By Sarah Birnbaum | Tuesday, April 26, 2011
Apr. 26, 2011
BOSTON — The Massachusetts House is one day into its deliberations on a controversial budget would give cities and towns the ability to change employee health plans without union approval.
On Tuesday, union officials milled about the State House hallways, wearing buttons that said "collective bargaining = affordable health care." They passed out leaflets to House members as they entered a closed-door caucus to talk about the budget.
AFL-CIO president Bob Haynes says unions are working to avoid the kind of measure that stripped their counterparts in Wisconsin of their bargaining rights.
“All these public sector unions want to do is be able to negotiate their health care plans. We don’t want to be like Wisconsin. We want to make sure we have the right to be at the bargaining table," Haynes said.
House Speaker Robert Deleo's plan would limit public workers' collective bargaining rights on health care plans. Deleo’s proposal would allow cities and towns to raise health insurance co-payments and deductibles for firefighters, teachers and other local government employees without prior union approval.
Union leaders are gathering support for an amendment that would require some negotiation with unions before health plan changes could be made. About 50 Democrats have signed on so far, including some members of Deleo’s leadership team.
Deleo’s backers argue that municipal workers have some of the most generous health insurance plans in the state, and the costs are unsustainable. They say that employee health care costs are draining local budgets and crowding out funds that could be spent, for education and other municipal services. Debate on the amendment is expected over the next few days.
By Sarah Birnbaum | Wednesday, April 6, 2011
Apr. 6, 2011
BOSTON — Gov. Deval Patrick is renewing a push for lower health care costs. On Tuesday, he convened a State House forum on the issue.
The governor opened the meeting by calling on lawmakers and health care interest groups to rein in the spiraling costs of health care — and to do so quickly.
“We are going to have to solve this problem together. And we have got to stop being defeated by the complexity of it," Patrick said. "Because while we ring our hands about how complicated it is, there are small businesses and working families and working communities going under because premiums keep going up at an unsustainable rate. And you know it.”
Patrick filed a bill back in February that he says will help reduce premiums by changing the way healthcare is paid for. It would move from a fee-for-service system, where every test and procedure is paid for individually, to what’s called “global payment.”
That means doctors and hospitals would be given a yearly budget for the care of their patients, and therefore would have an incentive to keep them healthy and out of the hospitals, and not to order unnecessary tests. Patrick says that if this bill passes, Massachusetts will lead the nation in health-care cost containment.
But Lora Pelligrini is not convinced. She heads the insurance company trade group, the Massachusetts Association of Health Plans.
“The attorney general in her report last march showed us that providers who are globally paid are some of the highest-paid providers in the state. So paying globally isn’t the panacea,” Pelligrini said.
Pelligrini says a bigger problem than the way doctors and hospitals get paid is that large, name-brand hospitals can charge more for care without necessarily delivering higher quality medicine. She says Patrick should focus on ways to curb the negotiating clout of large hospital groups.
The cost-containment debate now moves to the Legislature. A first public hearing on Patrick’s bill is scheduled for May 16.
By Ben Taylor | Tuesday, March 22, 2011
Mar. 23, 2011
By Sarah Birnbaum | Thursday, March 3, 2011
Mar. 3. 2011
BOSTON — Democrats in the Massachusetts House Wednesday defeated a Republican-led effort to set up an independent commission to redraw the state’s political map.
By tradition, law and raw political reality, the party in control of the Legislature also gets to redraw a state’s election map every 10 years.
In Massachusetts, that means that Democrats, who control both houses, are arguably in the position to put some local and congressional seats out of reach for the GOP.
House Republicans proposed a measure that would establish a purportedly independent, non-partisan redistricting commission with members appointed by government officials from both parties. The GOP says that the public would have more confidence in an independent commission that was free of any hint of political influence.
Democrats rejected the proposal in a party-line vote of 121 Democrats to 31 Republicans. They argue it's too late in the process to create a new panel.
House GOP Leader Brad Jones of North Reading says he never expected the measure to pass. Still, he says, it’s important to bring attention to the issue. And now he says, Democrats are on the record, voting down the GOP measure.
“I actually had one member come up to me and said, well, if we had done this maybe two years ago I would have been for it. And I said, well, here’s the roll call from 2 years ago and you voted against it… oh, maybe 3 years ago… it highlights that,” Jones said.
For their part, House Democrats promise a fair and transparent redistricting process, beginning with a dozen public hearings around the states.
And it does seem that no one wants a repeat of what happened in 2000, the last time districts were redrawn, when minority groups successfully sued Massachusetts over the Legislature’s proposed district map. They claimed that the election map discriminated against black and other minority voters in Boston while protecting incumbents such as then-Speaker of the House Thomas Finneran.
By Sarah Birnbaum | Friday, February 18, 2011
Feb. 18, 2011
BOSTON — Massachusetts Governor Deval Patrick is filing a bill Thursday that aims to reduce health care spending by changing the way doctors and hospitals get paid. Most insurers and health care providers reacting to the bill are positive, but cautious.
Patrick's bill would move the state toward a so-called “global payment” system, where doctors and hospitals receive a lump sum per patient, plus bonuses for keeping the patient healthy, instead of getting paid for every office visit, test and procedure. The governor says the change will save money, because there won’t be a financial incentive for doctors to order unnecessary and costly tests.
Blue Cross and Blue Shield, the state’s largest health insurer, is already paying some doctors this way. And Blue Cross CEO Andrew Dreyfus says the system is working.
“Quality is going up, costs are coming down, and I think as those experiences are understood, people are actually going to see – this is a better system,” Dreyfus said.
Dr. Alice Coombs is president of the Massachusetts Medical Society. She says one in five Bay State doctors are already in a global payment system, but she says many other doctors are worried they won’t be able to afford new electronic health records which would be required under the new system.
“They want to know what do I need in order to do this? They need the bells and whistles, the infrastructure, if you will, the electronic medical records and those things… it takes capital to get there," Coombs said.
Health care providers and insurers say the way forward will be complicated. Earlier this week, the state’s largest union representing healthcare workers recommended that changes to the payment system should be made gradually.
Health care advocacy groups, however, have urged lawmakers to act quickly, saying the recession has led to a jump in the number of people struggling to pay health care premiums.
By Sarah Birnbaum | Tuesday, February 15, 2011
Feb. 15, 2011
BOSTON — President Barack Obama unveiled his budget plan yesterday for the upcoming fiscal year. It cuts back or eliminates some 200 federal programs -- and municipal officials in Massachusetts say they'll feel the pain.
The budget is a mixed bag for Bay State, according to UMass Boston economist Christian Weller. He says the budget would preserve or expand funding for education and clean energy. Massachusetts, with its strong academic and tech sectors, could benefit from those investments.
"The good news for Massachusetts is continued spending in innovation, more money in research and development, particularly for renewable energies, more money for education, especially in k-12 and more support in college education," Weller said.
But experts say the budget also contains some bad news for the state: Proposed cutbacks in heating assistance for poor families would disproportionately affect New England, where winters are cold, although some observers say Congress is unlikely to accept the President's proposed $2 billion or more cut in the program.
And Geoff Beckwith, executive director of the Massachusetts Municipal Association, says the president's planned reduction in so-called community development block grants would be particularly painful for Massachusetts cities and towns. Beckwith says the grants fund a wide range of neighborhood improvements, everything from road repairs, to the Boys and Girls club to senior housing.
“So we’re talking about basic human services, leveraging housing, leveraging job creation, economic development projects. These funds are irreplaceable really,” Beckwith said.
President Obama’s budget proposal is just the first move in the Capitol Hill spending debate. Republicans are calling for even steeper cuts.