Monday, July 21, 2014

Barry Carol often offers thoughtful comments on this blog about health care issues in general and about Massachusetts in particular (even thought he lives out of state.)  He has chosen to comment to the Trial Court about the proposed settlement between the Attorney General and Partners Healthcare System.  He, like others, submitted comments in time for the July 21 deadline.  We all later learned that the AG had asked for a postponement, so that the case will not be heard until after the September gubernatorial primary in which she is a participant.

I've previously posted excerpts from Professor Alan Sager's comments, as well as my own.  I'm sure there are many more that will be submitted in objection to this deal.  If you have filed comments, please send them to me at goalplayleadership [at] gmail [dot] com, and I'll do my best to publish excerpts.  Thanks!

Here's Barry's filing:

I would like to offer a comment on the Attorney General – Partners Health System proposed agreement.

First, I think the proposed deal does not do enough to mitigate the significant price premium paid to the Partners Health System facilities compared to competing hospital systems for similar work and comparable outcomes. These price premiums are paid because of PHS’ dominant local and regional market power. The resulting higher healthcare costs and health insurance premiums make it more difficult for Massachusetts employers to raise wages as much as they might otherwise.

To mitigate this problem, I think there needs to be full price transparency from all providers and all payers. Confidentiality agreements that currently preclude disclosure of actual contract reimbursement rates need to be eliminated so both patients and referring primary care doctors can more easily determine the cost of care before services are rendered and compare prices charged by all providers in the market. We want as much care as possible to be delivered by the most cost-effective high quality providers and we need full price transparency to facilitate this.

I also think insurers should be able to contract with either Massachusetts General Hospital or Brigham & Women’s instead of having to either accept both hospitals in their network or neither.

To the extent that patients like to go to higher cost hospitals that offer better amenities even if they don’t affect medical outcomes, insurers need to be able to charge insured members enough more to go to those facilities to get their attention. Tiered insurance networks should be encouraged.

Healthcare in Massachusetts is the most expensive in the country, I believe. Since the 2006 reforms signed by then Governor Mitt Romney were largely a model for developing the Affordable Care Act, healthcare developments in Massachusetts are closely followed at the federal level. I think the proposed deal with PHS shortchanges the people of Massachusetts and is way too favorable for PHS.


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