My Stance on Health Care Reform

In August a new 237 page health care reform bill was signed into law by Gov. Patrick. The Pioneer Institute found 941 instances in which the bill mandated that something ‘shall’ be done, including 25 kinds of penalties, fines, and surcharges. The time has come for REAL health care reform, not rubbing salt to an already horrible wound. 

As a doctor my practice is also a business. It’s how I make my living, pay the bills, feed my family, and pay the rent. With any business comes static costs for doing business: taxes, regulation, licensing, insurances (malpractice & other), rent, utilities, supplies, equipment, marketing, advertising etc. These costs fluctuate depending on location and they are all deducted from the fees charged for a patient visit. Pardon me while I vent a moment… Health care is the only industry, to my knowledge, where a service is provided at a particular price but state and federal mandates and insurance companies will, somehow legally, substantially discount fees for services rendered. Try walking into an attorney’s office or purchasing your groceries and telling them you are not going to pay full price for the service or goods because you don’t think it’s 'usual or customary pricing'… you’ll be in court or go hungry! But it's ok to do in a doctor’s office. Is that fair?

With that said, back to the topic at hand, Massachusetts health care reform has dramatic affected businesses by increasing labor costs, eliminating jobs, and reducing production. Businesses have been forced out-of-state, or flat out shut their doors as a result. Its effects have trickled down to employees as lower wages, higher premium contributions, and uncertainty of job safety as companies struggle with the realities of 'reform'.  Residents pay for health care reforms with higher sales and property taxes. Health care reform as it has been mandated, has not bent the cost curve down, but instead added economic stress at every level and dramatically increased costs overall. 

Healthcare reform should focus on reducing costs and expanding access in a responsible way, not with tax increases and debilitating cuts to vital programs. Three reforms can be invoked immediately without devastating economic consequences: 

1. Tort reform would result in a 5-9% cost reduction and savings of $60-108B each year, without affecting quality of care. As an added benefit, total physician malpractice premiums would drop by $6.3B.

2. Pool individuals and small businesses together, allowing them to purchase health care as a group. Purchasing pools are a way by which individuals and small employers can (1) reduce the cost premiums, (2) increase choice of plans, (3) better negotiate rates and benefits, and (4) potentially provide a benefit that employees may take with them to a new employer.

3. Elimination of government mandates and allowing individuals to purchase coverage 'a la carte'. Over the past 6 years, 43 new mandated benefits have been added costing $1.03B.

We need to start taking rational and responsible steps to eliminate waste and fraud to accomplish the goal of reducing healthcare costs. For context, my opponent Senator Donnelly has voted AGAINST a moratorium on further state mandates (requirements for health care plans to cover additional benefits), AGAINST allowing insurers to offer 'Mandate lite' policies (lower cost, less coverage policies), and AGAINST verification for free medical care (confirm residency and eligibility of applicants before paying benefits).