Massachusetts Health Care Reform

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Missive From Massachusetts: Addressing Health Care Costs

Editor’s note: The Massachusetts health care overhaul has been a model for the federal plan. The state has reached near-universal access, but that’s only one piece (albeit a big one) of health care reform. Another big piece is cost, which the state is now addressing.

By Martha Bebinger, Kaiser Health News

Boston, as seen from Boston harbor. (Nietnagel/Flickr)

The skyline of Boston, Massachusetts. (Nietnagel/Flickr)

Massachusetts is the first state to say that health care costs must stop increasing faster than that of most other goods and services. Prof. Stuart Altman, a Brandeis economist who advised President Richard Nixon on health policy and President Bill Clinton on Medicare, has responsibility for helping the state achieve that goal.

Gov. Deval Patrick recently named Altman to chair the Health Policy Commission, the new board overseeing the sweeping cost-control law. The board, whose other members were announced last week, will monitor progress toward keeping health care spending in line with state economic growth overall. While he’s “hopeful” the state can meet this goal, Altman notes that many attempts have failed over the years. Here is an edited transcript of my interview with Altman about the challenge facing Massachusetts:

How do you see this new role?

“[Historically,] I’ve seen both the private sector fall apart and the government sector fall apart. Now, I think what’s being done is smarter.”
Massachusetts has put together the best kind of balanced program that I could think of in the country, where it is relying at one level on the many changes that are going on in the private sector. But it also has put together an overarching public assessment of what’s going on to make sure that it works, and it actually brings cost down without hurting quality.

If the changes that are currently in place don’t do that, this commission is responsible for giving an early warning sign. So we don’t have direct regulatory power to force the system to change, but we do have a monitoring role to make sure that it is working. If it’s not, [we would] first direct the delivery system and the payers to change, and if that doesn’t work, we could also recommend back to the legislature that the state needs more authority. Continue reading

No Death Panel Debate–Mass. Senate OKs “Palliative Care Awareness”

By Martha Bebinger, Kaiser Health News

(Ryan Wilcox: Flickr)

(Ryan Wilcox: Flickr)

It’s been almost three years since Sarah Palin claimed that end-of-life care options could turn into death panels.

But last week, with no discussion, legislators avoided a minefield that exploded repeatedly during the national health care debate. With a quick call of the ayes and nays, the Massachusetts Senate approved Amendment no. 121, “Palliative Care Awareness.” It requires that physicians and nurses in Massachusetts must talk to terminally ill patients about their end of life options, their risks and benefits and how best to manage their symptoms and pain.

Senate Republican leaders confirm that they have no objections … and it’s also supported by one of the state’s leading right-to-life groups.

In 2006, Massachusetts passed statewide health insurance reform which requires nearly every resident to carry health insurance. It’s considered a model to the feds’ Affordable Care Act.

Since then, Massachusetts has been implementing its plan. Counseling advocates say they won’t let Palin’s interpretation of end-of-life care derail their mission.

“The national controversy about death panels — what AARP called lies about death panels — is completely misguided,” said Dr. Lachlan Forrow, who directs ethics and palliative care programs at Beth Israel Deaconess Medical Center. “In Massachusetts we can unite and show how to do it right.” Continue reading