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The Marty McFly solution

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In the 1985 movie “Back to the Future,” Dr. Emmett Brown (Christopher Lloyd) modifies a DeLorean DMC-12, so when it reaches 88 miles per hour, it becomes a time machine. Brown’s original intent was to use the machine to travel to the future, but the first voyage involves local teenager Marty McFly (Michael J. Fox) going backward in time.

In 2006, Massachusetts enacted a health care law that mandated universal coverage, which many viewed as the beta version of PPACA. Predictably, premiums have soared there and legislators and regulators are in a frantic race to find solutions.

State Senate President Therese Murray (D-Plymouth) says, “We don’t want to break the system we have, but we want to bring costs down. It’s complicated. If you move one little piece, something pops up somewhere else.” What a revelation! Health and Human Services Secretary Judyann Bigby says, “The issue is how quickly you can reform such a big system without having mistakes and unintended consequences.” That’s a laudable concern, if not exactly prescient.

Now they figure this stuff out? When these laws and regulations were proposed, we tried to tell the legislative knuckleheads that this would be the inevitable consequence. No one wanted to listen then.

It has taken four years for Massachusetts’ version of reform to “reach 88 miles per hour,” but it appears that the Bay State itself is on the brink of time travel. The fine folks in Boston have decided that the best way to curb costs is to move away from a fee-for-service model (paying doctors and hospitals for the number and type of tests they do) and to begin to compensate them for maintaining their patients’ health over the long term. This definitely seems more like the past than the future.

Either we have all gone back to the future, or this is the strangest instance of d?j? vu ever. Wait…it is worse than that — it is d?j? moo. That’s when you know you’ve heard this “bull” before.

Check out more blog entries from David Saltzman.


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