Hope you checked out the Globe's fine work — an old story, but never too late to tell — on the historic “gentleman's agreement” to essentially create a health care provider/insurer cartel, between Partners and Blue Cross Blue Shield.
And so, in May 2000, the two simply shook hands on this: [BCBS's CEO] Van Faasen would give Partners doctors and hospitals the biggest insurance payment increase since Massachusetts General and Brigham and Women's hospitals agreed to join forces in 1993.
In return, [Partners'] Thier would protect Blue Cross from Van Faasen's biggest fear: that Partners would allow other insurers to pay less. Those who helped broker the deal say Thier promised he would push for the same or bigger payment increases for everything from X-rays to brain surgery from Van Faasen's competition, ensuring that all major insurers would face tens of millions in cost increases. Blue Cross called it a “market covenant.”
And that, my friends, is why we have the highest health care costs of any state in the country — at least in part. We always hear it's because we have the best docs, the best facilities, and it's Harvard's teaching hospitals, yadda yadda. We should be grateful to pay so much. It's actually because the market players decided to, well, cheat.
And Marcia Angell reminds us of the kind of delightful activities that go on in Partners facilities!
Take the case of Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and chief of pediatric psychopharmacology at Harvard's Massachusetts General Hospital. Thanks largely to him, children as young as two years old are now being diagnosed with bipolar disorder and treated with a cocktail of powerful drugs, many of which were not approved by the Food and Drug Administration (FDA) for that purpose and none of which were approved for children below ten years of age.
… In June, Senator Grassley revealed that drug companies, including those that make drugs he advocates for childhood bipolar disorder, had paid Biederman $1.6 million in consulting and speaking fees between 2000 and 2007. Two of his colleagues received similar amounts.
Look, let's just be as blunt as the subject deserves: Apparently our vaunted hospitals, our jewels of the region and temples of healing, are now so entwined with the money changers that their reputations can now only be considered hopelessly sullied.
And that may as well apply to the entire practice of medicine in the Commonwealth. It is all suspect. The medical culture itself is now suspect: The docs whose offices look like a NASCAR speedway; the drugs they prescribe; the rotted conflicts of interest that inform deform the research that rationalizes their prescription. There's just so much bad faith in the industry that Angell, a former New England Journal of Medicine editor, states baldly:
It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.
Wow.
Look, the thing I want to get across is very simple: Health care costs, particularly in MA, are not just high because of some vague, unknowable “market forces”; it isn't just that the Health Care Invisible Hand mysteriously keeps us all under its thumb, and gosh golly, after all There's Nothing That Can Be Done.
No, it's simpler than that. We're actively, intentionally, unethically and possibly illegally getting screwed.
Partners colluding with BCBS.
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p>Physicians and hospitals colluding with drug companies.
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p>Does anyone care for and about the patients!?!
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p>Doctors and hospitals must rededicate themselves to honest patient care!
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p>The series of Globe articles was an indictment of Partners, some ‘esteemed’ hospitals, ‘excellent’ physicians, and much more.
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p>Somebody should be minding the store!
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At some point in the Partners story, I just had to stop reading, it was that bad.
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p>What a freaking catastrophe in medicine that company is. People should go to jail.
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p>More reason than ever for single payer – at least we’d have the ability to make sure these collusion don’t happen and have the political power to make sure that people get the best care at a reasonable price that’s sustainable for this country.
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p>Meanwhile, it’s stuff like this that’s forcing (or is gleefully allowing a better phrase?) insurance to become so expensive… which, in turn, is bankrupting this country and a Town Near You. How many schools had to close because Blue Cross made sure other companies had to pay far more to get the same services?
of consumers and their doctors; that is what Blue Cross did. Giving consumers what they want comes with a pricetag attached.
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p>Meanwhile, Partners has consistently put out a quality product that is in high demand; for this they should apologize? Quality comes with a pricetag, as well.
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p>We, as health care consumers, demand the best treatment, the best treatments, and the best drugs. If we expect to get that without paying for it, we are only deluding ourselves.
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p>Even if the Globe’s completely undocumented story of the “handshake” were accurate (please stop promoting “stories” you read in the paper as facts), we consumers are as much responsible as these two companies that were trying to work in a system where consumers demand more and more service for less money.
Hmmmmm….that’s an interesting one.
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p>So yes, everyone, when you read a story in a newspaper, don’t think of it as something supported by facts if you have issue with the article. Please, everyone stop.
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p>gonzoD, do you have any supporting materials concerning “Giving consumers what they want”. I’m not sure I’m understanding you. (But please no newspaper articles, those things aren’t reliable).
The Globe story was not the first time I’d heard about “the handshake”. And the arm-twisting of Tufts by Partners was also common knowledge, widely reported at the time.
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p>Now, you have a point as to the public demanding “high quality” in health care. However, the demand comes from the recommendations and referrals of their own providers — it’s an inside game. Rather than merely asserting “quality”, providers should agree to be utterly transparent, with a wide dissemination of information on matters of quality of care. That has not been the case: Partners providers have consistently resisted dissemination of quality information on the flimsy pretext that the public might “misunderstand” that information.
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p>In case I didn’t make it clear, the Globe article is really excellent reporting. If anyone is smug about the demise of the professional media … well, they should have their heads examined. We stand to lose one of the pillars of a free society, if so.
taken over by a consortium of local corporate leaders, and the Herald being liquidated? (This was alluded to in a recent Boston Phoenix story, I think)
I agree- the Globe is still doing a lot of great work, and seems to generally be an independent watchdog of both government and business. Some, such as Ryan, might disagree with this assessment, at least vis a vis the casino issue, but in most respects they seem objective and appropriately skeptical of our various local power brokers. Even the Herald has its moments.
Don’t believe everything you read in the newspaper. Still good advice.
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p>1. The Globe article not only repeats the handshke story that Charley on the MTA “heard” about before — no documentation, no eyewitness accounts, no “on the record” sources, but then tries to elevate this story to an anti-trust violation. A little critical analysis please. Stringing together conjecture and rumour may make for a good story, but is not a substitute for facts.
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p>2. When consumer groups were leading the charge for HMO reform, the system was no different than it is today – “the demand comes from the recommendations and referrals of their own providers — it’s an inside game.” But, consumers thought that they would be better served by allowing the providers to control that “inside game” without interference from insurers. The Blue Cross deal with Partners was consumated as the insurers were taking a public relations beating for putting themselves between patients and doctors. This was a step to give consumers better access to the quality care they were demanding.
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p>3. If this story had been written several years ago, Partners would have been a “hero” for standing up to the big bad insurers who were refusing to pay for high quality care.
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p>4. As for facts about consumer demand, we need go no further than the same Globe story when they actually report the facts about demand for Partner’s services. Yes, newspapers can report facts, and when they do, their stories can have credibility. When they don’t, they deservedly should be used as birdcage liners.
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p>5. I guess my biggest complaint is that promoting these kinds of stories as quality journalism without some stricter analysis of journalistic standards and historical context does us all a disservice.
Partners doesn’t argue that the facts of the Globe story are wrong, they intentionally note that they believe that the story “incorrectly asserts” the results of their activities. I wonder how many lawyers it took to write that.
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p>So for those who rate posts save the little 3’s and 4’s and provide something substantial. You might even enlighten people with some revelations. Try it sometime.
The Globe is not reporting the handshake as “conjecture and rumor”. They are reporting it as fact. And like it or not, there are journalistic standards behind that — confirmation from more than one reliable source, etc. Now, people don’t always get that right — true.
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p>But your assertion that the Globe’s claim is “conjecture and rumor” is, in fact, conjecture.
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p>Furthermore, it’s not even the most important part of the story. It was plainly obvious at the time — not hidden by anyone — that BCBS was going to pay Partners what they wanted, and Tufts was not going to play ball.
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p>You offer so many false choices and strawmen in this comment it’s hard to keep track. But I will simply say that providers dictating their prices is not helpful, either; certainly not with the collusion or assistance of an insurer who wished to grab bigger market share.
If you don’t get the dead-tree edition of the Globe, you might have missed the full-page ad that Partners took out in today’s Metro section, presumably in response to the article Charley is discussing. Here’s the text:
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Is it December 2000 – December 2008? That is months before the May 2000 agreement.
Partners posted their response. They note a Globe article in 2007, so I imagine the numbers are for the entire year (2000).
maybe Mongan might be better served if he has some charts that broke out Partners from other Boston hospitals and the national average instead. He’s hiding behind other hospitals in the city instead of what the article is pointing out.
BCBS, Partners, etc. were feathering their own beds.
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p>Docs, hospitals, other health care professionals need to remember that patient care should come first.
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p>Not ingratiating yourselves with drug companies, insurers, drug companies, and other suppliers!
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Hats off to the Boston Globe Spotlight Team and the series of articles on the negative impact Partner’s healthCare has and is having on health care delivery in Massachusetts. The Attorney general’s office should investigate what’s been going on between partner’s and the Insurers…gives new meaning to “not-for-profit”…but what did they expect when Advertising/PR gurus are put in charge of a healthcare giant?…they are not concerned about health care delivery in the suburbs, their goals are for the bottom line….when we get tired of paying $30 for a bandaid and $20 for an aspirin maybe something will be done to stop them.