tag:blogger.com,1999:blog-3697603232354740832.post872690978873813517..comments2023-08-16T06:30:12.495-07:00Comments on HealthMatters: The New York Times: A Real Choice on MedicareUnknownnoreply@blogger.comBlogger7125tag:blogger.com,1999:blog-3697603232354740832.post-76210606583951232812011-05-19T01:15:50.529-07:002011-05-19T01:15:50.529-07:00Paula, is MA doing anything at the government leve...Paula, is MA doing anything at the government level to address their shortage of primary care physicians? I appreciate that this is a nationwide problem, but from what I understand going to universal coverage exacerbated this in the Bay State. I rush to add that I see this as a problem to be solved, not as a reason to not do universal coverage.K.https://www.blogger.com/profile/10222703055177237209noreply@blogger.comtag:blogger.com,1999:blog-3697603232354740832.post-79395550792891339392011-05-17T06:43:26.563-07:002011-05-17T06:43:26.563-07:00Massachusetts is inching its way toward single pay...Massachusetts is inching its way toward single payer model, but may be waiting until Sen. Brown is out and the state gets bluer. As an interim, Gov. Patrick is setting up regional councils (?) to set fees and act as overseer. My guess is the next step will be to just go to single payer. <br />Vermont's program won't start for a few years. In that state, there's only one really big hospital, which makes it fairly easy for the state government to take on the task. That would not be the case in Massachusetts or CT, not sure about the other three NE states.Paulahttps://www.blogger.com/profile/09591148539500576959noreply@blogger.comtag:blogger.com,1999:blog-3697603232354740832.post-44268046555340270882011-05-16T05:43:03.529-07:002011-05-16T05:43:03.529-07:00Arguably, the driving factors are different from s...Arguably, the driving factors are different from state to state. Vermont, for example, is moving toward universal coverage because its rate of medical inflation is one of the highest in the country. Coverage is actually pretty good there.<br /><br />When Oregon tried u.c. (and they are likely to try it again), they set a hard budget and prioritized conditions. That fit state political sensibilities. The point is that unlike Social Security, Medicare actually does face severe fiscal issues brought on by medical inflation and an aging population (some economists argue that the latter factor isn't as important as the former). <br /><br />Should Congress punt -- a not inconceivable proposition -- we have to consider alternatives. I was 100% mistrustful of a state-based approach, but developments in Vermont have dialed that down somewhat. After all, success there would put immediate pressure on the other New England states to follow suit. I suspect that the sociopolitical culture of Vermont (a small blue state) has allowed it to move sooner rather than later.<br /><br />Note of course that Vermont's proposed approach doesn't incorporate Medicare/Medicaid.K.https://www.blogger.com/profile/10222703055177237209noreply@blogger.comtag:blogger.com,1999:blog-3697603232354740832.post-78069890967464661392011-05-15T11:52:28.945-07:002011-05-15T11:52:28.945-07:00>>strong incentives to individual states to ...>>strong incentives to individual states to tailor universal coverage to their needs and sociopolitical culture.<br /><br />what sociopolitical culture? Do people need different health care models in SC than they do in, say, IL? Are New Yorkers healthier/sicker than Mississipians so they need more/less benefits? It looks to me like the states than need the most help are already getting at least some of what they need in the form of Medicaid dollars from the federal government. Why would they want to go it alone...unless, of course, they're planning to limit the population receiving benefits. That is, exclude the poor, the immigrants (legal or illegal), the unemployed, the very young, the very old?Paulahttps://www.blogger.com/profile/09591148539500576959noreply@blogger.comtag:blogger.com,1999:blog-3697603232354740832.post-85464760036893926752011-05-01T18:17:02.795-07:002011-05-01T18:17:02.795-07:00Good hard common sense here, K. Too bad Washingto...Good hard common sense here, K. Too bad Washington severely lacks it.Cowtown Pattiehttps://www.blogger.com/profile/07384649567351202679noreply@blogger.comtag:blogger.com,1999:blog-3697603232354740832.post-52905927798922147512011-04-25T23:12:54.968-07:002011-04-25T23:12:54.968-07:00Thanks, Paula. And good luck with your surgery.Thanks, Paula. And good luck with your surgery.K.https://www.blogger.com/profile/10222703055177237209noreply@blogger.comtag:blogger.com,1999:blog-3697603232354740832.post-79570995509888707142011-04-25T06:35:34.537-07:002011-04-25T06:35:34.537-07:00Thanks for this, K. It's clear, concise and of...Thanks for this, K. It's clear, concise and offers a viable alternative. I'll pass it around.Paulahttps://www.blogger.com/profile/09591148539500576959noreply@blogger.com