Wednesday, February 23, 2011

Massachusetts Health Care administrator supports single payer

From Massachusetts we get this endorsement of single payer health care from a guy who should know:
A senior Patrick administration health care official said Friday that a single payer system may work more effectively and efficiently than Massachusetts’s existing insurance market, a high-profile endorsement that raised eyebrows at a legislative hearing.

“I like the market, but the more and more I stay in it, the more and more I think that maybe a single payer would be better,” said Terry Dougherty, director of MassHealth – the state-run Medicaid plan that insures nearly 1.3 million Massachusetts residents – when lawmakers asked for his “personal view” on a single payer system.

Dougherty’s comment, made during a budget hearing at the Boston Public Library, prompted his boss, Secretary of Health and Human Services JudyAnn Bigby, to interject: “That’s his personal opinion.”

Dougherty noted that MassHealth, by far the largest program in state government, spends just 1.5 percent of its $10-billion-a-year budget on administrative costs – compared to about 9.5 percent by the private market, according to studies by the state Division of Health Care Finance and Policy. That figure won plaudits from several lawmakers on the panel, including some who have supported implementing a statewide single payer system.

After his remarks, Dougherty told the News Service that he’s learned to appreciate “elements of single payer” during his 30 years in health care.

“It’s got to be better than this devil-may-be marketplace,” he said. “We don’t build big buildings. We don’t have high salaries. We don’t have a lot of marketing, which makes, to some extent, some of the things that we do easier and less costly than some things that happen in the marketplace. Overall, my point is, we have individuals who work in state government in MassHealth ... who are just as smart, just as tactile, just as creative as people who work in the private sector, but they work for a lot less money.”

A single payer system would replace the state’s patchwork of nonprofit and private insurers with a single, public insurer through which all health care dollars would flow to hospitals, doctors and other health care providers. Supporters say it would eliminate administrative waste and ensure that all residents receive adequate coverage.
So - no fancy buildings and the money that is wasted on excessive salaries is instead spent on providing health care. What's not to like - unless you are a health insurance executive drinking excessively from the health care teat.


Anonymous said...

the trobule is that he keeps the books different than the insurance companies so the 98.5% medical loss ratio is a sham. And he doesn't tell you that a huge percentage of his claims/expenses are very expensive nursing home charges but for single people. Administering them is much easier than administering claims for millions of $20 bottles of pillss with $15 copays. See

-- Dennis Byron

Richard said...

I am very familiar with government accounting and with private business GAAP. The differences reflect the fact that private companies base their books on income from financial transactions while government entities base their books on appropriated funds. There is no "bottom line" for the government. There is only control of expenditure of funds given them from the legislature in ways the legislature requires.

The kinds of control of funding and expenditure is different so the form of the books looks different. That is quite irrelevant to whether the money is wasted on big fancy buildings and extreme wasted executive salaries. Those expenditures can easily be compared by any competent accountant.

Political pundits with no formal training in accounting simply cannot competently comment on the differences between government accounting and private entity accounting. They invariably get it wrong because they are the ignorant attempting to persuade (not inform) the even more ignorant.