Healthcare roadblock
Reports of the demise of healthcare reform on Beacon Hill are premature.
Hard things like this are always dead five times before they live. But with the twin threats of the loss of nearly $400 million in federal Medicaid money and a possible ballot question next fall, the maneuvering is going on frantically behind the scenes to find consensus -- and new money -- to expand coverage in Massachusetts when other states are cutting coverage. It is not an easy thing.
The continuing roadblock: House Speaker Sal DiMasi's insistence that companies that don't offer insurance to their employees pay their fair share. DiMasi's original proposal: a payroll tax on employees -- a very bad idea considering the state of the Massachusetts economy.
Not surprisingly, the business community has opposed a payroll tax, but in January four key business groups for the first time said they would be willing to support mandating that all companies, including those that don't offer insurance to their employees, be required to pay into the state's uncompensated healthcare pool. The pool helps cover the medical costs of those without insurance. That assessment, paid by all businesses, would amount to $62 per employee per year.
Now, with DiMasi continuing to demand more, three of the four business groups are floating a new plan that would cost companies that don't cover their employees much more -- as much as $300 per employee annually, according to executives who are part of the negotiations. The plan would raise an estimated $75 million -- the number varying depending on whether it would apply to companies with two employees, 10, or 50. The numbers and the details all remain fluid, the executives caution.
The architects of the proposal insist the $300 assessment will go down, not up. That is because it is tied to the state's uncompensated care pool, and as the number of uninsured people shrinks from the current 600,000 as coverage expands, the assessment should drop.
The plan has created a split in the original business alliance. The Greater Boston Chamber of Commerce, the Massachusetts Business Roundtable, and the Massachusetts Taxpayers Foundation all back the concept, more or less. Associated Industries of Massachusetts does not; a spokesman declined to comment.
By all accounts DiMasi and Senate president Robert Travaglini are not a happy couple these days. This is obviously not helpful. To be durable, a reform plan of this magnitude has to have broad support -- from the Legislature, employers, providers, and people who use the system. It is no accident that the universal healthcare plan that passed the Legislature narrowly in the Dukakis administration unraveled. Ballot initiatives, while useful leverage, are no way to address complicated matters like this.
The word ''incremental" gets a bad rap. But if the Legislature can find a way to cut the uninsured rolls by 300,000 or more, DiMasi, Travaglini, and the governor will have had a very good day at the office. Do you think Bill and Hillary Clinton would do it differently if they had the chance? Some of those compromise healthcare plans that weren't good enough then look good today.
There is a lot at stake. Healthcare represents about one in seven jobs in Massachusetts. And the state's hospitals and life science sectors are as good a bet as any we have for the future.
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Neighborhood news: Boston Herald publisher Pat Purcell yesterday sent a note to employees in response to a report in this space Wednesday that The Boston Globe is in negotiations to print the New York Post. Wrote Purcell: ''Please be aware that the Herald was offered the same opportunity by the Post. Because of our own production limitations, we were not able to accommodate the Post. . . . While we would have welcomed the additional revenue, it did not concern me that the Post would be printed in New England as opposed to New York." He added: ''With regard to our discussions with investors, I am sorry for the ongoing uncertainty. The process certainly has taken longer than anyone had imagined."
Steve Bailey, a Globe columnist, can be reached at bailey@globe.com or at 617-929-2902. 
