The Boston Globe lead story today is "A handshake that made healthcare history." It might at well be "How the leading hospital combination and insurance company in Massachusetts ganged up to rip off everybody in the Commonwealth."
The gist of the story: In 1993, Massachusetts General Hospital and the Brigham and Women's Hospital, the two most prestigious hospitals in the Boston area, combined to form Partners HealthCare. By 2000, Partners had sufficient power to force Blue Cross Blue Shield of Massachusetts (BCBS/MA) to increase its reimbursement rate to Partners, a pattern that continues to this day, by a total of 75% since 2000.
Within a few months, Partners used this unwritten agreement to strongarm Tufts Health Plan, a competitor of BCBS/MA, to increase its reimbursement rate also. The article estimates that the cost of medical care in Massachusetts is now more than $900 per family above the national average. More to be outraged about after the fold:
Partners' total operation has increased, as measured in total discharges, about 128% ince 1993. During that same time, its operating revenue has increased 381% and its total corporate profit has increased by 3736% to $583 million in 2007. Most of that has come out of the pockets of Massachusetts insurance payers.
BCBS/MA didn't suffer from all this. Their profits have gone from $82.7 million in 2002 to over $200 million every year since then.
Massachusetts gave up much its control and oversight of this racket early on, in the deregulatory excesses of the 1990s. Charles Baker OK'd the deal as Secretary of Health and Human Services for Gov. Bill Weld at the time. He lived to regret it, when as CEO of Harvard Pilgrim Health Care (another insurance competitor), he too got strongarmed by Partners.
I don't think I need to ask anyone on DailyKos what's wrong with this picture. The story is all too sadly familiar. The health care industry and the health insurance industry wink at each other, then stick it to the businesses that pay for health insurance and the consumers who pick up the rest of the tab. The rich get richer and everybody else gets taken for a ride.
I admire the Globe for spending the effort and the space to reveal this outrage. What they don't add is the obvious question: What does anyone, outside of Partners and BCBS/MA, get out of this arrangment? Why does there need to be a for-profit health insurance company in the loop at all? Why does Partners need to roll up such obscene profits?
If single-payer health care existed, Partners would no longer be able to play off one insurance company against another. They would have to take what was on the rate sheet. They wouldn't be able to roll up huge profits with no recourse to the public. They wouldn't be able to draw resources away from businesses which could use the money better to keep workers employed and invest for the future.
We have a unique opportunity. We have a President who knows that the current health care situation is broken. We have sufficient working majorities in both houses of Congress. We have a population which knows that something major has to change. Will we get what we need?