Yesterday, the Massachusetts House and Senate approved by overwhelming margins a final version of legislation to control the rate of growth in health care spending in Massachusetts -- on the final day of the 2011-12 legislative session. The bill is now on Gov. Deval Patrick's desk, and he is certain to sign it. This is the third cost control bill approved by the legislature (2008 and 2010) since the passage of the 2006 Massachusetts health reform law which Gov. Mitt Romney signed and now hopes everyone forgets.
Governor Patrick is certain to hope everyone remembers his signature on this law, a measure he hopes will "crack the code" on controlling rising health care costs and provide a model for other states to follow. More importantly, he hopes that positive coverage of this law will help bolster confidence in the Massachusetts reform process and, by extension, the Affordable Care Act/ObamaCare. The new Massachusetts law may or may not help, and it certainly won't hurt.
And will it do any good?
As my dear friend, Dr. Norbert Goldfield, likes to say: "Implementation is everything." Everything, once legislative passage is done. Meaning -- this law may succeed or fail, and the reason for success or failure will rely on legislative and administrative commitment to full and effective implementation. Not an easy chore. Don't blame the law -- blame the people in charge of making sure it works.
Consider, for a key example, the new macro limit on the rise in state health care costs. The new standard: health care costs shall not rise by more than the increase in the gross state product. The requirement does not have any effective enforcement provision tied to it. So when costs increase beyond that level, and they most surely will, we will need to rely on the political will of the then-Governor (not Deval Patrick) and the then-legislature to act. Times change and moods change. Maybe they will and maybe they won't.
But unlike the current legislature, they will have been handed the mandate and the mission to act. And we'll all be watching.
Meanwhile, congratulations are in order to the House leaders, especially House Health Care Financing Chair Steve Walsh (D-Lynn) and Speaker Bob DeLeo for sticking to their guns on the tighter spending control target; and congrats to Senate President Therese Murray and Senate Health Finance Chair Dick Moore for their many smart and thoughtful contributions to this lengthy debate.
Special congrats are in order to legislative leaders for the inclusion of $60 million in funding over four years for public health and community based prevention. And kudos to the public health community for their determined advocacy to achieve this advance. If there is a health cost control version 4, it will most certainly focus on prevention, wellness, and public health. There could have been a lot more added to this version along these lines -- though this is a notable start.
Kudos also to Health Care For All and the Greater Boston Interfaith Organization for their determined efforts to bring a serious and committed consumer voice to this often arcane and impenetrable public policy process.
It's been a long process from Gov. Patrick's submission of legislation in February 2011 to yesterday's passage. This is a significant milestone -- the first state in the nation's history to set a statewide healthcare spending target. It may fail spectacularly, and it may even achieve real success.
At least Massachusetts leaders are trying; and that's more than can be said for just about any other state -- with the exception of those folks up in Vermont who are really trying to set the world on fire.
More to come.
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