Each Patient Counts: Massachusetts Medical Society Weblog

A Really Bad Idea

In a co-authored commentary in today's Boston Herald, MMS President Mario Motta, M.D. and Massachusetts Hospital Association Chair and Tufts Medical Center CEO Ellen Zane call attention to a proposal being considered by Congress that would dramatically alter Medicare payments and thus have a huge impact on health care in Massachusetts and 13 other states. The proposal, if enacted, would force Medicare to equalize payments for the same services without regard for regional differences, such as the cost of living. Each state would be reimbursed the same amount for each patient and procedure, even though costs vary widely from state to state. 

The potential effects on Massachusetts? A reduction of more than $1.1 billion in Medicare funding every year along with thousands of job losses at health care facilities across the state. Primary care physicians and nursing homes would also be affected. "The proposal does nothing to control health care costs or improve coordination of care," they write. "This provision just shifts the same money around the system, resulting in a less rational allocation of resources....[and] residents in Massachusetts and 13 other states will suffer significant losses in jobs and, thus, in access and quality of care."

Read A formula to hurt Mass. hospitals

Update of September 8: The New York Times reports on the issue.
Read: Data Fuel Regional Fight on Medicare Spending

A Snapshot of U.S. Physicians

"Physicians are the linchpins of the U.S. health care system because their clinical decisions affect how up to 90 percent of every health care dollar is spent." So begins Data Bulletin No. 35, the 2008 Health Tracking Study Physician Survey, from The Center for Studying Health System Change, dated September 2009. The survey covers a number of topics on physicians and their practices, including demographics, practice organization, career satisfaction, compensation, and distribution of physicians around the nation. "If policy makers are to guide the health care system toward greater value," HSC writes, "they need timely, credible information about physicians and their practice of medicine."   

MMS, AARP Join to Urge Health Care Reform

In a unique collaboration, the Massachusetts Medical Society and AARP Massachusetts have come together to urge Congress to pass meaningful health care reform upon their return to Washington. In a commentary appearing in today's Telegram & Gazette in Worcester, MMS President Mario Motta, M.D. and AARP Massachusetts State Director Deborah Banda call on Congress "to guarantee that patients have a choice of affordable insurance options and to preserve the patient's choice of doctors - doctors who will work with patients to reach the best possible health care decisions. We must keep our eye on the goal - dependable, affordable health insurance for all Americans....With rising costs and shrinking coverage, the need for fair measures to improve health care in America has never been so urgent." The opinion piece has been distributed to some 12 daily newspapers across the Commonwealth. 

Read Health Care Reforms a Must  

A Call for Individual Health Reform

Physicially and financially, obesity is hurting us severely, writes MMS Vice President Lynda Young, M.D. in a commentary published August 7 in the Worcester Telegram & Gazette. Dr. Young cites no less than five national studies issued in July showing how heavy Americans have become (two-thirds are now either obese or overweight) and how costly obesity is to our health care system (9.1% of all medical spending, for a grand estimate of $147 billion, double the amount a decade ago). 

Dr. Young, who co--hosted a special edition of the MMS's monthly television program Physician Focus, Obesity in Massachusetts, which was collaborativly produced by the MMS, the State Department of Public Health, and Hopkinton Community Television, states that, while politicians and lawmakers debate the details of national health reform, each of us should engage in some individual health reform - to become more conscious of obesity and overweight, eat better, and exercise. "Those actions," she says, "will make a huge difference for our personal health, our public health, and our health care system."

MMS's Physician Focus Obesity in Massachusetts

It's time to step up for our veterans

Whatever side you take on the wars in Iraq and Afghanistan, the fact remains that too often the service and sacrifice of our military men and women get lost in the noise of debate about such issues as staying or going, more troops to deploy, or more money for resources.

Remarkable advances in military medicine have meant fewer battlefield deaths, thankfully. But with the nature of today's weapons, more soldiers survive with serious wounds and impairments.

As good as military health care has been over the years, recent revelations have pointed out serious inadequacies in how our returning veterans are being cared for by the available military and Veterans Administration facilities.    

The Massachusetts Medical Society recently passed a resolution in support of quality medical care for those personnel wounded in these wars and will urge the American Medical Association to do the same.   

It's time for civilian hospitals and health care professionals to step up and help. Yes, physicians, hospitals, clinics, and allied health care workers are under stress with the day-to-day care of our citizens. But can we ignore the sacrifices that our men and women in uniform have made on our behalf? Do we not have a professional, moral, and ethical obligation to help in the treatment and rehabilitation of these brave men and women?

I certainly think so.

Hospitals and clinics could provide beds and outpatient care, and physicians could offer necessary medical expertise and advocacy, all to help ensure these heroic men and women are provided with the treatment they require and deserve.

Other health care providers - such as physical therapists and mental health professionals - can assist in rehabilitation and ancillary efforts. Whether such services are reimbursed from the government or performed voluntarily is not of paramount concern.

What matters most is helping our veterans. Let each of us ask ourselves, what can we do to help?

Let's show that we do care, that we are not aloof, that we do recognize the sacrifices of these men and women, that we are ready, able, and willing to help them in their time of need. Let's join together with all involved on a state and national level in this noble, humanitarian effort.

Hubert I. Caplan, M.D.
Internist and Rheumatologist
Newton, Mass.