Volume 18, No. 2, Spring 2010
By Senator Rob O’Leary
The recent passage of federal healthcare reform represents enormous opportunities for Massachusetts residents to have even better access to care and to resources.
With the monumental 2006 Health Care Reform already in place, Massachusetts is poised to receive hundreds of millions of federal dollars in reimbursements for FMAP, CHIP, and people already using our Commonwealth Connector program. This will help families, children, seniors on Medicare, and the average consumer by reducing out of pocket expenses and focusing on preventive care instead of the fee-for-service structure that currently exists.
I applaud the passage of the federal bill. Despite its gradual implementation, it represents a most important first step at tackling one of the largest budget and moral issues of our generation. But people need to keep in mind that, like the landmark 2006 Massachusetts bill, there is room for improvement.
One major issue that remains both in Massachusetts and on the national level is medical malpractice reform. I was disheartened to learn that Congress would not be tackling a problem that represents hundreds of millions of dollars of wasted money. With the lack of a solution on the national level, I intend to push the legislation I filed this session to address this problem.
The current adversarial malpractice system in Massachusetts stands in the way of efforts to improve patient safety, retain quality physicians and cut high medical costs.
My Senate Bill 573, An Act Providing for a Fair Judgment Interest Rate for Medical Malpractice Actions, will help to improve the status quo by lowering the cost of medical malpractice lawsuits. Between 1992 and 2005, the cost of professional liability insurance to Massachusetts physicians rose by 132 percent to become one of the major factors in the decreasing numbers of licensed physicians in the Commonwealth.
This is particularly true in the specialties of obstetrics, radiology and neurosurgery. In addition, physicians wary of financially and emotionally draining litigation increasingly limited their areas of practice and practiced more and more expensive “defensive medicine.”
Malpractice insurance premiums have momentarily stabilized, but they remain at unacceptably high levels, mainly because of the sheer size of final settlements.
One little-known factor in the high costs of these settlements is the artificially high interest rates tacked on to the amount for the entire period that the case was pending through the date a verdict was rendered or a final order made.
This can encourage attorneys for the plaintiff to extend the trial as long as possible, while attorneys for the defense advise their clients to settle quickly, even in cases of innocence.
My legislation to rein in these interest rates will save money, increase patient safety and ensure a reliable insurance structure for doctors. It must be included in future deliberations. Added to the national reform package, it will keep Massachusetts in the forefront of true healthcare reform.
(Senator O’Leary, D-Cummaquid, represents the Mid and Lower Cape and Islands and is a member of the Legislature’s Joint Public Health Committee.)
By Senate President Therese Murray
Healthcare costs are the No. 1 issue facing our economy and the urgency to bring down costs is greater than ever. Here in Massachusetts, spending on healthcare is 15 percent higher than in the rest of the nation.
In March, I spoke at the first annual public hearing on healthcare costs, mandated by legislation I passed two years ago this month, along with Senator Richard Moore (D-Uxbridge).
When Senator Moore and I introduced this comprehensive legislation, we stressed that controlling cost increases was essential to our long-term economic growth and the sustainability of our healthcare reform model. This will be our time to take action and bring relief to families and small businesses while also setting course for long-term payment reform.
Healthcare spending has reached a level where annual increases of three or four percentage points higher than the state’s economic growth will continue to inhibit employers’ abilities. This high spending also will harm job creation and the ability of state and local government to maintain other essential services. These costs squeeze state finances and make it increasingly difficult for young people, families and businesses large and small to make ends meet.
A key piece of this legislation was a requirement that the Attorney General and the Division of Healthcare Finance and Policy hold annual public hearings to examine healthcare cost-drivers and hold insurers and providers accountable for increases. These hearings will help illuminate the rising costs, identify what all parties can do to slow cost growth, and give health policy experts, consumers, doctors and others the chance to provide input.
These hearings are designed for other voices–consumers, business people, doctors, hospital administrators, insurance company representatives and health policy experts–to offer information and recommend solutions. These hearings are truly unprecedented in both scope and depth, and reflect our shared commitment to thoughtfully addressing this complicated issue.
Our state’s landmark Healthcare Reform Act of 2006 was step one. As a result, more than 97 percent of Massachusetts residents now have healthcare. Step two is Chapter 305, a Massachusetts healthcare cost-containment law, signed in 2008, which attacks costs on several fronts and mandates the hearings. This is essential to making sure that healthcare in the Commonwealth continues to move forward.
We must act quickly and decisively to make the solutions a reality – free from bureaucratic red tape and complete with the knowledge and wisdom of the people who work daily in the healthcare field and those most affected by the hardships of increasing costs.
(Senator Murray, D-Plymouth/Upper Cape, is the first female President of the Senate in Massachusetts history.)By Representative Cleon H. Turner
The pros and cons of the new Federal Health Care Plan are difficult to determine this soon after passage because it addresses so many issues. In addition, although there has been a lot of media discussion touching various elements, those of us who were not involved in its drafting and redrafting have had no real opportunity to closely examine the contents of the bill.
It can safely be said that the initial intent of the legislation, to provide health care coverage to as many Americans as possible, will likely be met. The question remains as to whether that coverage will be affordable and comprehensive.
Many have compared this bill to legislation passed in Massachusetts. Well, in my view, mistakes were made in the Massachusetts plan that have yet to be corrected and those same mistakes seem to have been made in the federal plan.
The major mistakes include failing to have the insurance companies create coverage plans before the bill was passed so that consumers would know both the cost and extent of coverage. In Massachusetts, that failure has led many people who were covered before into plans that cost more and provide less coverage. Another mistake was not mandating a level of coverage for specific costs. In other words, the profits of insurance companies will not be limited to keep the costs down. Without limiting profits, the cost of coverage can go out of control quickly.
While I can applaud Massachusetts for covering many more people and the goal of the federal plan to do the same, both plans lack significant detail to ensure success.
The promise in Massachusetts was that we knew there would be a need for revision. Yet, even now, no revisions have been forthcoming. I suspect that the federal plan will suffer a similar fate.
That’s because legislators fear that if you open up the package for revision, you never know what else will get thrown in.
Only time will tell whether the new federal plan will cover more people with quality coverage at an affordable price.
(Representative Turner, D-Brewster/Dennis/Yarmouth, is a member of the Legislature’s Joint Public Health Committee.)