State Attorney General and candidate for the United States Senate wrote an Op-Ed piece in the Boston Globe. Herewith my humble attempt at criticism:
MASSACHUSETTS HAS some of the best doctors, nurses, and other caregivers in the world. Yet our national health care system costs too much and covers too few. Climbing costs put basic coverage beyond the reach of millions. This is economically unaffordable and a moral disgrace.
Complicated by the fact that nurses are being laid off; and there is a shortage of primary care physicians, with no plans to train more in the numbers needed.
Promoting affordable, quality health care has been one of my top priorities as attorney general, and it will be a top priority if I serve in the Senate. National efforts should draw on lessons that we have learned in Massachusetts.
Not based upon your record to date. While the sweetheart deal between Partners HealthCare and Blue Cross/Blue Shield that created the problem (and whose principals funded the political impetus for the Massachusetts plan) preceded your tenure as Attorney General of the Commonwealth, nothing was done to address the antitrust and restraint of trade issues that resulted.
The good news is that our reforms here show that it is possible to provide insurance to almost everyone. We have done so by building consensus with the business community, doctors and hospitals, insurers, and most of all, consumers.
By limiting access to medical care and ridiculously high premiums:
As an aside, those premiums were already the highest in the country.
Our state’s experience also raises warning signs. While costs for individuals, employers, and the state spiral upward, cost often does not correlate to quality. National reform must tackle the cost crisis up front. The most effective way to lower costs is through competition that a strong public option will provide.
No shit!!! The problem is that you and your office have done nothing to anti-competitive behavior by hospitals and the larger insurance companies.
My office has been involved in health care issues – and we’ve gotten results. We reached a historic $17 million settlement with an insurance company that misled consumers and unfairly denied coverage. We have achieved several record national settlements with drug companies for deceptive marketing and sales, recovering tens of millions for individuals and the state. And we have promoted greater transparency regarding quality, costs, and executive compensation.
While ignoring the more costly abuses noted above.
Here are the key elements on which I’ll focus as a senator:Strong public option. A strong public insurance plan would provide choice to individuals, expand access, and lower costs by promoting competition.
As long as the plan doesn’t include the abuses you and your office ignored in Massachusetts.
Preserving women’s rights. The Stupak/Pitts amendment included in the House health care bill represents an unnecessary, significant step back in women’s rights. It violates the very intent of health care reform by severely restricting access to reproductive health services, especially for low-income women. This amendment represents a false choice. We can and must pass meaningful health reform without compromising women’s access to reproductive care.*
Given a choice between no bill and a bill with Stupac, a majority of the House of Representatives would have gone for no health care bill at all.
Consumer protections. With a requirement that all people obtain insurance, federal and state government must enforce strong consumer protection measures. Insurers must not be allowed to deny coverage based on preexisting conditions or make false marketing promises. Being a woman should never be a preexisting condition. In some states, victims of domestic violence are denied coverage, which is reprehensible.
What about age? Premiums also vary by age; the law allows carriers to charge older people twice as much as they do a younger person for identical coverage.
Cost control. Immediate steps to curb costs include reducing preventable hospitalizations, readmissions, and hospital-acquired infections. We should also encourage standardized billing and claims processing to reduce administrative overhead. We need to focus on prevention and develop better models for primary care. We should close the Medicare Part D coverage gap, and help seniors afford the drugs they need.
See extended link above.
Payment reform. Federal reform should look aggressively at ways to reshape the incentives that providers face. Our current fee-for-service models reward hospitals for performing more procedures and tests, not for quality. In contrast, models such as global, bundled, or episodic payments encourage integrated care management and reward providers for better outcomes. That said, I will oppose federal funding cuts aimed at our state’s health care providers, which would jeopardize the progress we have made in covering the uninsured.
Again ignoring the fact that the Commonwealth has disinvested in primary care and primary care training for decades.
Protecting Social Security and Medicare. Health care reform will improve the quality of care in Medicare, reduce costs for seniors, and preserve Medicare for future generations. In the Senate, I will support reform that eliminates excessive government subsidies and results in lower out-of-pocket costs on prescription drugs.
The problem isn’t government subsidies per se, it’s the deregulation of pharmaceutical advertisements, coupled with the incestuous relationships between too many doctors and the pharmaceutical industry. A relationship not always acknowledged by the doctors.
Achieving real health reform will take a different kind of leadership than the old partisan fighting we’ve seen in Congress. Massachusetts showed a different kind of leadership in passing health reform three years ago. Senator Ted Kennedy himself was a different kind of leader, and I hope to follow in his footsteps, and work to bring real reform to health care.
No disrespect to the late Senator, but Kennedy advisors were a big reason we got in this mess to begin with. To quote the Columbia Journalism Review:
One health care provider who asked for anonymity told me: “Nobody wants to be quoted as going against Senator Kennedy. Nobody wants to be the one who says the emperor has no clothes. If you or your organization speaks out, you get cut off politically.”
Nuff said.
*Bold print in original