Massachusetts Health Stats

Massachusetts' Acorn Union Organizing to Increase Massachusetts Healthcare Spending

Just what we need in Massachusetts: higher taxpayer funded healthcare spending.

I admit to being very confused with what the Massachusetts Acorn union is asking for in its May 2013 PR and advertising campaign.  The press release from the SEIU local rambles incoherently for about eight paragraphs but concludes:

"Under a budget amendment (#598) proposed by 1199SEIU and supported by a growing number of state senators, hospitals that see a higher percentage of Medicaid and Medicare patients would be slated to receive a larger portion of new Medicaid funds."

So I guess -- in the Acorn union's view as well as in the view of the half dozen political hacks in the Massachusetts Senate supporting the union  -- there is (1) some link between Medicaid and Medicare spending at hospitals and (2) there is something called "new Medicaid funds" for the political hacks to divvy up among favored constituents.

What the amendment proposes exactly is to add the following words onto some existing law:

"provided further, that notwithstanding any general law, rule, regulation, or special act to the contrary, the Office of Medicaid shall expend from this item and/or from item 4000-0500 to provide an additional 10% of its Standard Payment Amount per Discharge (SPAD) or of reimbursement provided under any subsequent inpatient payment methodologies to any acute care hospital that has greater than 63% of its gross patient service revenue from governmental payers and free care as determined by EOHHS; and provided further, that the Office of Medicaid shall also expend from this item and/or from item 4000-0500 to provide an additional 10% of its Standard Payment Amount per Discharge (SPAD) or of reimbursement provided under any subsequent inpatient payment methodologies to any acute care hospital that that has greater than 63% of its gross patient service revenue from governmental payers and free care as determined by EOHHS and that also has greater than 10% of its Medicaid inpatient discharges for behavioral services; provided further, that such additional payments shall be paid directly to each such qualifying acute care hospital”

So increased Massachusetts taxpayer-funded Medicaid spending will be linked to Medicare admissions (or discharges to use the specific wording of the amendment; at least, if you die in the hospital because one of these Acorn union workers screws up, they won't count you). You seniors who have paid your own way with massive and increasing Medicare and federal income taxes over your working lifetime wil fund this decrepit union depending on what hospital you decide to go to. The insulting attitude toward seniors by Massachusetts' politicians -- constantly mixing up Medicaid with Medicare -- continues.

Oh by the way, despite the Acorn union's PR and advertising wording, there are apparently no "new Medicaid funds."

Good News/Bad News: ObamaCare Exchanges Worse Than RomneyCare Exchange

In a surprising admission of bad news (behind the Boston Globe paywall on May 20), the Boston Globe reports that Obamacare's federally run state exchanges will be even worse than the RomneyCare exchange that has existed here in Massachusetts for the last few years.  Hopefully there is some good news in that comparison for President Obama -- he needs some this week -- and the Patient Protection and Affordable Care Act (PPACA). If the comparision holds up, Obama will be happy to learn that very few people in Massachusetts actually use the RomneyCare exchange to buy health care insurance.  

As the first illustration above shows, only around 40,000 people -- much less than 1% of Massachusetts' 6,500,000 residents -- are covered by insurance bought through the political-hack-ridden Massachusetts Connector Authority, which basically duplicates Massachusetts political-hack-ridden Medicaid organization. The 30 or so states that decided not to implement their own hack-ridden PPACA-related authority are saving themselves tens of millions of dollars. 

The membership in insurance bought on the RomneyCare exchange has plateaued at the 40,000 number more or less since after the initial marketing. Most of the membership involves individually purchased insurance.  There have been multiple failed attempts to involve small businesses. Discretion being the better part of valor, Obama has decided to forgo an attempt to involve small businesses in the federally run exchanges in other states.

As the second illustration¹ shows, most of those insured by policies bought on the RomneyCare exchange are choosing the highest deductible policies possible. Their idea is to simply do the minimum mandated by RomneyCare to avoid the RomneyCare tax.

¹ Subscriber numbers differ from membership numbers because some subscribers insure spouses or other family members on their policies. YAP refers to a high deductible plan for young adults that apparently do not want to be insured on their parents' policies any more than they want to live in their parents' basements.

Massachusetts' Far-Left NPR Site Keeps Pitching Strained Tie Between Medicare and Sequestration

Boston is lucky enough to have two taxpayer-funded far-left-wing NPR outlets. One caters to the stodgy old descendants-of-the-Puritans, Symphony-Hall crowd and the other is the Boston University radio station and web site.

Kind of surprising to me given late BU-president John Silber's reputation, the BU college radio station -- WBUR -- is the further left of the two. Therefore, not surprising at all, this May 17 article -- entitled "Sequester Hits Mass. Medical Industry On Multiple Fronts" -- is just another in a long line of WBUR's deceitful stories about Medicare. But this WBUR story takes some typical Journolister techniques to a new low level of deceit and cynicism. 

The WBUR journalist can't actually find a Medicare person deprived of cancer treatment because of sequestration? So he or she just finds some poor unfortunate non-Medicare non-senior with brain cancer -- who admits to having very good insurance -- and gets that poor unfortunate person to say it would be terrible if a Medicare subscriber couldn't get treatment. 

Well, yeah it would be. But it is not happening. What the WBUR Journolister has done is intentionally or unintentionally get involved in a 10-year-old battle between a bunch of rich doctors (the rather scary sounding Community Oncology Alliance) and Congress and the Medicare bureaucracy. I have no dog in that hunt but is clear if you do any research that the decade-long battle has nothing to do with sequestration.

The WBUR article actually refers to a study by an apparently overlapping group called the American Society of Clinical Oncology -- ASCO. Both ASCO and the Community Oncology Alliance (COA) did studies at the same time (maybe it's even the same study?) and breathlessly found that some small percentage of Medicare beneficiaries are not getting care from some small percentage of clinics

"unless they have supplemental (Medicare) insurance."

What none of the rich doctors or WBUR tells you is that 96% or more of Medicare beneficiaries have supplemental coverage. 

So basically no one on Medicare is going without because of sequestration. Some may be turned away for other reasons having nothing to do with sequestration -- such as the rich doctors built clinics on their own that demand in their geography cannot support. (I have reviewed the COA research in detail but the ASCO research is not available.)

The malarkey in the WBUR story about research in Massachusetts is equally misleading. For example, supposedly the government is now funding only 7% of research requests when 40 years ago it funded 40%. Well beside the obvious fact that that can't possibly have anything to do with sequestration given the timeframe, does that reduced percentage possibly have anything to do with the fact that researchers are making five times as many applications than they did 40 years ago?

RomneyCare Drives Up Healthcare Usage Claims Boston University Professor

A story has been floating around third- and fourth-string web sites during the week of May 10 that claims -- depending on who wrote the headline -- that healthcare and/or hospital costs didn't go up and/or went down in Massachusetts under RomneyCare.  Here is an example from a web site called ScienceDaily.  

I was waiting for some name-brand web site to pick up the story because I could not find the source of the "news" on the third- and fourth-string web sites, I could not find a link to allow me to read the research itself, and I could not even find a web site that even described the research's findings other than to garble the headline as noted above.

None of this information is yet appearing in the real world but at least ScienceDaily did describe the findings.  I think I now know why no namebrand web site is repeating the thought that healthcare and/or hospital costs didn't go up and/or went down under RomneyCare. Despite the fact that ScienceDaily repeated the headline, the article itself says that some BU professor said:

• "The total days of inpatient care increased by 0.94 percent in Massachusetts, compared to 0.80 percent in the comparison states.
• "Hospital charges per quarter increased by 1.1 percent more in Massachusetts than in the comparison states.
• "Hospital use increased among previously high uninsured groups -- the number of hospitalizations increased by 2.8 percent among blacks and by 4.5 percent among Hispanics."

So apparently -- despite headlines and lead sentences that say that healthcare and/or hospital costs didn't go up and/or went down under RomneyCare, they in fact did go up.  That explains why the name-brand press isn't running with the story.

In reality, no one would seem to care.  The effect of RomneyCare on hospital admissions were never an issue.  A dramatic decrease in ER usage and cost control is what Governor Romney promised.  RomneyCare failed totally in both as well as in all the other promises noted in the Novemeber 2004 Romney op-ed to which I linked. 

RomneyCare did not cure baldness nor cause the sun to rise in the west either.

 

 

Neither Left Nor Right Cares Whether Employer Sponsored Insurance Is Up or Down Under RomneyCare

As of May 14, many publications and news services are picking up on a highly promoted Price Waterhouse Cooper (PWC) study called "Masschusetts Essentials," which claims -- among other things -- that employer sponsored insurance (ESI) is/was up in Massachusetts post the passage of RomneyCare in 2006.

I commented on this yesterday and noted that the state of Massachusetts disagrees. Just for the record, the state's numbers are illustrated above and are quite different.

The difference seems to be totally methodological. PWC uses Census Bureau numbers that are based on a much larger sample but that are not mututally exclusive. That is a person can have no insurance, ESI, Medicare and what Massachusetts calls "public or other" insurance all in the same year. Many people have Medicare and ESI or Medicare and Medicaid at the same time. The state numbers are a snapshot in time but based on a much smaller sample using a biased methodology.

All of this matters a lot if you are a big proponent or opponent of the Patient Protection and Affordable Care Act, better know as Obamacare.  For the rest of us, what's the big deal: both conservatives and liberals want to get rid of ESI anyways.

Did Employer Sponsored Insurance Rebound in Massachusetts in 2011?

One of the major questions in understanding likely healthcare-insurance marketplace dynamics nationwide under the Patient Protection and Affordable Care Act (PPACA), better known as Obamacare, is:

"What happened in Massachusetts under RomneyCare?" 

Here -- from the Census bureau -- is a 2001-to-2011 snapshot of total Massachusetts population, those on employer sponsored insurance (ESI), those on government insurance and those uninsured.  (I left out the even-numbered years to keep the chart readable. these numbers gyrate wildly so this trend line is not consistent with the 10 years ending in 2010).

Oregon Medicaid Study Fires Up Both Far Left and Far Right over Nothing

The Oregon Medicaid Study is the topic throughout healthcare-statistics Twitterland. My reading of the posts about this final version of the study tell me my opinion of the study itself (should I again beg the lead author to send me a copy of the report that I otherwise would have to pay for) will be the same as my opinion when the first stage version results were released two years ago:

"I think what the (Oregon Medicaid study report authors) found is that a bunch of intelligent Oregonians who wanted free medical care and proactively sought to win a lottery in order to get it, then took advantage of the free medical care. Did the (authors) really need to spend $30 million – much of it Federal money from the Stimulus bill and the Patient Protection and Affordable Care Act (PPACA) -- to find this out? I'd have rather seen the money spent on public health outreach. 

"But thanks, Oregon.  It looks like a bunch of guys here in Massachusetts (the authors were from Harvard and MIT) got the $30 million while you got a few percent of your (already sick) low income population to go to the doctors..."

These results mirror dozens of studies of RomneyCare results in Massachusetts but are considered better research because the Oregon groups were sort of partially -- depending on your political view -- randomized and sort of, maybe -- depending on your political point of view -- large enough to be statistically significant.  

Tufts Health Plan Executive Runs Massachusetts Medicaid Art Gallery, Medicaid Marching Band

What a tour de force of political correctness Massachusetts’ Medicaid insurer, Network Health, must be. Its Human Resources vice president just spoke – probably on the Massachusetts’ taxpayer’s dime -- about cultural diversity at a swank hotel on the Potomac in Maryland south of DC.

The head of the group promoting the apparently taxpayer-funded boondoggle claimed:

“The expansion of Medicaid in many states under the (Patiient Protection and) Affordable Care Act will mean that health plans will not only need to serve a more diverse population but also have workforces in place that reflect such diversity.”

Health Affairs Blog Hits Trifecta of Left-Wing Absurdity on RomneyCare

On April 17, the far-left-wing faux-academic Health Affairs blog posted an analysis of recent research-for-hire concerning Massachusetts' healthcare insurance exchange. Apparently it was intended as part of the calvacade of celebratory posts and articles about RomneyCare in honor of RomneyCare's 7th birthday. But no one told Health Affairs that the celebration was called off this year because the Massachusetts legislature effectively repealed RomneyCare in 2012. 

Despicable Huffington Post Article Lies about RomneyCare

This Huffington Post article about the Boston Marathon terrorist attack and Massachusetts' so-called healthcare reform is both ignorant and insulting. It is ignorant about RomneyCare and Romneycare's relation to Obamacare. It is also a further victimization of those injured and killed by the Boston terrorists because the article attempts to make some political points using a tragedy.

(Clearly, Huffington Post -- in its left wing zeal -- follows the Obama rule of not letting a tragedy goes to waste when it can be used in politics. I mean Obama lied about his mother's terminal illness for chrissake so nothing his acolytes in the press do will ever be that despicable.)

The premise of this Huffington Post article is

• If a terrorist-bombing victim -- from Massachusetts or otherwise -- doesn't have insurance, the RomneyCare "Health Safety Net" will cover him or her
• Obamacare is great because it is based on RomneyCare

That is totally ignorant for two reasons.