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Massachusetts Remedy for Sick Is for More Neglect, Less ‘Benign’?

Spikes in influenza, three circulating viruses, along with “significant workforce shortages,” according to healthcare officials are driving the “full-to-capacity” Massachusetts hospital dilemma.

Commonwealth HHS head Kate Walsh’s Jan. 9th memo confesses that “severe capacity challenges … exist across the [Massachusetts healthcare] system.” Characteristic ills of a system strained by understaffing, riddled with the effects of draconian cuts in funding on display during the COVID-19 years, are reemerging. Patient-clogged emergency departments, where staff resort to administering patient care in gurney-lined hallways, an existing lack of inpatient beds coupled with persisting declines in patient-to-nurse ratios all are worse.

However, rather than introducing or advocating for remedies which address these glaring inadequacies, an ultra-liberal Healey Administration instead cozies up with financial vultures of the mega-health insurers businesses such as BlueCross Blue Shield of Massachusetts.

From Jan. 9 through to April 1, 2024, the administration has agreed with the insurers to “voluntarily waive prior authorization for transitions from acute to subacute care and rehabilitation facilities.” What does this mean for a sick patient? This insurer’s “legalese” translates into a new non-medically-determined policy decree, which routes a patient first to subacute care and rehabilitation facilities before use of an acute care hospital or institution is deemed medically necessary! (It also pressures the health facility to compel patients to accept an early discharge/transition to subacute or rehabilitation care, without a professional medical determination.) The insurance business Shylocks uniformly extend what type of care one receives across policy lines. The new decree applies to commercial policies such as Medicare Advantage, not merely Medicare, Medicaid.

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