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Thursday, August 23, 2012

Canute the Great and Controlling the Cost of Health Care 

About a thousand years ago, Canute the Great, a Dane, was King of England and a big chunk of Scandinavia.  Legend has it that one day he set his throne by the sea shore and commanded the tide to halt and not wet his feet and robes. 

I am reminded of that by the recent enactment of another piece of health reform legislation by the Commonwealth of Massachusetts, this time focused on cost control.  Though I haven’t read the 300-page bill, I conclude from the article about it in the August 1 issue of the Boston Globe that the approach being taken is not that much different from that of Canute and the tide.  The Massachusetts government is declaring that health care costs will not rise more rapidly than the growth of the economy as a whole.  It then admonishes providers to conform to the limit and sets up new government agencies to watch them as they try. 

Much faith seems to be placed in the conversion of the payment system from fee-for-service to HMO-style capitation (euphemistically referred to as global payment).  The law requires Medicaid and state employee plans to convert, but only urges private insurance to do so.  Commentators doubted that the private sector would rush to comply. 

According to reports, the tide did not respond to Canute’s command.  We’ll see if health care providers in Massachusetts are any different.

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