Patrick At Harvard: Health Care May Be Complex But I’m Done. We’re Moving.


Maybe they decided it was a forum, not a press conference? Or maybe there was a technical glitch?

For some reason, The Forum at Harvard School of Public Health did not read aloud our question for Gov. Patrick — not two other excellent ones from our readers — when he spoke about health care reform yesterday. They had requested questions via email, but ah, well. It’s always fun to hear him say, yet again, with undiminished emphasis, “This is going to happen.” Referring to the next, cost-containing phase of reform, that is. He wanted the health care types who parse his words as if they were reading entrails — as he put it — to know that yes, it’s all still on. Just in case you’re one of those entrail types.

My favorite bit of Gov. Patrick’s talk, which is online here, came about 50 minutes in when he shared a glimpse of what it’s like for him to grapple with the state’s health care forces and the complexity of the system. He said:

“This experience of trying to understand what’s driving health care costs, for a non-medical professional — I mean, I listen well, I’m trying — but for a couple of years, we had all these luminaries around the table, the brightest lights, and I would simply say, ‘How come, in a recession we’re seeing these kinds of increases? And it would always start the same way: ‘Governor, it’s complicated.’

And then they would do this (he crossed his arms and pointed in opposite directions.) The insurers point to the hospitals, they say, ‘It’s because the rates of the hospitals, the costs of the hospitals, are going up, and that’s why your premium went up double digits.’ And the hospitals would say, ‘We haven’t seen any double digit increases in our reimbursements! It’s not us, it’s him! It’s the doctor practices.’ The doctor practices say, ‘It’s not us, it’s the imaging lab down the street!’ Nobody takes any responsibility for it because it’s complicated.

Okay. We could spend the next two years peeling away all that complexity. I’m done. I’m not interested anymore. We’re moving. Something has got to give. Because when we debate the complexity, the point is that the people paying those bills, those families, those small businesses, those cities and towns are seeing those premiums go up. It’s not sustainable.”

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  • Dino

    It looks like the People’s Republic of Mass wants to chase every doctor from its state. When that happens, perhaps the governor can put on a white coat, grab a stethoscope and treat the people himself. Its all for the ‘common good’. It didn’t work in Russia. It doesn’t work in Canada or the EU. So, stop trying to create a welfare state.

  • Josh Archambault

    Didn’t take my questions either, but touched on my first one, but glossed over the implications.

    1) If he thinks the experience of Massachusetts will play out in a similar fashion in other states under the federal health care law—when many states start with double digit uninsured rates, less of an employer commitment towards offering insurance, have less medical infrastructure compared to the Commonwealth, are not high income and don’t have the same market regulations (such as guaranteed issue and community ratings) that often spike the cost of insurance when implemented? Is it possible the federal law will be bad for many states?

    2) How much federal stimulus money has helped to offset increasing costs of reform here in Massachusetts? Without the federal money, how much additional state money would have been required?

    3) Medicaid spending is crowding out other public goods in the state budget and enrollment expanded significantly last year. What will happen if the Governor is not able to break the historic cost trend in Medicaid of 5% growth per year and hit his target of a 3.5% reduction which the Governor’s budget plan calls for? If he is wrong, the resulting gap is over $900 million this year.