone that needs wound care from home. (Not bad enough to be in hospital).
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In order for a doctor (MD) to order wound care dressings (bandages) and have the health insurance pay for them (Medicare,MassHealth,subsidy or a combination of), those dressings MUST be placed on wounds at least once a day by a NURSE visiting the home. (VNA or private). A doctor CAN NOT just order them for a patient and have the patient administer to themselves! (WHO DECIDED THAT RULE? the legislature?) Though if dressings need to be changed more than once a day, the patient or family member or PCA type must do it anyway. So isn’t the VN an overpaid redundancy and VNA can only come and be paid once a day (BTW -standard rate $100.00 p/h)
The other caveat – Patient must be UNABLE to leave home in order to qualify!
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So if you have independence as a person w/disability, such as myself, you must remain in the home and give over your life to the nurses, because you never know until the last moment when they will show up, and you MUST be there.
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SO JUST WHO IS IN CHARGE OF MY HEALTH AND WELL BEING? The doctor being paid $200.00 at the local clinic? or the Visiting Nurse making $100.00? Or the bean counters that decide don’t leave home and you’ll be taken care of! Well, that’s what we’ve been fighting TO WIPE OUT for DECADES! I could give the Governor 10’s of thousands $$$s wasted all by myself.
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And I shudder at the administrative overhead on this one , dealing with as much as 4 or 5 agencies, suppliers, and doctors! Ouch! Talk to me Governor Patrick, or at least send me Dr. Bigby!
I’d love a copy – thanks! Email is fine, web site would be even better so I can reference it.
http://www.mass.gov/healthcareaccess/ is the direct link to LECG Report
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FYI It’s been up on the state’s website ever since we requested that the state post it back in 2002. (“we” being the Alliance to Defend Health Care, http://www.DefendHealth.org, which had an advisory committee member participating in the LECG process too. We list the LECG Report on our “Resources” page). I’ve referenced the Report, quoted from it, and posted links to the LECG Report on BMG in the past; it contains very potent information and data, facts that were intentionally ignored by many of the powers that be. (Might one consider that to be a crime considering where it’s led us with state HC spending…to the Chapter 58 sham plan?!)
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blockquote>LECG, LLC, Mercer Government Human Services Consulting, and McDonell Consulting — health care consultants selected by the Massachusetts Legislature’s Advisory Committee on Consolidated Health Care — completed a feasibility report on consolidating and streamlining health care finance and delivery in the Commonwealth. The report provides a detailed review of the current health care finance and delivery system, and presents future models outlining various service delivery mechanisms and costs associated with expanding health care coverage.
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The process was aided by the collaborative efforts of health care professionals, providers, advocates and policymakers.
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The final report was submitted to the Legislature on December 30th, 2002, and includes an addendum featuring comments from Advisory Committee members.
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Members of the public shared their views with the consultants at forums and through surveys. These surveys are no longer being received, however you may view them on-line.
The 39% in that report refers NOT to administrative cost of each health care dollar. The 39% is derived by analyzing admin cost per health insurance dollar.
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Insurer:
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Profit: 3.%
Admin: 10%
Reserves for claims: 3%
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Provider:
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Hospital: 37%
Physician: 18%
Pharmacy; Behavioral health, other: 29%
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Of the provider’s 84%, 23 percentage points are administrative.
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The report adds the 16% for insurance and calls it ALL admin (since its not direct healthcare), then adds the 23 points from the provider to reach the 39% of EACH INSURANCE DOLLAR PREMIUM, not each healthcare dollar.
Taken in the context of the problems with health care and Mass. state government, the current health care “reform” regime at the state would almost be funny, if lives and health were not at stake. Must reading: today’s (1/27) Globe story on salaries enjoyed by the employees of the Connector. It appears that this Connector is no more cost-efficient than another now-notorious Connecter built under another bloated state entity. Let’s hope this Connector is not headed for the same disastrous results.
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At least this Connector has done us the service of illustrating the real causes of health care unaffordabilty – bloated adminstrative cost and plain greed. It is also truly disheartening to see advocates like John McDonough (once my own representative in the lege) trying to justify the public-trough feeding frenzy by dragging out the old excuse about being competitive with private industry. Does anyone else detect the circular logic here? Maybe it is this particular idea of public service that is part of the problem with getting real solutions to the health care crisis.