It basically comes down to whether you should have the choice to get your health care in Massachusetts a la carte or Prix Fixe. And whether Deval Patrick, Theresa Murray and Blue Cross/Blue Shield (BC/BS) should run the bistro. This post is the second of three concerning this question, which is the whole reason people in Massachusetts even care about -- or should care about -- healthcare statistics.
In the first post I outlined how the whole subject comes up because of a coordinated propaganda campaign by the Massachusetts state government and the leading insurers to set up barriers between you and your chosen healthcare providers. This is done under the guise of promoting a so-called new way for you to receive and pay for health care, called integrated/accountable care organizations (ACOs) and a global payments system (GPS), respectively. The propaganda involves both outright deceit and a general attitude that government bureaucrats know best.
The statistics are regularly skewed and lied about by both the insurers and the state government but the bigger issue is that the whole concept that ACOs and GPS is linked is not logical. The goo-goos in favor of it such as Dr. Bigby just want to increase their control over peoples' lives. The insurers just want to hold down costs so they can keep the goo-goos off their backs.
Think about it. On one hand, coordinated care is indisputably a good idea. On the other hand, there is no logical reason why how it is paid for should matter. Why should you not be able insure yourself for integrated care but pay for it a la carte. Or why can't people coordinate and pay for their own basic health care if they so choose but pay one price to insure themselves against catastrophe? I notice that Mr. Leyy of "no longer running a hospital" fame has written recently about the same subject.
I am saying this as someone that has had my care integrated for me for 25-30 years by an HMO (which is yesterday's term for an ACO) under a capitated-fee payment system (which is yestereday's term for GPS). Does that mean that when the ophthamologist that works with my primary care integrator at the same clinic looks at my cataract and also sees that I have had retina surgery, and recommends I hold off on the cataract surgery I need, that he is less concerned about the chances my cataract operation would not be successful than he is about maximizing the profits of their integrated practice?
I don't think so. In fact, I would have never thought of it at all if it hadn't been for Deval Patrick, Theresa Murray and BC/BS.
-- Dennis Byron