SENATE President Therese Murray has taken on a thankless task: containing healthcare costs in Massachusetts. The bill she filed this week contains several useful initiatives that should become law, but its greatest value is to show that the state's political leadership is determined to get these costs under control.
The most impressive aspect of the bill is its insistence that every physician be connected to an electronic medical records system by 2015. Electronic sharing of information is the only way that healthcare payers and providers can get solid comparative data on costs and effectiveness of various medical procedures. Murray is right to combine money with her mandate. She would provide at least $25 million a year to help defray the costs of connecting to the system. That's probably only a small fraction of the entire cost. Longer-term savings will still require significant investment over the next few years.
Another important element is Murray's insistence that hospitals and physicians reveal what they charge for their services, and that insurance companies explain the rationale for any rate increase more than 7 percent a year. That sounds impressive as a way to lay out the differences in the payments for the same service. But once these price schemes are revealed, will it force the high-cost providers to lower their prices, or encourage the lower tier to raise them? Nobody knows.
Murray is on target with her proposal to prohibit drug and medical-device companies from offering gifts, including free meals, to physicians. It would be the toughest ban in the nation, but two loopholes would remain. Drug companies could still give out free samples for use by patients, and could still pay physicians for speaking and consulting work. The traditional largesse by drug companies has created an ethical morass for doctors, and it's time that stopped, but prescribing patterns will take a while to change.
Murray's bill contains useful provisions to increase the number of primary care physicians. It would expand the use of nurse practitioners; coordinate treatment of patients with chronic diseases; and prohibit hospitals from collecting payment for horrendous mistakes that should never happen, such as amputating the wrong leg. But the bill would not prevent hospitals from accepting payment when they readmit patients to treat problems caused by medical errors during an earlier stay. The joint Healthcare Financing Committee ought to fix that omission when it holds hearings on the bill Wednesday.
None of the elements of Murray's bill is guaranteed to contain costs, but together they make a mighty jawbone to wield over healthcare providers and insurers. They are now on notice: keep costs down, or face intense criticism and tougher measures than Murray put forward this week.
