Massachusetts health bill too hopeful
By JoAnn Fitzpatrick
BOSTON ― Massachusetts lawmakers boast that their newly enacted health-care-cost control plan will be a national model. But it is based more on hope than practicality.
The attention to cost control comes six years after the state's universal health-care law was passed. In that ancient, bipartisan hour, Mitt Romney smiled alongside Ted Kennedy as both cheered the achievement. Now Romney disparages Obamacare, which is based on the Bay State law, every chance he gets, and Kennedy is not around to support it.
It's hard to imagine the new Massachusetts initiative as a blueprint for America. Its purpose ― cutting the annual growth in health-care costs by half ― is noble, but securing the $200 billion in savings projected over 15 years would be miraculous.
It supports better health initiatives that are key to slashing costs, but these would require a wholesale shift in provider and consumer attitudes and habits. The main thing is to keep people out of the hospital and away from unneeded tests. Hospital overhead ― especially in Massachusetts, where it's among the nation's highest ― and new technology drive up costs.
What's most needed across America is more community-based care and better primary care. The new law helps smaller, less-expensive community hospitals with a surcharge on insurers, and companies that offer wellness programs will get a tax break.
There is $15 million set aside each year for the next four years to provide grants for community-based prevention and wellness programs. And the law mandates a "cooling-off period" for negotiation designed to reduce the costly medical malpractice suits that often lead doctors to prescribe those expensive tests.
So, the carrots are in place but there are no sticks. The law has no mechanism for punishing doctors and hospitals that fail to meet the financial targets. Despite that, a new commission, sure to include many highly paid bureaucrats, will be created to monitor the cost-control effort.
Massachusetts loves its reputation for first-rate health care. To prove it, it seems that every year new hospital buildings appear on the Boston skyline. Changing that culture ― and dislodging the Bay State from its ranking as one of the places with among the highest medical costs ― will take a lot more than this new law.
JoAnn Fitzpatrick is a Boston-based writer and former editorial-page editor of The (Quincy) Patriot Ledger.