Globe says state reform works so far; week of hearings predicts the future.

The Globe has a huge take-out on the impact of health insurance reform in the state and it basically says – it’s working so far.

Taken in sum, it is a far cry from what critics of Romney, and of Obama, are saying about the Massachusetts plan. The attacks often rely on distortions, omissions or flagrant inaccuracies, and typically ignore the fact that the law accomplished its principal goal — expanding coverage to nearly every citizen.

“Health reform is virtually a fact-free zone in Washington,’’ said Jon Kingsdale, who was the first executive director of the Commonwealth Health Insurance Connector, the marketplace for insurance plans set up by the 2006 law, and is now a consultant to states preparing to comply with the national law.

“Massachusetts has, since 2006, been the prism through which ideologues attack or promote national policy on health care coverage,’’ Kingsdale said. “In this country, 99.9 percent of the people don’t understand the mind-numbing complexities of the financing of our health care system, so people are free to use factoids to promote or attack any reform.’’

Get ready for more complexities. The state starts four days of hearings on health care costs tomorrow. And, the AG just issued a report that found accountable care organizations – which will offer all of your care one price – have yet to control costs. 

The single-payer advocates over at Mass-Care continue to point out what they see as the pitfalls of the mandated coverage approach. They refer to the AG’s report as a case in point. This came via email: 

WBUR’s online health care blog, “CommonHealth,” has a flashy headline article today titled “Massachusetts Attorney General Drops Health Reform Bombshell.” What’s the bombshell? That the state’s proposal to control health care costs by moving people into accountable care organizations (ACOs) is unlikely to work, because patients who are currently covered by similar arrangements receive care that as just as expensive as everyone else. ACOs are supposed to control costs using old managed care tactics that led to patient and provider revolts in the 1990s: forcing patients into limited networks, where they have a limited choice of doctors and hospitals, and paying providers on a “capitated” basis. Capitation means that providers get paid a fixed amount for treating a patient for a whole year, regardless of how much or how little it ends up costing to treat them.

The theory is that this will remove the incentives for providers to over-use certain types of care, since they actually lose money by providing more care. The reality is that it gives providers an incentive to avoid people with serious health issues, and to provide less care (appropriate and inappropriate) to those they do cover.

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