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Patrick urges action on health bill

Governor wants his cost curbs to be passed soon

By Liz Kowalczyk
Globe Staff / April 6, 2011

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Governor Deval Patrick, hoping to propel his proposal to curb medical costs, urged lawmakers and the health care industry yesterday to stop “wringing hands about how complex this is’’ and move quickly to pass legislation to change how doctors and hospitals are paid.

“This is not an option,’’ he told several hundred people gathered at a State House forum where top administration officials discussed health care costs. “We are not going to debate this to death.’’

Patrick, who proposed legislation in February that he said would control soaring costs, is clearly growing impatient and wants to keep the heat on the Legislature, which is not planning to begin hearings on the bill until next month at the earliest.

Legislative leaders have said it could take one to two years to analyze the governor’s plan, negotiate changes, and pass legislation that would improve care for patients while reducing wasteful and duplicative medical care.

“It’s got to come sooner than that,’’ Patrick said during a press conference after his formal remarks. The governor has said he wants legislation passed this summer.

House Speaker Robert A. DeLeo and other legislative leaders “don’t have to answer to me,’’ Patrick continued. “They have to answer to’’ people and businesses that pay premiums, he said.

Even before lawmakers debate the substance of the governor’s proposal, the administration and the Legislature are miles apart on timing.

“This is going to turn the [health care] system upside-down,’’ said Representative Ronald Mariano, a Quincy Democrat, who has predicted that the Legislature will not be ready to act until next spring. “There are tons of questions.’’

The governor’s 52-page bill would give him authority to scrutinize insurers’ contracts with, and fees paid to, hospitals and doctors and consider whether those fees are appropriate before approving insurers’ requests for premium increases.

The proposal also affirms the administration’s plans to shift 1.7 million state employees, Medicaid recipients, and other residents with state-subsidized health insurance, who are 1 in 4 residents, to a new health care payment system, in which hospitals and doctors would be given a set budget for each patient’s care.

This would largely replace the fee-for-service system, in which doctors and hospitals get paid for each procedure, treatment, and appointment, a system that many believe encourages unnecessary and disorganized care.

The legislation also encourages the private insurance market to adopt new ways of reimbursing providers.

Mariano said in an interview that legislators do not want a repeat of the 1990s, when insurers also put doctors on a budget to treat patients, under a so-called capitation system.

Consumers widely felt then that doctors were denying them care to stay within their budgets and not lose money, Mariano said.

The governor is focused on reducing health insurance costs for small businesses, Mariano said, “but what is this going to do to the consumer?’’

Health Care for All, a Boston-based consumer advocacy group, and the Greater Boston Interfaith Organization announced after the forum that they will put pressure on insurers and hospitals to cut costs by trying to hold them publicly to minimal premium increases.

Based on discussions with economists and the health care industry, the groups said they will announce a maximum premium increase that insurers should not exceed when setting 2012 rates and try to persuade insurers to agree voluntarily.

“This is an unprecedented step by consumers,’’ said the Rev. Hurmon Hamilton, president of the organization. “We have stood on the sideline for too long.’’

Liz Kowalczyk can be reached at kowalczyk@globe.com.