Obamacare 1, Robert Samuelson 0

Flickr/<a href="http://www.flickr.com/photos/moon_child/3965679774/">moon child</a> (<a href="http://www.creativecommons.org" target="_blank">Creative Commons</a>).

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Jon Cohn has already pretty thoroughly demolished Robert Samuelson’s Washington Post “Obamacare” op-ed from this morning. But I wanted to highlight one especially amusing/depressing failure on Samuelson’s part. In the column, which focuses on how problems for Massachusetts’ health care system could become problems for Obamacare, Samuelson mentions a state commission’s recommendation that Massachusetts move away from “fee-for-service—which ties reimbursement to individual services” because it “rewards quantity over quality and discourages coordinated care among doctors and hospitals.” The commission, Samuelson explains: 

…recommended a ‘global payments’ system to force hospitals, doctors and clinics to create networks (‘accountable care organizations’). These would receive flat per-patient payments to promote effective—not just expensive—care. Payments would be ‘risk adjusted’; sicker patients would justify higher payments.

But the commission offered no blueprint, and efforts to craft consensus among providers, consumer groups and insurers have failed. State Senate President Therese Murray, an advocate of payment change, has given up for this year. “Nobody is in agreement on anything,” she told the Boston Globe.

What Samuelson misses, however, is that the Affordable Care Act (dreaded “Obamacare”) includes a provision implementing the recommendations of the commission. It’s Section 2705 of the law, and it was inserted by Massachusetts Sen. John Kerry (see here, “modified Kerry #C3”). In other words, the Massachusetts senator successfully inserted the Massachusetts’ commission’s recommendation into the health reform law so Massachusetts could move forward on it. Sure, the Kerry provision only applies to Medicaid and is limited to five states. But the main point holds: The specific thing that Samuelson says isn’t happening, but should, is actually happening right now.

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THE BIG PICTURE

You expect the big picture, and it's our job at Mother Jones to give it to you. And right now, so many of the troubles we face are the making not of a virus, but of the quest for profit, political or economic (and not just from the man in the White House who could have offered leadership and comfort but instead gave us bleach).

In "News Is Just Like Waste Management," we unpack what the coronavirus crisis has meant for journalism, including Mother Jones’, and how we can rise to the challenge. If you're able to, this is a critical moment to support our nonprofit journalism with a donation: We've scoured our budget and made the cuts we can without impairing our mission, and we hope to raise $400,000 from our community of online readers to help keep our big reporting projects going because this extraordinary pandemic-plus-election year is no time to pull back.

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