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Provost Reif, Steward Through Financial Crisis, Elected MIT President

New MIT President L. Rafael Reif (Courtesy of MIT)

As WBUR reports here, MIT has just named its 17th president: L. Rafael Reif, an electrical engineer who has been the university’s provost for the last seven years and helped shepherd it through the recession.

The full MIT press release is here, but a couple of highlights: He helped balance the university’s budget through the financial crisis of recent years, and he grew up poor in Venezuela and earned electrical engineering degrees from Stanford despite speaking little English when he arrived. From MIT:

As the Institute’s chief academic officer since 2005, Reif led the design and implementation of the strategy that allowed MIT to weather the global financial crisis; drove the growth of MIT’s global strategy; promoted a major faculty-led effort to address challenges around race and diversity; helped foster the emergence of an innovation cluster adjacent to MIT in Kendall Square; led the development of MITx, the Institute’s new initiative in online learning; and led MIT’s role in the formation of edX, the recently announced partnership between MIT and Harvard University that builds on MITx and that aims to enrich residential education while bringing online learning to great numbers of people around the world.

On money:

The family was poor, supported by his father’s work as a photographer, and spoke Spanish and Yiddish at home.

Reif played a critical role in balancing MIT’s budget before, during and after the global financial crisis. Early in his tenure as provost, he led a “rebalancing” process that eliminated a $50 million structural deficit — putting the Institute in a much better position to weather the global downturn that began in 2008. Then, after the crisis struck, Reif led the team that designed and implemented the strategy for managing budget cuts. Among other steps, a 200-member Institute-wide Planning Task Force ultimately achieved significant long-term cost reductions by acting upon 77 percent of all ideas submitted by members of the MIT community.

And some fascinating personal notes:

Leo Rafael Reif (pronounced “rife”) is the youngest of four sons of Eastern European emigrés who fled Europe in the late 1930s, living first in Ecuador and then Colombia before settling in Venezuela. The family was poor, supported by his father’s work as a photographer, and spoke Spanish and Yiddish at home. Continue reading →

FILED UNDER: Medicine/Science, Money, Science, MIT

May 15, 2012 | 3:56 PM | By Rachel Zimmerman

Live: MA Senate Debates Health Care Cost Bill

As we speak, a debate on S.2260, the Senate’s health care cost bill, is underway. You can watch it live here.

But get comfortable: staffers report there are 265 filed amendments to consider.

Lawmakers weigh in on the Senate health care cost bill

Update at 4:53: The Senate voted 15-22 rejecting amendment #125 that sought to trigger a single-payer health care system.

FILED UNDER: Insurance, Money, Personal Health, Politics, health costs, Mass. Senate

May 15, 2012 | 9:07 AM | By Rachel Zimmerman

Patrick To Business: Cut Health Care Costs Aggressively, Let Government Play A Role

Gov. Deval Patrick. (Photo: Massachusetts Energy and Environmental Affairs/flickr)

For the first time since lawmakers in the Massachusetts House and Senate unveiled separate plans to cut health care costs, Gov. Deval Patrick is weighing in.

At a Greater Boston Chamber of Commerce breakfast this morning, Patrick told business leaders that the state should set aggressive spending targets, let government play a role in keeping insurance premiums down, and not necessarily create an entirely new agency to oversee the new reforms. In making his case for government oversight as a way to counter a not-always-reliable marketplace, Patrick put himself at odds with several elements of both the House and Senate plans.

“Industry can do better than the GSP [Gross State Product],” he said, according to a copy of his prepared remarks given to WBUR. “I certainly could not imagine accepting GSP plus anything…”

Here is Patrick’s entire speech, as prepared for delivery, from his office:

Thank you very much, Paul, and good morning, ladies and gentlemen.

As I think about the last couple of times we have been together at a Chamber breakfast, I realize I often come here to talk about health care. It makes some sense to do so in this company. Health care reform is one of the most important public-private initiatives in recent Massachusetts history. Many of you helped create and now help sustain it, and all of you deal with the challenge of rising insurance premiums. So you will understand if I return to the subject again this morning, especially given the developments of the past two weeks – and the past two years, for that matter.

We have a lot to be proud of when it comes to health care reform. We started with the belief that health is a public good and that everyone deserves access to affordable, quality care. That, for us, is a basic value, an expression of the kind of Commonwealth we want to live in, meaningful enough to motivate a broad coalition of legislators, policy makers, business and labor leaders and patient advocates in 2006 to reform the way we access health care.

And that reform is working. Here are the facts:

Almost everyone has access. 98.2 percent of our total population is insured. 99.8 percent of children. While the national trend between 2006 to 2010 was going in the other direction, we increased the number of insured in Massachusetts by more than 400,000 people.
Continue reading →

FILED UNDER: Insurance, Medicine/Science, Money, Gov. Deval Patrick, health cost bill

May 14, 2012 | 5:04 PM | By Carey Goldberg

Oh, Joy! The Prospect Of Laxative-Free Colonoscopies

(ex_magician/flickr)

Even now, weeks after my first colonoscopy, certain tastes and smells still trigger odd sensory flashbacks to the gallon of salty-swampy laxative liquid I had to glug to clean out my intestines before the procedure.

The taste didn’t seem so bad at first. I scoffed at all the whiners who have made the nastiness of colonoscopy prep so legendary. But near the end of the gallon, I found myself gagging and forced to suck on lollipops to help the swallowing along. Not that I’d ever skip the test. Colon cancer is too common and deadly, killing 50,000 Americans a year, and the effectiveness data on colonoscopies look good. Still, I couldn’t help wondering aloud: Does it really, truly have to be like this?

So even though the prospect of a laxative-free colonoscopy is years away, I can make no pretense of journalistic objectivity. I’m overjoyed to share this news: A new study out of Massachusetts General Hospital, following about 600 patients, suggests that a colonoscopy without the noxious preliminaries is feasible.

The point isn’t just to make life easier for people getting colonoscopies. It’s to help persuade them to get the test in the first place.

I did my due diligence: I asked the study’s leader, Dr. Michael Zalis, director of CT Colonography in the hospital’s imaging department, whether any potential financial conflicts needed to be disclosed — a start-up to develop laxative-free colonoscopies, that kind of thing? But no, no such disclosures, he said. The study was funded by the American Cancer Society, General Electric and the National Institutes of Health. Good enough — please sign me up for ten years from now.

A bit of background: Medical innovators had already invented the “virtual colonoscopy,” in which a patient’s innards are inspected using an abdominal CT scan rather than by inserting a long fiber-optic tube with a camera and a light on the end. But the patient still has to go through the colon-cleansing prep. The new study, just out in the May 15 Annals of Internal Medicine, takes the “virtual” one step farther: it uses software and a special contrast agent to make the colon cleanse virtual as well.

The point isn’t just to make life easier for people getting colonoscopies; It’s to help persuade them to get the test in the first place. Only about half of adults follow the recommendations for getting tested — which include universal testing for people over 50 — and surveys find that the nastiness of the prep is part of the problem.

Let me cut to the chase: If all goes well, I asked Dr. Zalis, how soon might the virtual cleansing be available? Conservatively speaking, he said, at least one more study is needed to confirm his team’s results, and that will probably take at least three years. Continue reading →

FILED UNDER: Medicine/Science, Money, Science, cancer screening, colonoscopy

May 9, 2012 | 8:29 PM | By Carey Goldberg

Pain Foundation’s Drug Money Was A Shame, But So Is Group’s Demise

Health columnist Judy Foreman

Note: This post was updated at 11:20 a.m. 5/10/2012. The original version was based on dated material. CommonHealth regrets the error.

ProPublica reports that The American Pain Foundation has shut down just as two U.S. senators are launching a probe into the heavy financial support it received from painkiller-makers. Syndicated columnist Judy Foreman, author of the upcoming book “A Nation in Pain: Healing Our Biggest Health Problem,” considers the news and its background.

By Judy Foreman
Guest Blogger

Okay, everybody, deep breath.

The US Senate on Tuesday launched what ProPublica, a generally terrific online investigative news organization, says is a probe into the makers of “narcotic painkillers” and the manufacturers’ ties to groups that advocate sane, responsible use of them. (By the way, “narcotic” is a loaded word; scientists prefer the less stigmatizing “opioid.”)

Let’s hope the Senate runs a genuinely open, fair investigation and that, in the laudable effort to examine the relationship between Big Pharma and advocacy and research groups, it doesn’t abandon pain patients who need the drugs and use them responsibly.

Out of the massive budget for the NIH, only 1.3 percent goes for pain research, even though pain is the main reason people go to doctors.

In the meantime, three thoughts. First off, what counts as an “epidemic?”

In a letter reportedly sent to drug makers by Chuck Grassley, an Iowa Republican, and Max Baucus, a Democrat from Montana, the Senate probe is necessary because of an “epidemic” of accidental deaths and addiction due to opioid pain relievers. Continue reading →

FILED UNDER: Medicine/Science, Money, pain

May 7, 2012 | 10:26 AM | By Carey Goldberg

Reactions To House Health Reform Plan: Confusion, Cheers, Concerns

Times like this separate the true health reform wonks from the wannabes. Did you spend your weekend poring through H.4070, An Act relative to Health Care Quality Improvement and Cost Reduction Act of 2012, which was finally unveiled Friday afternoon? For the hard core, this was a health cost weekend: No time for lilacs or Little League, what the heck does this thing say and what does it mean? (Here’s our initial summary.)

Though many of the bill’s proposals were long expected, reaction tended to be muted on Friday because everyone needed a chance to digest. Now, the considered analyses are beginning to roll in, and we aim to make CommonHealth their home, much as it was during the debate around the state’s 2006 health reform. The Senate is expected to weigh in with its own bill on Wednesday, and then comes the great sorting-out. Here’s a very early sampling of today’s opinion harvest, and we plan to update this post today as others come in.

Forbes:
Massachusetts moves toward health care price controls; Is America next?

Goodness, ‘The Apothecary‘ blogger Avik Roy — a member of Mitt Romney’s health care advisory council, according to his Forbes profile — re-posts a bit more of CommonHealth’s bill summary than is usual blogging practice. But he does make some interesting points, including a prediction that the proposal to impose a surcharge on high-cost hospitals will backfire badly. He writes:

The beauty of government-controlled relative pricing is that it creates an incentive for everyone to raise prices. There are two ways for a high-cost provider (say, Partners HealthCare) to get their prices within the 20-percent band: (1) lower their prices; (2) get everyone else to raise their prices.

Thanks to the transparency provisions of the bill (and transparent prices are, in general, a good thing), low-cost providers will know what their peers are charging. They will therefore have the ability to raise their prices considerably.

For example, let’s say Mass General charges $32,000 for a coronary angioplasty, whereas the state median is $21,000, driven in part by low-cost Tufts, which is charging $16,000. Now that Tufts knows that MGH is charging $32,000, Tufts knows that it can charge, say, $25,000 per procedure, and still gain favorable status from insurers, without incurring the new “luxury tax.” Continue reading →

FILED UNDER: Medicine/Science, Money, Politics, mahealthcosts

May 2, 2012 | 11:20 AM | By Carey Goldberg

Atrius Chief Calls For Speed On Health Reform

Atrius chief Dr. Gene Lindsey (courtesy of Atrius)

You know how when microwave popcorn begins to reach kernel-blowing heat, first you hear a few isolated pops and then they turn into rapid-fire, machine-gun-speed explosions? That’s the dynamic we can expect for the debate about the next, cost-cutting phase of Massachusetts health reform — and right now we’re in the isolated-pop stage. With the legislature expected to unveil its blueprints for cost-cutting very soon, we’re just starting to hear those first few pops of views, opinions, reactions.

Dr. Gene Lindsey, the chief of Atrius health, the state’s largest physician group, is just out in The Boston Globe (well, okay, yesterday but I somehow missed it at first) with an op-ed piece titled “Payment reform is working in Massachusetts.” It ends:

Governor Patrick wants us to move even faster. He delivered his draft legislation on payment reform in February 2011. Now, the Legislature is about release its proposed bill. What we really need from the Legislature now is the support to move forward with speed to implement changes so that patients and employers can begin to see a difference both in the care that is delivered and in the invoice that follows. Continue reading →

FILED UNDER: Medicine/Science, Money, health reform 2012, mahealthcosts

May 1, 2012 | 11:39 AM | By Rachel Zimmerman

Feds Grant $33M To Community Health Centers In Mass.

Health and Human Services Secretary Kathleen Sebelius today announced $33,716,628 in grants awarded to community health centers around the state for renovation and new construction projects under the new health care law, the Affordable Care Act. The agency noted that “these awards will help them serve approximately 42,539 new patients,” according to estimates from the grantees.

From HHS:

The announcement made today is for awards from two capital programs for community health centers. One will provide approximately $629 million to 171 existing health centers across the country for longer-term projects to expand their facilities, improve existing services, and serve more patients. This program will expand access to an additional 860,000 patients. The second set of awards will provide approximately $99.3 million to 227 existing health centers to address pressing facility and equipment needs. Continue reading →

FILED UNDER: Medicine/Science, Money, Politics, affordable care act, community health centers

April 26, 2012 | 7:34 AM | By Rachel Zimmerman

Health Payment Reform Can Bring Big Savings For Employers, Report Finds

Projected impact of growth scenarios on total employer savings on employer-sponsored health insurance. From "Benefits of Slower Health Care Cost Growth for Massachusetts Employees and Employers" by Jonathan Gruber and Ian Perry. (Courtesy)

WBUR’s Martha Bebinger reports that under new health payment reform (read cost-containment) plans currently underway in the state legislature, employers could save between $8 and $35 billion over nine years, according to a new analysis by MIT economist Jonathan Gruber.

That translates into direct financial benefits for workers, writes Bebinger:

Gruber says there’s a direct trade off between health care costs and wages. When premiums go up, wages don’t rise as quickly.

“What we’re saying here, by that same logic, is if we can control health care costs workers get more,” Gruber said.

In what Gruber calls a modest proposal, health care costs would increase 5 percent per year, just one point less than the expected 6 percent increase. The savings for employers would be $8 billion over nine years.

Under a more aggressive approach, health care costs would still rise, but only 2 percent per year. Employers would save almost $35 billion or about $1,000 per worker, per year. Continue reading →

FILED UNDER: Insurance, Money, Politics, cost, hospitals, insurance, payment reform

April 23, 2012 | 11:51 AM | By Carey Goldberg

Globe Calls For Analysis Of Taunton State Hospital Closing

The future "village green" at the new Massachusetts state psychiatric hospital. (Carey Goldberg/WBUR)

The Patrick administration announced three months ago that it would be closing Taunton State Hospital, moving most of its beds to the new state psychiatric hospital in Worcester.

Having toured the near-complete Worcester hospital, I can’t help but think that it will be a dramatic improvement for the mentally ill patients lucky enough to end up there, but the Taunton closing has brought protests on several fronts, including concerns that patients will be farther from their home communities.

The issue looks likely to re-ignite in the coming days in the state legislature, and the Boston Globe writes today that the state should not shutter Taunton without an independent analysis:

Such a study shouldn’t consume much time, but should answer lingering questions. Will the loss of the hospital leave a gap in mental health services from Brockton to Cape Cod, as critics contend? Or is it a meaningless geographic distinction in a statewide system, as the administration responds?

Does the closure represent a net loss of beds for people with acute mental illness? Not with a new state hospital coming on line in Worcester, say mental health officials. But critics contend that the total of 626 state beds remaining after Taunton closes is significantly lower than what the mental health department stated as its actual need as recently as 2004.

The outlook, according to the Globe: Continue reading →