→ Massachusetts shows the Next Step for Obamacare

Under the plan, all Massachusetts doctors, hospitals and other providers must register with a new state bureaucracy as a condition of licensure—that is, permission to practice. They’ll be required to track and report their financial performance, price and cost trends, state-sanctioned quality measures, market share and other metrics.

But Massachusetts takes 360-degree surveillance and converts it into a panopticon prison. An 11-member board known as the Health Policy Commission will use the data to set and enforce rules to ensure that total Massachusetts health spending, public and private, grows no more than projected gross state product through 2017, and 0.5 percentage points lower thereafter. (And Paul Ryan’s Medicare projections are unrealistic?)

No registered provider is allowed to make “any material change to its operations or governance structure,” the bill says, without the commission’s approval. The commission can also rewrite the terms of provider contracts with insurers and payment levels and methods if they are “deemed to be excessive.”

Of course this is the next step. There is no way the system can support itself unless it exerts more control over the doctors (i.e. the suppliers) prices. It will be interesting to see if Mitt Romney and Paul Ryan can explain this to the American people, especially with Governor Romney’s involvement in setting up the Massachusetts law looming in the background.