June 5, 2012
STATE HOUSE, BOSTON — The Massachusetts House of Representatives is set to debate a bill to contain health care costs after the Senate passed a similar measure last month. But health care experts are divided over whether the plan will actually bring costs down.
When the Massachusetts Legislature passed a near-universal health coverage law in 2006, it decided to extend health care coverage to hundreds of thousands of people first, and confront the rising costs of health care later. Now the time has come.
The measure would overhaul how doctors, hospitals and other providers get paid. It would provide some incentives to move toward so called “global payments” in which doctors and hospitals would get a yearly budget for the care of their patients – supporters say the system will provide incentives to keep patients healthy and out of the hospitals, while discouraging unnecessary tests and procedures.
A more controversial part is the bill would set a target for future health care cost increases, which would mean doctors, hospitals and insurers would need to figure out how to charge or spend a lot less. And the bill only vaguely defines enforcement measures regulators could take.
Amy Whitcomb Slemmer of the group Health Care for All, which lobbied heavily for the bill, said she’s optimistic the legislature's approach will work: “I think having a board with experts, an expert panel guiding it, making some of the nuts-and-bolts decisions that have to be made. I’m confident that we’ll be able to take steps forward.”
But prominent health policy experts have serious concerns. Harvard University’s John McDonough, who worked on the 2006 coverage expansion, said the new bill lacks teeth. Hospital and business groups, meanwhile, have been putting pressure on the Legislature to weaken penalties and enforcement language. The House begins debate on its version of the bill on Tuesday.