Massachusetts health policy
"Value" is a dicey word because we each value different things. This is especially true in relation to health insurance. Some people value insurance based on the price of premiums, and some people want to consider the required level of cost sharing in the form of copays, deductible, and coinsurance; some care mostly about choice of provider and others care more about the scope of services covered.
A new report from U.S. News and World Report takes a crack at answering this thorny question by closely evaluating near 6,000 health insurance plans across the U.S. that sell "non-group" coverage to individuals and families. Click here for the summary of the report and click here for access to the full report.
Bless USNWR, they also evaluated the value of plans state by state. We already know that Massachusetts has among the highest health insurance premiums in the nation. Surprise, surprise, though, U.S. News and World Reports concludes that Massachusetts health insurance plans "consistently offered broad coverage and protection against a potential flood of medical bills..."
Here are some more details, including their state by state map:FULL ENTRY
Seems surprising how little electricity has been generated over Question 2 on the November 6th Massachusetts ballot: "Prescribing Medication to End Life." Not too often that a ballot question has such direct life or death consequences.
As the most helpful summary in Secretary of State Bill Galvin's voter guide explains, the proposed law would:
"allow a physician licensed in Massachusetts to prescribe medication, at a terminally ill patient's request, to end that patient's life. To qualify, a patient would have to be an adult resident who (1) is medically determined to be mentally capable of making and communicating health care decisions; (2) has been diagnosed by attending and consulting physicians as having an incurable, irreversible disease that will, within reasonable medical judgment, cause death within six months; and (3) voluntarily expresses a wish to die and has made an informed decision. The proposed law states that the patient would ingest the medicine in order to cause death in a humane and dignified manner."
The bigger the build-up, the harder the fall. So it appears in the world of health information technology (HIT) and electronic health records (EHR).
For about 10 years now, many health policy experts have predicted that health system salvation lay in the universal adoption of HIT/EHR systems that would enable hospitals, physicians, and other medical providers to avoid duplicative tests and use advanced quality information available at their fingertips. If there were such a thing as health system salvation, it was digital. And across the board, health system leaders, public officials, and others accepted the gospel. I was one of them -- more on that below.
2012 will be known, among other things, as the year the bloom fell off the rose.FULL ENTRY
I want to write about John Auerbach, Massachusetts' Commissioner of Public Health who announced his resignation this week in response to the scandal over evidence contamination as the State Crime Lab.
John has been a friend and a colleague of mine since the late 1980s. When I was in the Massachusetts Legislature, I worked with him when he ran the AIDS Bureau in the Mass. Department of Public Health (DPH), during his tenure as the first executive director of the Boston Public Health Commission, and as DPH Commissioner since 2007.
The Crime Lab scandal, precipitated by an employee who allegedly distorted evidence that resulted in false convictions, is a serious and terrible tragedy, one that appears to have caused harm and injustice to innocent persons -- no one knows how many at this point. Gov. Deval Patrick is right to insist that someone has to claim responsibility for this, and John is the logical person, rather than any of his subordinates.
Mitt Romney has ended his self-imposed silence on his signature achievement as Massachusetts Governor -- declaring himself "very proud" of his signing of the Massachusetts Health Reform law (aka: RomneyCare, Chapter 58) in April 2006.
Appearing on Fox News and other outlets, Romney also declared that the Massachusetts Health Reform law is "better" than the Affordable Care Act (aka: ObamaCare).
Reasonable question: which is better? Personally, I am delighted that the two presidential contenders might debate which government-engineered scheme to expand affordable health insurance is better. Let me try and offer my own answer.
Thinking about the health care cost containment law signed by Governor Deval Patrick this past Monday; it's a milestone. Many see it as positive, and some see it as negative. While it's important, equally important will be the implementation effort. Many, myself included, have confidence in the Patrick Administration's commitment to effective implementation, and less confidence in the commitment of the Governor's successor in 2015, whoever that may be.
So is health reform completed, at least legislatively, in Massachusetts? We had three major access/coverage laws in 1988, 1996, and 2006. And we now have had three cost control laws enacted in 2008, 2010, and 2012. What's left to do?
I see full and real health reform as a four-stage process, along these lines:FULL ENTRY
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?FULL ENTRY
Last week, the U.S. House of Representatives held its 33rd vote to repeal all or part of the Affordable Care Act. Prior to the vote, the U.S. House Oversight and Government Reform Committee held a hearing on the proposal, and brought in a panel of five business voices -- four opposed to the ACA and one in support (recruited by the Dems). That sole voice belonged to Dan Wolf founder and CEO of the successful Cape Air company and a MA state senator from the Cape and the Islands.
Senator Wolf did a great job in the lion's den -- judge for yourself. Wolf testified as part of the Alliance for Business Leadership, the new name for the Progressive Business Leaders of Massachusetts, a great and growing voice for business leaders who see things differently.
Kudos to Senator Wolf!
Two of my favorite organizations, Massachusetts Health Quality Partners (MHQP) and Consumer Reports, have teamed up for an innovative new project to help consumers find physicians who best fit their own preferences. Based on a new MHQP survey of over 60,000 adults and parents, and nearly 500 practices, Consumer Reports today is releasing its first ever Patient Experience Ratings of primary care physician groups in Massachusetts.
The good news: according to the report, every Bay State resident lives close to a high-scoring practice, with no region scoring higher than any other.
"The flip side: there are probably some low scoring practices near you, too."
And "nearly every practice has room for improvement."
And while Massachusetts health reform increased the demand for doctors, people who already had providers found no issue getting the needed care.
So what? So Massachusetts residents have a new resource to help choose the best primary care practices. It's a milestone in providing consumers with valid, reliable, and useful health information. Let's hope consumers take advantage of it.
For nearly 20 years, MHQP has been doing meticulous work to make medical care in Massachusetts more transparent in order to improve quality. Teaming up with Consumer Reports, the world's largest product-testing organization, takes their abilities to a new level. Consumer Reports is also producing a special version of the magazine for distribution to its subscribers and newsstands in Massachusetts.
The Physician Ratings Report is now available online at www.mhqp.org. Check out your own physician practice to see how they rank.
(Research assistant: Gideon Duke-Cohan.)
It's a truism in public health that when their job is done well, no one notices. No one notices water that isn't dirty, air that's clean, poisonings that don't occur, diseases and infections that don't emerge.
Well, not always.FULL ENTRY