Mr. Suissa,
I am the research director of Health Care For All, a Boston-based advocacy organization working on health policy in Massachusetts. The Jewish community was deeply involved in supporting health reform in Massachusetts. The JCRC along with a broad coalition of synagogues were active participants in the campaign. As a result of his experiences in the Massachusetts health care campaign, Rabbi Jonah Pesner left Boston's largest temple to form "Just Congregations," a Reform project to teach synagogues how to get involved in public policy campaigns.
I was surprised to see you reprinted verbatim material from an opinion column in the Boston Herald, our tabloid newspaper. The writer, Michael Graham, is a far-right radio talk show host. Graham, a former campaign staffer for Pat Buchanan, has been repeatedly reprimanded or fired for violating the standards of conservative talk radio, if that's possible. Even Glen Beck criticized Graham's inflammatory statements as going too far.
Contrary to Graham's column, we think Massachusetts health reform has been a remarkable success, and this points to the likelihood that national reform will also expand affordable health coverage. Over 97% of the state's residents have health coverage. The proportion getting preventive care has increased, and the percent of people skipping needed treatments due to the cost is down. The most recent survey found 69% of state resident support the reform law. Employers, hospitals, doctors and advocacy groups like ours are all in support.
The points made by Graham are either false or misleading. Let me try to correct the record.
1. Exploding the budget - false. The best impartial referee of this charge is the non-partisan, business-backed Mass Taxpayers Foundation. They are a right-of-center policy institute aimed at controlling government spending. They reviewed Massachusetts health care reform and concluded that the costs were "modest and consistent with projections." The study is here: http://masstaxpayers.org/publications/health_care/20090501/massachusetts_health_reform_the_myth_uncontrollable_costs
2. Costs of health care - misleading. Graham is right that Massachusetts has the highest health care costs in the country. We had the highest costs before reform, too. Part of this is due to the fact that everything is more expensive in Massachusetts. Compared to median state income, Massachusetts is 41st in health care costs. Other factors are that insurance plans here are much more comprehensive than in other states, and the high number of brand-name teaching hospitals in Boston, which command higher rates.
The key point is that the 2006 reform law was not aimed at controlling costs. The goal of the law was to expand coverage, which has been an unquestioned success. So first, the reform is not responsible for the high costs of Massachusetts health care, and second, the goal of the law was not focused on costs. However, since 2006 the state has been focused on costs in a serious way - see below.
3. "Capitation" - misleading. Recognizing that the initial bill did not deal directly with costs, state policymakers set up a process to find innovative ways to improve care and bring down the costs of coverage. A panel of stakeholders, including business, experts, providers and state leaders, have proposed moving away from the current "fee-for-service" payment restructure, by which hospitals profit by doing more and more procedures, regardless of medical value, to a system that rewards health and wellness. The system is called "global payments," and is different from the capitation systems of the 1990s. As a consumer group, we strongly support global payments as way of controlling costs, prioritizing primary care and prevention, and building accountability to the patient. Graham's charges are wrong, and all experts would dispute his description of what is being proposed here.
4. Drop in coverage - wrong. Before health reform, the best estimates was that Massachusetts had about 9%-11% of the population uninsured. The current rate is 2.7% - close to universal coverage.
For us, it's been sad that our state's health reform law, which was championed by both Mitt Romney and Ted Kennedy, and was truly a middle-of-the-road incremental approach, has been distorted by opponents of Obama. We were able to build a bi-partisan consensus here, and a very similar policy being proposed in DC is now savaged as something radical.
Brian Rosman
Research Director
Health Care For All
www.hcfama.org
rosman@hcfama.org
(617) 275-2920
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