A Global Budget with No Teeth
Massachusetts has become the first state to set a firm cap on its health care spending. But apparently it has no way of enforcing it. This is Sarah Kliff:
The law does create a new state board that will collect health spending data and set new targets for Massachusetts’ hospitals. It can require those hospitals that don’t hit those targets to come up with a plan to lower their costs. But it cannot, as WBUR’s Martha Bebinger reports, penalize hospitals that fail to meet the targets.
“Our biggest concern is whether there are enough teeth to keep overall costs under control,” the Rev. Burns Stanfield, president of the Greater Boston Interfaith Organization, tells her.
That seems like a massive waste of everyone’s time if they can’ tdo anything but sit on the sideline.
@Alex, I agree.
Good heavens. How many times does this strategy have to be played before people understand its long range consequences?
This is the beginning. Once one accepts that government should control hospital spending, government becomes the arbiter of all that is good. Having successive legislatures pass penalties is easy.
Massachusetts has already shown how this will operate with its penalties/taxes/fees for not having insurance. They started out minimal, and are now $1,260 a year for people 27 and older with incomes above about $33,500 a year for a single person.
This doesn’t bode well for Massachusetts’ budget. Hopefully, other states learn from the ‘experiment’.
If Obamacare is repealed, I think some states will try something close to what Massachusetts has done.
Oh price controls. They don’t even sound good in theory . . .
Linda Gorman
That train left the station long ago here in Massachusetts
Even assuming that Massachusetts politicians had wisdom and courage — quite a stretch, I admit — there would be a big structural problem in trying to enforce cost controls on hospitals.
Namely, that it would cost jobs.
I do not have the data at my fingertips, but in the last 30 years the number of people employed in hospitals and their average wage has grown substantially
(and far faster than most other industries). This all occurred while Americans spend less days than ever in hospitals.
This is what makes hospitals a sink hole for money, and a major reason for rising insurance premiums.
But some of those jobs and almost all hospital salaries would have to be cut if we had serious global budgets.
American governments are loath to do anything that costs jobs. (ironically the Canadian government has laid off medical workers rather frequently.)
Almost 80% of hospital costs are fixed, and salaries are the major part of that 80%. In some other countries, one’s relatives are expected to make the beds and bring food, and there are often four patients to a room. Nurses do not make the equivalent of $125,000 in those nations, nor do hospital CEO’s make $1 million nor do hospitalist-doctors make $500,000.
That is what global budgets would mean, and both American political parties would be swamped by protests if we started imposing them.
Bob, which is why it took two legislative years for the Massachusetts legislature to pass it after filing (four years from the first recommendations) and has no teeth
I delight in, lead to I discovered just what I was having a look for. You’ve ended my four day long hunt! God Bless you man. Have a nice day. Bye