In January, I forecast the Legislature’s priority to address containment of health care costs during this session. Here we are, in March, the day after the Joint Committee on Health Care Financing held a lengthy and productive hearing on bills related to just that. The Committee now begins the process of parsing the bills and redrafting what promises to be the most significant health reform legislation since Chapter 58 of the Acts of 2006. Cost-containment is no small challenge. It is, in many ways, a greater one than expanding access to coverage. But it is a similar challenge in that it requires significant investments before some of the savings can be realized. Responsibility for expanding access had to be shared, and now investing in cost-containment has to be shared as well.
As expected, the hearing demonstrated the willingness of our provider, purchaser, and patient organizations to step forward and be part of the discussion, to be proactive and engaged. The Legislature relied on that collaboration during the development and enactment of Chapter 58, and this debate will be no different. One of the hallmarks of the development of Chapter 58 was that all stakeholders were heard and at the table. Many of the same groups and individuals will be at the table again, and we all look forward to another inclusive process.
We are approaching the third year of implementation of Chapter 58. It’s time for the cost and quality of health care in the Commonwealth to join access on the road to success for our patients—insured and uninsured, alike.
Salvatore F. DiMasi
Speaker, Massachusetts House of Representatives
“One of the hallmarks of the development of Chapter 58 was that all stakeholders were heard and at the table”
Not true. Many people tried to stop Chapter 58 and its individual mandate from passing and are still trying to stop it from being implemented.
In many ways Chap 58 is a harmful, wasteful law. Only 4% of the newly insured (~300,000) actually bought their own coverage – the 300,000 who remain uninsured cannot afford it so are now facing tax penalties for the pleasure of being uninsured. Most of the rest of us are being crushed by high health costs which the proposed bills do little to cut in to.
And regarding your “forecast” of the legislature’s priority to address cost control, that forecast existed in 1997 when many of us nurses, doctors, and patients formed the Alliance to Defend Health Care with its founding Call To Action: For Our Patients, Not For Profits.
Your constituents have been trying to help lead the way on cost control and other reforms but keep being blocked by industry and the legislature. In 1999 and 2000 citizens created a major cost control statewide ballot initiative to cap insurance and HMO non-health care spending (admin) at 10%, to have the state use its clout to reduce the cost of prescription drugs, and to require the state to have a universal health care program by July 2002.
But the state allowed the non profit insurers and HMOs to spend $5.4 of citizens’ health care dollars to hire a PR firm to crush the citizen initiative with deceitful ads. The attorney general at the time said “It’s wrong but there’s nothing we can do about it.” and legislators said the same thing.
From 2003 to 2007 Massachusetts citizens created and ran a citizen initiative to amend the state constitution and establish the legal right to comprehensive, affordable and equitably financed health insurance for all state residents. You, Mr. Speaker, and your colleagues including Senate President Travaglini and Sen. Richard Moore, intentionally defied the state constitution and denied the citizens of this state their constitutional rights when you refused to grant the health care amendment its second up or down vote on its merits.
details on this travesty at:
http://www.wbur.org/weblogs/commonhealth/?p=394
Mr. Speaker, the citizens of this state who are paying attention — there are many and the number is growing as the health cost crisis worsens — are appalled at your misrepresentation of the facts on this issue. The people of Massachusetts deserve better from their leaders.
cross-posted from Commonhealth entry
http://www.wbur.org/weblogs/commonhealth/?p=385#comment-6385
dianne posted about her perspective as a citizen being harmed by the Chapter 58 law:
“A sense of shared responsibility is what has made reform a success thus far.”
Is the success you refer to the 300,000 (at least) paying penalties to support those who get the insurance for free while the penalty-payers can’t afford to pay their bills and still have no insurance?
Or is it enforced poverty? (The way the affordability schedule is set up, people don’t dare earn a dollar over their current income bracket or their premium, copays or penalties will double. Even if they were to earn $300 over, they wouldn’t be able to pay those increases. In fact, someone might end up in Commonwealth Choice and then they will really be up a creek. Better to quit one of the part-time jobs or not take that raise even though the extra money is needed to pay the skyrocketing cost of living and property taxes, etc.)
Is it a success because residents are not only penalized for being uninsured but also for getting a good job? (The 2008 penalties are based on gross income so if a resident is uninsured for 4 months and owes a $35 per month penalty, and in month 5, said resident gets a great $50,000 per year job with insurance, the 4-month penalty will be much higher instead of being based on their low income during the 4 months.)
Is it a success to cause such stress to people who are trying to survive this unfair law? Stress is extremely unhealthy and until this law falls apart, many residents will have little to no sense of well-being which is also highly unproductive.
“. . . to keep this honorable first-in-the-nation experiment on course.”
Is it honorable to steal hard-earned money from low-to-middle income people because they can’t afford to purchase a specific product? Extortion and collusion are both crimes.
Is it honorable to use people as unwilling test subjects in an experiment that hurts them? When a law is passed that adversely affects a large population of people and has as many holes in it as Chapter 58, the legislature has not exercised due diligence.
Added to that, we have the Connector flying by the seat of their pants while hard-working residents continue to be left in limbo – unable to get any answers or never the same answer twice because one hand doesn’t know what the other is doing.
It’s time to end the charade and stop hurting people.
“One of the hallmarks of the development of Chapter 58 was that all stakeholders were heard and at the table.”
Two definitions of “stakeholder”:
1) One who has a share or an interest, as in an enterprise.
It seems to me that the people have the biggest stake here and yet are not considered “stakeholders”. We were not consulted on the passage of the Ch. 58 law. The people did present a legitimate citizen initiative as above outlined by Ann Malone, and yet that was twice squashed and buried like roadkill.
2) A person entrusted with the stakes of bettors; must deliver the stakes to the winner.
Perhaps this is the “stakeholder” to whom you refer? We know who the winners are, and it’s not the people.
“But there’s a political imperative behind the ”ownership society” theme: the need to provide pseudopopulist cover to policies that are, in reality, highly elitist.”
from: New York Times – August 13, 2004
By PAUL KRUGMAN – http://query.nytimes.com/gst/fullpage.html?res=9E0CE6DD143FF930A2575BC0A9629C8B63
While many of us do not agree with Mr. Krugman’s attitude toward the mandate concept, we can easily gain insight from these words.
Also, why have the Connector Board Meeting of February 14, 2008 not yet been published? Will it take a Freedom of Information petition to get this public document?
And, why have most Connector documents that were previously available online now been diverted to the Connector’s “Sign me up” page?
This is public money. These people are public servants. We demand full transparency.
[...] WBUR’s Commonhealth Blog, Speaker Sal DiMasi comments on cost control in the context of Wednesday’s hearing on Sen. [...]
Note to all health care allies:
St. Patrick’s day is Monday. Let’s get the snakes out of Massachusetts.