Item #2 on healthcare agenda
THE COALITION that put together the Massachusetts health reform law met yesterday to celebrate the successes of its first year, and has begun conversations about how to address the next great healthcare challenge in the state: how to control costs. It won't be easy, but the coalition has to stick together to restrain healthcare inflation so that health insurance is affordable for all those who must buy it under the state mandate, which takes effect July 1.
The meeting was put together by the Blue Cross Blue Shield of Massachusetts Foundation, which helped to spearhead the campaign for the new law. Foundation President Nancy Turnbull listed the most important achievement of the first year: insurance coverage for 122,000 people, perhaps a third of the uninsured in the state. They are covered either by Medicaid or by Commonwealth Care, an insurance offering of the Commonwealth Health Insurance Connector, which was established by the law. Many more of the uninsured will sign up once the mandate comes into force.
But there are already anecdotal signs of resistance to the cost of new connector policies, which range in price from zero to $869 a month, depending on benefits, income, age, and location. The law is based on the premise that all residents of the state have a responsibility to get health insurance, but that shouldn't mean they endure annual increases exceeding the general inflation rate.
At the Blue Cross meeting, Senate President Therese Murray said she would be offering proposals to address the cost issue. These include incentives for primary care doctors and nurses to work in the state; an insistence that healthcare providers invest in computer technology; and an increase in the number of immunizations. JudyAnn Bigby, a physician and the new secretary of health and human services, said that patients need to know that several expensive procedures, such as caesarean sections and angioplasties, are overused. Neither Bigby nor Murray, however, provided enough detail to show how the ideas she raised would control costs.
Bigby is the chairwoman of the Quality and Cost Council, established by the reform law. Unlike the connector, the council has not made much of an impact. Governor Deval Patrick only wanted to give it $209,000 next year, but the House wisely raised that to $800,000. The Senate, which will debate the state budget this week, needs to sustain the higher amount so the council can set the agenda for cost containment.
The coalition responsible for the healthcare law includes insurance companies and major hospitals. Controlling costs will impinge on the financial interests of these groups. The council needs the full support of the political leadership of the state to align these powerful forces, and keep the cost down. 