When people talk about health reform it’s often shorthand for covering the uninsured. But improving access without tackling costs is a recipe for a fiscal crackup.
Just take a look at Massachusetts, a pioneer in universal coverage, where the cost of medical care is growing at more than 8 percent a year. Ballooning subsidies for coverage of the poor are one problem. Another is heavy use of high-priced hospital care.
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The Boston Globe reports on the recommendations of a state commission to pay doctors and hospitals a set amount for each person’s care for a year. (Read the report here.)
Some might call it capitation redux. The payment approach, once popular with managed care, aims to curb incentives for doctors and hospitals to do more to get paid more. Previous attempts at capitation were too stingy and inflexible and remain worries this time around, critics say.
On the national front, the cost of health reform is moving to the fore, galvanizing opposition to the plans advanced in Congress. The Washington Post reports that the head of the Congressional Budget Office “delivered a devastating assessment” of the fiscal consequences of the proposals because they don’t do enough contain the fast-growing costs of government health programs.
AP Medical Writer Carla K. Johnson takes a look at health care reform in Massachusetts and Tennessee and how the coverage plans in those states can inform Congress’ approach to a nationwide expansion of health coverage.
In Massachusetts, Johnson reports, folks adopted a coverage first, cost second approach, with the assumption that once universal coverage was in place, it would be easier to use that leverage to pare down costs.
The Tennessee method, on the other hand, was to provide a limited, cautious program at first with the understanding that it would be gradually expanded if possible.
Ten journalists were named to the 2009 class of the Health Coverage Fellowship sponsored by the Blue Cross Blue Shield of Massachusetts Foundation.
Fellows include: Jennifer Berryman, WCVB-Boston, Ceci Connolly, The Washington Post; Andy Dworkin, The Oregonian; Latoyia Edwards, New England Cable News; Megan Hall, WRNI-Radio, Providence, R.I.; Josie Huang, Maine Public Broadcasting; Ralph Jimenez, Concord (N.H.) Monitor; Aaron Nicodemus, Worcester, Mass., Telegram & Gazette; Sacha Pfeiffer, WBUR-Radio, Boston; and Lisa Wangsness, The Boston Globe.
The fellows will focus on health care issues ranging from uninsured to mental illness, ethnic and economic disparities and environmental health. They’ll also examine public health scares, such as avian flu.
The program, led by former Globe reporter Larry Tye, runs for nine days starting Friday at Babson College’s Center for Executive Education in Wellesley. Other supporting organizations include Maine Health Access Foundation, New Hampshire’s Endowment for Health and the Northwest Health Foundation.
Liz Kowalczyk of The Boston Globe reports that a new Massachusetts law restricting contact between doctors and pharmaceutical companies is threatening Boston’s medical convention industry, which makes up 40 percent of the city’s total convention traffic and contributes tens of millions of dollars to the local economy.
Kowalczyk reports that the law – which will be implemented within the next two months – allows drug companies to continue sponsoring such conventions, but prevents them from paying doctors to attend or from paying for doctors’ travel and lodging. The law allows representatives from pharmaceutical companies to present talks at such conventions, but requires that they give objective presentations that are more than mere advertisements for their products. Additionally, such presentations will no longer qualify for the continuing education Massachusetts doctors need to keep their licenses, Kowalczyk said.
Two organizations have already canceled their 2015 conventions, Kowalczyk said, and more are considering following suit. According to one of those organizations, the American Society of Gene Therapy, the new regulations will “cripple the content and quality” of their conventions.
In a blogged response to the Globe‘s story, author and journalist Alison Bass observes that the convention cancellations may be intended by major pharmaceutical companies as a threat aimed at the state of Massachusetts and its new regulations.
“What the article neglected to mention was that all three of the medical societies named in the article – The American Academy of Allergy, Asthma and Immunology, the American Society of Gene Therapy and the Heart
Rhythm Society – have received major funding from the pharmaceutical and medical device industry over the years,” Bass said.