Reform: The other Massachusetts health plan
Legislation on the floor by the end of July: That’s what Nancy Pelosi said Wednesday after she and key House committee heads met with President Barack Obama.
“This is about costs” she said.
Obama’s word: “Unsustainable.”
But fixes to the way we pay for health care will move a lot of money around. There will be winners and losers. It will get ugly. Still, there is serious momentum.
Some of that could be seen during the last of three Senate Finance Committee meetings on the reform bill. The Tuesday video is still up on C-Span.
Brandeis professor Stuart Altman has been trotting back and forth between Waltham and Washington for years trying to find fixes for the system. He has a serious health policy resume. Altman told the committee (PDF) the Massachusetts plan — which expands coverage — is only half of the package
“The second stage, which is now being designed, will attempt to rein in the fast-growing cost of health care. In fact, this month a special commission established by the state Legislature on healthcare payment reform is scheduled to recommend a global payment system that would set a total payment amount for each patient that covers all that person’s care for an entire year. In order to make such a system work, the state will be seeking CMS’ permission to cover Medicare and Medicaid patients as well. The hope is that by creating a global payment, and limiting its growth, healthcare cost growth in Massachusetts could be reduced from 8 percent a year to 5 percent.”
Did I just bury the lead? The state is going single-payer and taking on Medicare? This will be worth watching.
The Boston Globe describes the approach this way:
“A single, yearly fee is intended to discourage doctors and hospitals from providing unneeded tests and treatments, so patients could find it harder to get procedures of questionable benefit. And because doctors and hospitals would have to work together more closely to manage the budget, the hope is they will better coordinate care for patients, which could improve quality.
“The ‘fee-for-service’ system ‘has all the wrong incentives,’ said Dolores Mitchell, a member of the Special Commission on the Health Care Payment System and head of the state employees’ insurance program. ‘It encourages excessive use and does nothing to discourage waste. People know the system has been dysfunctional for years.’
Back to the D.C. hearing: Cambridge was well represented, with Harvard School of Public Health professor of health economics Katherine Baicker and M.I.T. economics professor Jonathan Gruber both testifying.
Oh yeah, Swine Flu
Last count 115 cases in the state, two hospitalizations, no deaths. End of panic. More cases are emerging, mostly in North America. No one is dying. So that took a little air out of the Globe’s Sunday story on how Harvard, the city and the state dealt with a cluster of infections among Longwood Avenue dental students. Still worth a read:
“Over the next 10 hours on that Thursday a week ago, as afternoon melted into evening, investigators from the city and administrators from Harvard embarked on a race to stop the virus’s spread. Harvard is a temple of medical knowledge where ego and arrogance are not unknown, but by all accounts, the university’s top officials worked seamlessly with Boston’s experienced disease detectives.”
Back to health reform: The big Massachusetts player
The Globe’s story Sunday on Ted Kennedy’s last push on health reform passed was, well, a little sentimental. But this is Boston and we’re talking about a Kennedy brother with a fatal illness:
“Given a grim diagnosis last May 20 – a malignant glioma in his brain, a fast-growing tumor that has taken the lives of many of its victims in a matter of months – Kennedy made a difficult decision: He would battle the tumor with aggressive, exhausting treatment, following the advice of the best doctors he could find.
“And except for carving out more time with his family, Kennedy decided to spend all his remaining workdays trying to give all Americans access to quality healthcare.
“It’s a goal he’s pursued for nearly five decades, always running up against critics who insisted that his plans were too costly, too complicated, too focused on government solutions. His approach has changed somewhat – he now vows to work with private insurers – but the country has changed more, in its willingness to accept a greater government role in the private sector.”
To get a little perspective, take a peek at the Senator’s campaign contributions. Lots of healthcare industry names in there. The Federal Election Commission has a handy database.
Reform: Another Massachusetts player
The Wall Street Journal’s Health Blog noted earlier this week that David Blumenthal — currently head of Obama’s HIT effort, and, when not in D.C., head of the Harvard Institute for Health Policy — is getting ready to define the term that will drive stimulus money for HIT: “meaningful use:”
“‘Meaningful use is very much on our mind,’ David Blumenthal, the feds’ health IT chief, said this morning on a conference call with reporters. ‘We hope to provide a direction and some specifications in the late spring, early summer.’
“Figuring out the criteria for certification is also a high priority, but Blumenthal wouldn’t say whether CCHIT, the main body for health IT certification in this country, will continue to have a key role.”
Blumenthal has the president’s ear on more than HIT. In a few weeks — June 6 — Blumenthal’s book on the history of health reform and the presidency comes out.
The publisher of “The Heart of Power: Health and Politics in the Oval Office” — University of California Press — has a podcast interview with Blumenthal. This is one of his key points:
“It ultimately comes down to whether the president cares enough to take the political and policy risk of overruling what is usually the unanimous view of economic advisors — that health care should be postponed, reduced, modified, deflected.”
There’s more by Tinker Ready over at Boston Health News.