Volume 17, No. 4, Fall 2009
By Senate President Therese Murray
Double-digit growth in healthcare costs imperils not only our landmark state reform effort, but also the ability of government, businesses, and families to afford quality insurance.
With that in mind, last year, I introduced a comprehensive bill to begin to address this problem. Reflecting the urgency of the crisis, the bill—Special Commission on Health Payment Reform, now known as Chapter 305 of the Acts of 2008—was passed by the House and Senate and laid before the Governor within five months of its initial introduction.
The law contains four principles that the state should pursue to bend the curve on double-digit growth in healthcare premiums.
We need to:
As the Commission began work, I encouraged them to remember the lessons of the original healthcare reform bill. Once it was thought that no one state could act alone to greatly expand access to affordable healthcare. Today, more than 350,000 additional residents enjoy quality health insurance and Massachusetts has the lowest uninsured rate in the country.
In 2006, a coalition of government leaders, health providers, health insurers, and the business community united to pass that landmark bill. Now we face a different and more difficult challenge—to form a new coalition to create a new delivery system that is more efficient, more transparent, more accountable, and delivers higher quality care to the all citizens of the Commonwealth.
(Senator Murray, D-Plymouth/Upper Cape, is the first female President of the Senate in Massachusetts history.) By Senator Rob O’Leary
“And this is the cause of my life, new hope that we will break the old gridlock and guarantee that every American—north, south, east, west, young, old –will have decent, quality health care as a fundamental right and not a privilege.”
These were the words spoken by our Senator Edward M. Kennedy at the Democratic National Convention in 2008. When he passed away in August, he left a legacy of a man committed to bettering the lives of the people of Massachusetts and the entire nation. Since Massachusetts was the first state in the nation to successfully pass universal healthcare legislation, it is only fitting that the senior Senator from Massachusetts led the fight on this issue.
At this writing it is impossible to know the final form any healthcare bill will take, but there is satisfaction in knowing that our own universal health plan was used as a model for many of the plans that were presented and helped set the standard for any final national legislation.
Some of the major items that I’d hoped to see adopted nationally directly mirror reforms from Massachusetts’ landmark universal health care plan signed into law in 2006. We have helped people who already have insurance get better care by increasing who has to accept patients on MassHealth. We have also greatly expanded the number of people covered by offering a public health insurance option. Since 2006, Massachusetts has insured an additional 430,000 people and the population of uninsured people has dropped to 2.6 percent. That means almost 97 percent of Massachusetts residents have insurance versus 85 percent nationally.
Massachusetts is also going after the costs associated with health care in a new wave of reforms here on Beacon Hill. I have filed legislation that seeks to lower the cost of medical malpractice lawsuits because the current adversarial malpractice system in Massachusetts stands in the way of necessary efforts to improve patient safety, retain quality physicians and cut high medical costs. I expect other reforms such as “fee-for services” to be addressed and we have passed legislation aimed at streamlining the use of electronic medical records, allowing doctors better and more current access to a patient’s health history while saving money in the process.
Massachusetts is being used an example in the national debate. While I believe we have achieved great success, many have tried to paint our universal coverage as a fiscal nightmare costing millions more than we ever anticipated. This simply is not true. Massachusetts began implementing universal care in fiscal year 2008 and the state’s final overall spending was $628 million. In this past budget for fiscal year 2010, the final budget number was $724 million with an additional $40 million added back in for legal immigrant health care. This is hardly an astronomical increase, especially coming in the face of the greatest economic crisis in recent history.
A recent poll conducted by the Harvard School of Public Health showed that over half the people in Massachusetts continue to support the healthcare legislation.
(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 Representative Cleon H. Turner
Massachusetts students who suffer from diabetes and cystic fibrosis currently are legally allowed to carry and self-administer their personal medications as often as necessary.
Except for students who experience severe allergic reactions. They do not have the same easy access to their epinephrine dispensers, also known as EpiPens.
Epinephrine keeps airways open during an allergic attack and allows normal breathing until emergency medical assistance is available. But the drug must be administered within a very short time after exposure.
In Massachusetts schools today, EpiPens must be secured under locked storage while children with allergies attend school. When a child suddenly undergoes an allergic reaction, a delay in medication is inevitable while the EpiPens are retrieved. For some severely allergic children this can mean the difference between life and death.
It is a risk we can no longer take. House Bill 2077, an act relative to access to epinephrine in schools, will help to eliminate this problem.
The bill allows epinephrine to be added to the list of medications students can self-administer. Specifically it will require that epinephrine must be stored in a secure but unlocked place, easily accessible to students with life-threatening allergies. Critically, epinephrine must be kept in multiple locations where students are most at risk, such as classrooms and lunchrooms.
Students will be able to take and self-administer epinephrine as needed during an allergic reaction. If a student is in no condition to self administer, teachers and staff will have ready access to the EpiPens.
This legislation has been proposed in the past without reaching a vote on the House floor. Currently the bill is before the Public Health Committee on which I serve and received a hearing September 15. I am hopeful the committee and the Legislature as a whole will see the common sense need for this bill and pass it before a child dies needlessly.
(Representative Turner, D-Dennis, is a member of the Legislature’s Joint Public Health Committee.)
As of our deadline, the Cape Care Coalition was preparing for hearings on Beacon Hill before the Joint Committee on Health Care Finance. This was expected to be the crucial forum for the Cape Care Community Health Trust bill, HB4138, which has establishment of a community-owned public corporation as its core. At the same time, important recent proposals for healthcare delivery and payment reform from the high-level state Special Commission were very much in synchrony with the community health system proposed in the Draft Model Plan, which is available, along with the legislation, at www.capecare.info.