…than I can on choosing a hospital to go to. While I can turn to consumer guides for purchases of anything but healthcare, patients and purchasers are left in the dark when it comes to important details about the quality of care in hospitals. A case in point is hospital acquired healthcare infections.

Hospital-acquired infections represent a direct threat to patient safety and health care quality. When SEIU 1199 analyzed 2005 discharge data for Massachusetts’s hospitals, we found that nearly 8 out of every 100 inpatients may have acquired an infection while in the hospital. We also found that the mortality rate among inpatients with a possible hospital acquired infection was 8.8%, compared to a mortality rate of 1.6% among inpatients without an infection. In 2005 alone, possible MA hospital acquired infections were associated with an additional 4,619 deaths.

Hospital acquired infections are life threatening, but they are also very costly. Read more…

Last week, the Patrick administration and the Connector Board shared the news that 300,000 residents now have health insurance, and these numbers are still climbing week by week.

And as we conclude the first full year of our efforts to provide health insurance coverage to nearly all Massachusetts residents, this administration, members of the business community, healthcare advocates, and providers remain committed to our approach of shared responsibility.

As a longtime healthcare advocate, I remain firmly committed to the true spirit of the law, which is ensuring that individuals are only asked to purchase insurance if it is affordable. The law recognizes that at rates of 10-12% medical inflation each year, individuals are uninsured in Massachusetts simply because they can’t afford it.

Massachusetts has made incredible progress by providing affordable, comprehensive coverage this first year, and we have some very valuable lessons to share with our fellow states on the verge of healthcare reform and the nation:

Lesson #1: Most states don’t know how many residents are uninsured. Massachusetts is no different. Read more…

The increasing cost of providing care to the uninsured is making health industry and health reform insiders nervous. Some suggest that they want to “control costs” by increasing insurance costs for the working poor. For them, cost shifting to the backs of the working poor and uninsured may give them more control, but it certainly does not constitute cutting the cost of health reform. Here are two current examples of Connector doublespeak on cost containment vs. cost shifting:

Example #1: There are more uninsured than the Romney Administration projected. There are more people signing up for CommCare than expected. We might have a cost problem because of this. So, as the Connector Board is preparing to bargain with the insurance plans that are covering this population, we are being asked to prepare for a fight of “cost containment”. Last month, at the Board meeting, hidden in a slide show were bullets that mentioned the possibility of higher premiums, co-pays or cuts in benefits. While expecting people to pay higher premiums or limiting some benefits is controlling costs for the state (who strongly subsidizes CommCare), it is also shifting costs to consumers who sign up for CommCare. The cost problem of an increased number of uninsured cannot just be shifted onto those least able to pay.

Example #2: Everyone agrees that in today’s medicine, prescription drugs are an essential part of treatment for many diseases. Read more…

It’s September and that means it’s back to school for millions of children, and back to session for our Congress. There isn’t a healthcare advocate that I know who doesn’t realize that this session of Congress holds the healthcare and future welfare of almost 9 million children in their hands. It is a deeply disturbing fact that in this country, with all it’s wealth and innovation, we have children without access to consistent and comprehensive healthcare.

Many states have extended coverage to school-aged children through the States Children’s Health Insurance Program (S-CHIP). Yet there still are too many working families living in poverty or near poverty who can not afford health coverage.

Masschusetts is a state that has made covering kids a priority. But without a full appropriation of $50 billion, roughly 14,000 children in the Bay State will lose that coverage. Some of them were just covered by our health reform expansion, and now they are again in health insurance jeopardy. These are children living in families who earn between 250 – 300% FPL.

Without this funding for S-CHIP, chances are their parents will be in health insurance jeopardy as well. Read more…

We all make assumptions, and the soundest assumptions help us move forward when forging a brand new path. They are temporary beacons and light the way for a very short distance. So, here are a few lessons learned by the Connector board Read more…

As a member of the Connector Board, and as a member of the ACT!! Coalition, it has always stunned me to look out at the room of people who are interested in reform.

From the Blue Cross Blue Shield “Roadmap to Coverage” forums, to the regular attendees of Connector Board meetings, to the composition of the Connector Board and staff itself, the visual of healthcare policy in Massachusetts is a sea of white faces with an occasional face of color visible. I should add I am one of those white faces myself. Over the past six months, the Connector board has addressed minimum creditable coverage, affordability levels, consumer choice and a slew of other meaty issues. But we haven’t addressed the topic of racial and ethnic disparities. And with the exception of our new Governor and the head of EOHHS, Dr. Judy Ann Bigby, there is little input to how we should change, manage or improve our decisions that have helped us understand potential disparities we’ve built into our system of access. Read more…

As recently reported by Alice Dembner in The Boston Globe, the Commonwealth needs to focus its attention on collecting business penalties from corporations who do not currently offer affordable health insurance to their employees.

The good news is that over 70% of Massachusetts residents get their coverage from employer sponsored health plans. The bad news: There are still several hundred thousand workers and their families that remain uninsured today.

The top dozen employers who employ more than 50 people and fail to cover a large part of their workforce are shocking. Read more…

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for most voluntarily established pension and health plans in private industry to provide protection for individuals in these plans. What began as a law to provide minimum standards and protections for private benefit plans has become a major obstacle to health insurance reform.

A state can mandate an individual to buy health insurance, but it can’t mandate a business to provide insurance, because of ERISA. Read more…

We are entering the most important phase of our work on healthcare reform this week. The Connector board will define what’s affordable for working families and who will be required to buy health insurance. Consider the obvious and often reported facts we all know well: we have the third highest housing costs in the nation; the real value of the minimum wage is equivalent to what it was roughly 30 years ago; and we have sporadic job growth. And the number of uninsured is growing throughout the nation.

Determining what’s affordable for the hard working families I know is enough to make my blood pressure rise. Regardless of what economists speculate, health care workers that I talk to are not sitting around with much cash in their pockets! Read more…

Many of us working on the implementation of health insurance expansion know that several things must happen for this law to result in universal participation. Read more…