A Race to the Bottom

Philip Betbeze, for HealthLeaders Media , January 13, 2012
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But despite protestations to the contrary, how can anyone see this Bay State proposal as anything but rate-setting? It seems unlikely that hospitals would be on the winning side in most of the decisions put before the panel, so it's in their interest never to have to appear before the committee. That puts an unseen ceiling on healthcare costs that is far from competition-driven.

The serious question I ask about all this as it goes on in Massachusetts is whether we want healthcare to be provided by the low bidder as determined not by economics, but by the vote of a committee.

In reading the story, I was reminded of a quote from astronaut Alan Shepard: "It's a very sobering feeling to be up in space and realize that one's safety factor was determined by the lowest bidder on a government contract."

Again, it's an imperfect analogy, but it occurred to me that if Massachusetts is a petri dish under which many of the provisions of healthcare reform are being tested, one day, we all might legitimately co-opt Shepherd's quip by replacing "up in space" with "in a hospital bed."

This article appears in the January 2012 issue of HealthLeaders magazine.

Philip Betbeze is senior leadership editor with HealthLeaders Media.
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