It’s us versus them, and normally you want to side with the home team, but when it comes to the so-called “Bay State boondoggle” — the extra hundreds of millions the feds are sending to Massachusetts hospitals — we are, regrettably, in the wrong. Rather than fighting a rear-guard action to justify the unjustifiable, Massachusetts’s pols need to stand up and lead the way to a reformed and more equitable system.
The scam was, no question, wicked clever. Medicare is the federal program that covers health care for those over 65. Under its rules, labor-related payments to urban hospitals have a floor that is equal to wages at a state’s rural hospitals. In the Bay State, it turns out there’s only one such qualified rural hospital: the lovely Nantucket Cottage Hospital, just at the edge of the island’s historic district. Of course, we’re not talking some godforsaken region of Appalachia here, where land is cheap and wages crushingly low. Rather, Nantucket is the playground of the wealthy, and everything is exceptionally expensive (to their credit, islanders do their best to soak the rich in their midst).