| Hope you checked out the Globe's fine work -- an old story, but never too late to tell -- on the historic "gentleman's agreement" to essentially create a health care provider/insurer cartel, between Partners and Blue Cross Blue Shield. And so, in May 2000, the two simply shook hands on this: [BCBS's CEO] Van Faasen would give Partners doctors and hospitals the biggest insurance payment increase since Massachusetts General and Brigham and Women's hospitals agreed to join forces in 1993. In return, [Partners'] Thier would protect Blue Cross from Van Faasen's biggest fear: that Partners would allow other insurers to pay less. Those who helped broker the deal say Thier promised he would push for the same or bigger payment increases for everything from X-rays to brain surgery from Van Faasen's competition, ensuring that all major insurers would face tens of millions in cost increases. Blue Cross called it a "market covenant."
And that, my friends, is why we have the highest health care costs of any state in the country -- at least in part. We always hear it's because we have the best docs, the best facilities, and it's Harvard's teaching hospitals, yadda yadda. We should be grateful to pay so much. It's actually because the market players decided to, well, cheat. And Marcia Angell reminds us of the kind of delightful activities that go on in Partners facilities! Take the case of Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and chief of pediatric psychopharmacology at Harvard's Massachusetts General Hospital. Thanks largely to him, children as young as two years old are now being diagnosed with bipolar disorder and treated with a cocktail of powerful drugs, many of which were not approved by the Food and Drug Administration (FDA) for that purpose and none of which were approved for children below ten years of age. ... In June, Senator Grassley revealed that drug companies, including those that make drugs he advocates for childhood bipolar disorder, had paid Biederman $1.6 million in consulting and speaking fees between 2000 and 2007. Two of his colleagues received similar amounts.
Look, let's just be as blunt as the subject deserves: Apparently our vaunted hospitals, our jewels of the region and temples of healing, are now so entwined with the money changers that their reputations can now only be considered hopelessly sullied. And that may as well apply to the entire practice of medicine in the Commonwealth. It is all suspect. The medical culture itself is now suspect: The docs whose offices look like a NASCAR speedway; the drugs they prescribe; the rotted conflicts of interest that inform deform the research that rationalizes their prescription. There's just so much bad faith in the industry that Angell, a former New England Journal of Medicine editor, states baldly: It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.
Wow. Look, the thing I want to get across is very simple: Health care costs, particularly in MA, are not just high because of some vague, unknowable "market forces"; it isn't just that the Health Care Invisible Hand mysteriously keeps us all under its thumb, and gosh golly, after all There's Nothing That Can Be Done. No, it's simpler than that. We're actively, intentionally, unethically and possibly illegally getting screwed. |
