State Rep. Harriett L. Stanley (D-West Newbury), Chair of the Joint Committee on Health Care Financing, says the overarching principles of payment reform are beginning to emerge:

Even this morning, major media coverage was about the progress of national health care legislation. If the Globe and the Times are correct, we’re likely to have two bills – a.k.a. Pelosi 1 and Reid 1 — that can be conferenced in early 2010.

That’s a great way for the nation to start a new decade.

Here at home in Massachusetts, we’ll welcome the new decade a little differently. We’re already ahead of the nation on providing people with health care coverage; now we need to focus on cost containment within the delivery system.

The Health Care Finance Committee has spent the last six months meeting with a wide array of the Massachusetts health care community. We’ve been from Boston to the Berkshires with the goal of identifying the real cost drivers in the state’s health care system.

As of this morning, more than 90 work sessions have been completed. With any luck, we’ll reach 100 by New Year’s Eve.

Those sessions built on last summer’s report by the Special Commission on the Health Care Payment System.

The Special Commission made broad recommendations about cost containment. Since then, we’ve been researching implementation issues. We don’t yet have many answers, but a few themes have emerged:

–Sustain the 2006 health care reform bill. In 2006, Massachusetts opened up access to health insurance by operationalizing the principle of shared responsibility. There was an employer mandate to provide coverage and an individual mandate to purchase coverage. Via the Connector, the state made it easier for both of those things to happen. Today, about 98% of Massachusetts residents have secured health insurance. Government and employers have a responsibility to help maintain the public and private insurance markets.

–Put primary care doctors (and nurses) in charge. Patients probably get the best care from doctors and nurses who know them and are familiar with their medical histories. Emphasizing and paying more for primary care probably means focusing more on what the patient needs, rather than what the delivery system can offer.

–Pay for quality, rather than quantity. Quality care may not always be the most expensive care. The financial power of both government and business has not always been used effectively. Going forward in payment reform, it should be used to promote quality and (on occasion) penalize quantity. Read more…

State Representative Harriet L. Stanley, Chair of the Joint Committee on Health Care Financing, offers her thoughts on the the controversial public health emergency preparedness bill known as the “Pan Flu Bill.” The West Newbury Democrat says her post is adapted from a lecture developed by Professor William Stanhope of the Institute for Biosecurity at Saint Louis University and from a summary by Representative Steven M. Walsh (D-Lynn):

Everyone knows that the Commonwealth is facing unprecedented revenue shortfalls and massive budget cuts are on the way. Yet, somehow that financial anxiety has broadened into a general sense of mistrust that has found its way to the gold dome on Beacon Hill.

On October 8, the Massachusetts House adopted public health emergency preparedness legislation previously known as the “Pan Flu Bill.” The bill had been considered in the last three Legislative sessions. Yet, even with last spring’s swine flu scare and predictions of an early onset in 2009, it did not pass easily. It came with so much controversy and misinformation that it took weeks of internal persuasion and heavy editing in order to pass.

What’s going on here? We know the reality is that a worldwide epidemic is overdue or that the next terrorist attack could contain pathogens. Yet, any real attempt to prepare for a new pandemic or bioterrorist attack is met with resistance. Sometimes completely irrational resistance. We should really learn from history and our past mistakes.

In 1918, an influenza pandemic swept through the United States, known as the “Spanish flu.” It was one of the deadliest pandemic outbreaks of the 20th century, with some 50 to 100 million deaths worldwide.

At the height of the epidemic, two cities took two very different paths and forever changed history. Read more…

As I sit here listening to a webcast of President Obama campaigning for health care reform up north in Portsmouth, I’m surprised by the civility. (Actually, civility bordering on candy-coating.) Then again, this is the President of the United States, who flew in on Air Force One, not an elected official that you come across in the grocery store.

What a difference from the experience that Members of Congress have been having back home and from the comments that arrive in this office each day. You might say that a good part of it is misinformation by mail, electronic or otherwise.

Some of the confusion is genuine, because every version of the proposed legislation is incredibly complex, and bloody few of us even try to keep up with it. (I’ve given up.) People simply want to know if they will be able to keep their insurance and their doctor – or if, under reform, “the government” will assign them a physician. Fair question to which the answer is no.

Some of the misinformation seems to have been manufactured – such as the e-mails from ”patriots” warning that Obamacare will lead to medical murder for some of us and more free care for “others.” Read more…