Senate Republicans are railing against the rising costs of the state’s health care law during floor debate this afternoon. Click here if you want to watch it live. The bill before the Senate is the health care cost containment measure filed by President Therese Murray. But the minority party is taking the opportunity to point out that the cost of Commonwealth Care continues to rise beyond estimates and consume money that some lawmakers would like to spend in other areas. If you haven’t heard it yet…Republicans are asking if the health coverage law is the state’s next Big Dig.

Senate Democrats say the law is a victim of its own success as enrollment rises faster than expected.

There is a lot of talk lately about whether all the parties that agreed to support the state’s health coverage law are doing their fair share. This is an update on the employers’ share; in particular, the penalty that some employers who don’t offer coverage must pay.

You might remember that the state requires companies with 11 or more workers to make a “fair and reasonable contribution(pg 3)” to employee health coverage. The legislature initially expected to raise 48 million dollars in fines. That estimated was revised (down) several times. The first round of fines collected late last year raised 5 million. As of late March, the total was up to 6.6 million. Here’s the second notice and a sample bill the state sent last month to 4, 582 companies that have still not submitted information about their insurance coverage.

Business groups say employers are doing more than their fair share by adding more than 111,000 new workers in company health plans in 2007. They say that many employers who don’t offer coverage can’t afford to do so and that now is not the time to increase business costs.

Last week in this forum Dr. David Torchiana of the Massachusetts General Physicians Organization offered both support and caution regarding some of the elements of Senate President Therese Murray’s proposed health care legislation. As the discussion begins this week at the State House on S.B. 2526, I join Dr. Torchiana in applauding the Senate President and the legislature for their leadership in helping address the complexity of reining in health care costs. But it isn’t only about reining in costs; the other equally important component is maintaining the attributes that contribute to the Commonwealth’s well-deserved reputation for excellence in its providers and health plans. To my thinking, it comes down to this fundamental question, “How do we improve access to high-quality health care while keeping health care costs as affordable as possible?”

As we are all aware, the Health Reform Law has been extremely effective in expanding access to insurance coverage to more residents of the Commonwealth. That’s laudable. However, the soaring costs of health care threaten its long-term success and viability. Read more…

Discussions of health care quality often center on physicians and hospitals, with too little attention to patients and their families. But one local organization, the Dana Farber Cancer Institute, has put patients exactly where they belong in the quality movement: everywhere.

Readers of this blog are likely familiar with the tragic series of errors that led to chemotherapy overdoses at Dana Farber in 1994. What you may be less familiar with is Dana Farber’s exceptional commitment to patient and family-centered care, a commitment which grew even stronger as they worked to ensure those tragedies would never be repeated. Read more…

The Connector is out with a series of new ads it hopes will convince Mass residents who don’t have health insurance to sign up. You can see the print ad here and listen to the radio ad here.

The Connector is trying to boost pressure to enroll by stressing the costs of remaining uninsured. The state is spending roughly a million dollars this Spring to place these ads in papers, on the radio and on buses.

Persuasive?

Yesterday was an important day for health care reform. In an event pulled together by Health Care for All, Governor Patrick, Speaker DiMasi, and Senate President Murray joined with representatives of the business, advocacy, provider and insurer communities to celebrate health care reform’s second birthday. What we have accomplished to date was underscored by compelling comments from Madelyn Rhenisch and Danielle Nickerson – two of the tens of thousands of people for whom the availability of health insurance through Commonwealth Care has meant better health, improved economic security and greater peace of mind. Read more…

The health care legislation introduced last month by Senate President Therese Murray contains some very positive policies that I hope will make their way into law: improving primary care access, testing the concept of a “medical home” and mandating adoption of technology that has been shown to improve quality, safety, and efficiency.

With an additional 300,000 people now insured thanks to the 2006 health care reform law, we need to make sure that their care is effectively managed. The Bank of America and the state have already made an important contribution – financing loan forgiveness programs for new primary care physicians (PCPs) who agree to practice in areas of high need. The Murray bill goes several steps further, authorizing the state’s medical school to increase its primary care class, offering more loan forgiveness, organizing recruitment efforts and dealing with housing affordability. It’s a balanced approach, also increasing loan forgiveness for nurses and expanding the role of nurse practitioners and physician assistants in primary care. Access is one of those problems we have to keep chipping away at to solve and President Murray’s bill knocks off a big chip.

Another creative idea for improving primary care is also in the Murray bill. Read more…

Sherry Glied talks about health insurance mandates is in today’s New England Journal of Medicine.

Here’s the last graph:

Perhaps the most important benefit of mandates is symbolic. By mandating the purchase of health insurance, governments signal to their citizens that coverage is critical. For many uninsured people as well as their families, communities, and elected representatives, this public commitment to coverage may lead to a reassessment of priorities. Although making mandates functional will be demanding, just passing a mandate may serve an important purpose by moving health insurance higher on the agendas of all these constituencies.

Click here to listen to the series on Primary Care doctors. The full one hour documentary will air on Friday at 3 and 8 pm and on Sunday at 8 pm.

In a recent post, Dr. David Himmelstein provides a critique of cost-control ideas being discussed in Massachusetts and elsewhere, and closes with his argument in favor of a single public financing program. Read more…