Domenic Paolini, a heart surgeon turned lawyer, told The Pulse yesterday that the prognosis for health care in Massachusetts isn’t good.
“When doctors lose money, patients lose lives, and limbs,” warned Paolini, a critic of the new health care payment plan state leaders will soon roll out. “When doctors aren’t adequately compensated, they need to see more patients, and because there’s only so many hours in a day, they spend less time with patients, and less time preparing for patients, and that’s when accidents happen.”
By month’s end, Gov. Deval Patrick and the state’s most powerful legislators are expected to make national news, with a bill that aims to curb health care costs by changing how we pay for care.
If the bill becomes law, insurers will stop paying doctors for each test and office visit, and implement “global payments” and “accountable care organizations.”
All this means that in the future, insurers and the government will put doctors’ groups and hospitals on an annual per-patient health care budget, by giving them a lump sum of money to spend on care. Eventually, supporters say, doctors will stop treating a specific illness, and start treating the whole patient. And, they say, as our collective health improves, we’ll wind up paying less for health insurance.
It sounds great, but Paolini isn’t buying it. He’s skeptical because the architects of this plan claimed in 2006 that once everyone had health insurance, our premiums would nosedive, and that patently hasn’t happened.
Of this latest initiative, Paolini said, “We’ve already tried this, but back then it was called managed care, and that began when businessman decided to move money out of the health care system, and into their own pockets,” he added.
To make that happen, he said, the government and the insurers began slashing doctors’ pay.
Back in 1977, when Paolini was fresh out of Harvard Medical School, a doctor was paid $15,000 for each open heart surgery he or she performed.
By 1991, a doctor who performed that same surgery made $1,500.
“All the other money was going into the bureaucracy, the $2 million-a-year hospital administrators and the insurance companies,” he said, adding that they are the ones who have the governor’s and legislators’ ears. Take the money away from doctors, and watch the case loads and errors rise, Paolini said.
So, he says, take a good look at what the state is getting ready to sell you, and find out who really benefits. He doesn’t think it’s you and me.
Cite: McConville, Christine. "DOC: Pay Plan Bad Medicine." The Boston Herald, 4 January 2011. Accessed January 4, 2011.