Michael Dukakis on ACOs: “We tried that, folks. It didn’t work.’’
[fragment number=0]
The creation of accountable care organizations or a global payment structure won’t fix the health care system in Massachusetts and make it more affordable, former governor Michael Dukakis told an audience at Harvard last week.
Speaking during the Harvard School of Public Health Voices from the Field series, Dukakis said urging the health care market to fix itself is “a colossal waste of time.’’
“If the market doesn’t work you have to regulate,’’ he said. “R-E-G-U-L-A-T-E. Thoughtfully, responsibly, and with the active involvement of all of the people who provide health care and who are very important to us.’’
Dukakis said Governor Deval Patrick today has all of the authority he needs to regulate the health care market. He cautioned that if Patrick submits a bill asking for regulatory power “it might come back with half of his authority stripped from him.’’
Here’s an excerpt from the event. See the video above more of Dukakis’s comments, including harsh words for Mitt Romney, his thoughts on what role preventive care should have in the national conversation about health care, and the intersection of public policy and politics:
If we paid a little attention, it might be a good idea, to the experience of other countries around the world who are doing this and who, for some reason, seem to be able to provide rather good health care to their people at half the cost we do — whatever the siltstone, whether it’s Australian medicare or a multi-payer system in Germany or an essentially privatized system in Switzerland — every one of them regulates cost, without exception.
What do we do? Come up with this ACO, global payment thing… We’ve done it. ACOs and global payments. What did we used to call them? HMOs and capitation. We tried that, folks. It didn’t work. Why are we doing it again?
Now don’t get me wrong. Nobody loves having to regulate. We had something called the rate-setting commission when I was governor… We treated hospitals as public utilities. They couldn’t raise their rates a nickel unless they went to the rate-setting commission. We certainly didn’t have these huge disparities between what Partners gets and what the BI gets. Wouldn’t allow it. So, we’ve got to get on with the business of regulating costs. And I think the least bureaucratic way to do it, rather than getting into setting elaborate fee schedules and so forth, is essentially to use the authority we have in this state under the state insurance statutes to regulate the rate of increase and the cost of premiums… You’ve got to involve the key players — providers, consumers, legislators, and so forth — in the process of developing how we’re going to regulate and then carefully monitoring it so that, in point of fact, it work and works effectively and at the same time make sure that we provide people with excellent health care, which we do in this state.
What I’m worried about is that we’re futzing around with new institutional arrangements, accountable care organizations.
To comment, please create a screen name in your profile
To comment, please verify your email address
Conversation
This discussion has ended. Please join elsewhere on Boston.com