September 2012

September 28, 2012
(photo by RecordNet.com)

On Friday (9/28) at noon, the Purple Bus VoteHealthCare.org Tour pulls into City Hall Plaza, by the Government Center T stop.

Kathie McClure is a lawyer and a mother of two from Georgia who embarked in "The Purple Bus adventure" to tell the "truth" about the Affordable Care Act across the country. Her children have pre-existing conditions and could not be insured in the private market until the ACA was implemented. Now she wants to educate the public about the benefits of "Obamacare" for her children and other 50 million uninsured Americans.

Health Care For All and Community Catalyst are joining efforts with the Purple Bus Tour to highlight the importance of health care issues in this upcoming elections and to ask the public to sign the pledge to be "a health care voter."

Join Kathie and us at noon on Friday.

September 27, 2012

Mass.gov website on cost containament law

The Governor's office today unveiled a new website that will serve as a central information source on the implementation of the Chapter 224, the Health Care Payment and Delivery System Reform law: www.mass.gov/governor/healthcarecostcontainment.

From the state's news release:

– The Patrick-Murray Administration today launched a new website that will be a clearinghouse for information about efforts to control health care costs, creating a transparent home for updates on progress, notice of upcoming events and other information important to consumers throughout the Commonwealth.
“We took the next big step forward on health care reform by proposing and passing a cost containment bill,” said Governor Patrick. “This website provides important information on the law’s implementation in a centralized location and will keep the public updated on the progress we’re making.”

...

As the central location for information and updates on implementation, the website includes information on the law, notice of upcoming events, and a single portal for connecting with health care-related state agencies, authorities, and commissions. In the coming weeks additional resources will be added to the site with timelines of when specific provisions go into effect and how these efforts will benefit Massachusetts businesses, consumers, and health care providers. Stakeholder groups are encouraged to share this website with their constituents as a valuable resource to understand health care cost containment and the implementation process in Massachusetts.

In addition, they announced the first information forum for updates and input from stakeholders. The first forum will be held on Wednesday, Oct. 10, at 9:30 a.m. at One Ashburton Place on the 21st Floor. The forum will include the Executive Offices of Health and Human Services, Administration and Finance, and Housing and Economic Development, and the Health Connector Authority. The forum will provide progress reports and detail which areas of implementation each of the four agencies will oversee.

September 20, 2012

MA has the nation's lowest uninsurance rate

Today the Census released the American Community Survey, with state-level data on income, poverty and insurance coverage. The Mass Budget and Policy Center has all the numbers, including a page on health insurance, which is the source of the graphic above.

The overall MA insurance rate, at 4.3%, declined .1%, a not-statisically-significant amount. But coverage for young adults - age 18 to 24 - improved substantially. Their uninsurance rate went down from 8.7 percent in 2010 to 7.5 percent in 2011.

If you like playing with charts, the Census web site lets one drill down lots of different ways to construct your own data. For example, this chart shows uninsurance rates (and margins of error) in certain cities and regions:

  Percent Margin of Error
Massachusetts 4.3 +/-0.2
Boston city, Massachusetts 5.5 +/-0.6
Brockton city, Massachusetts 7.4 +/-1.8
Cambridge city, Massachusetts 3.5 +/-0.8
Fall River city, Massachusetts 7.6 +/-2.2
Framingham town, Middlesex County 7.7 +/-2.0
Framingham CDP, Massachusetts 7.7 +/-2.0
Lawrence city, Massachusetts 10.5 +/-2.1
Lowell city, Massachusetts 8.6 +/-2.5
Lynn city, Massachusetts 7.2 +/-2.0
New Bedford city, Massachusetts 6.6 +/-1.7
Newton city, Massachusetts 1.4 +/-0.7
Quincy city, Massachusetts 3.9 +/-1.3
Somerville city, Massachusetts 4.7 +/-2.2
Springfield city, Massachusetts 6.6 +/-1.3
Worcester city, Massachusetts 4.3 +/-1.1

Source: U.S. Census Bureau, 2011 American Community Survey

-Brian Rosman

September 19, 2012

Today the Department of Public Health approved temporary regulations that make a mockery of the legislature's changes to the state's drug and device marketing restrictions, further eroding doctor-patient protections (see joint press release from HCFA, AARP, MassPIRG and Community Catalyst (pdf)).

The regulations implement a law passed over the summer to relax state restrictions on meals provided by pharmaceutical and medical device companies to doctors. Under the previous law, meals may not be provided unless in a clinical setting. The amendment permits “modest meals and refreshments” to be offered at educational programs outside of a health care setting, such as a restaurant. The regulation approved today ignored the legislative direction to limit permitted meals to those considered modest, and instead, astonishingly, defined “modest” as “similar to what a health care practitioner might purchase when dining at his or her own expense.”

In other words, pick anything off the menu, Doctor. "I'll have the usual." Order a drink or two, too. Be our guest.

As a result, drug companies are free to ply doctors with lavish multi-course meals and drinks, paid for by pharmaceutical industry marketing budgets, and ultimately tacked on to the price of prescriptions. Plus the marketing expenses are tax deductible, meaning we all pay higher taxes so drug companies can take doctors out for a great meal.

The temporary regulations approved today expire in December. DPH will conduct a hearing on October 19 to consider permanent regulations.

At today's Public Health Council meeting to approve the regulations, a number of Council members were openly skeptical. One member asked about alcohol. The DPH staffer explained that there was no barrier to providing any alcoholic beverage at an educational session sponsored by a drug or device marketing department. Another Council member asked how the restrictions would be enforced. Self-reporting was the answer, but with the standard being so vague, how could anyone report a violation in the unlikely event that one wanted to blow the whistle? Another question was raised about how DPH will know whether the "educational" sessions were truly educational, with the member using air quotes to indicate his skepticism. The answer, again, was that it is up to the drug manufacturer to make its own decisions.

In the end, the regulation is a complete capitulation. In fact, the DPH staff indicated that the Mass Life Sciences Center, chartered to be a cheerleader for the industry, was consulted in drafting the regulations. Consumer protection suggestions submitted by HCFA, the Mass Prescription Reform Coalition, and many other groups were not included in these regulations (see our comments (pdf)).

We were distressed when the legislature weakened the gift ban on behalf of the restaurant industry. We are now sickened that Massachusetts regulations have defined “modest” to mean -- whatever! Modest means modest. We have 30 days to make our case. We intend to be major presence at the upcoming hearings, and to continue to press our case. The regulations should establish a strict dollar limit, and proscribe industry-provided alcohol at educational programs. To get involved, contact Alyssa Vangeli, 617-275-2922, avangeli@hcfama.org.
-Brian Rosman

September 14, 2012

Today, the Connector Board met to consider offering non-standardized plans in Commonwealth Choice and discuss the Connector’s Affordable Care Act (ACA) implementation work.  Materials from the meeting are posted here.

September 13, 2012

Our friends at MITSS (Medically Induced Trauma Support Services) are currently accepting nominations for the 2012 MITSS Hope Award. The MITSS HOPE Award recognizes people--families, healthcare providers, hospitals (or teams or departments therein), academic institutions, community health centers, grassroots organizations, EAP Programs, etc. – who exemplify the mission of MITSS: Supporting Healing and Restoring Hope to patients, families, and clinicians impacted by adverse medical events, medical errors, or unexpected outcomes. The winner of the HOPE Award will receive a monetary prize of $5,000 to continue their work. The Award will be presented at the MITSS 11th Annual Dinner and Fundraiser to be held on Thursday, November 29th, 2012, at The Westin Copley Place, Boston, MA. The Deadline for submissions is Friday, September 28th, 2012.

-Deb Wachenheim

September 11, 2012

Today we remember the attacks on the World Trade Center and the Pentagon. As we remember these events, let us also remember the men and women who are serving and their families. For the last 11 years, military personnel and their families have served all of us. As we begin to transition as a nation away from war-time, let us be mindful of the transition these men, women and families have to make to civilian life.

The Massachusetts Department of Veterans Affairs has recently launched a website to address any question that may arise for veterans or their families regarding their benefits. This resource is incredibly helpful and easy to use.

Our work, however, is far from done. As you can see from the infographic below, 1 in 10 veterans under 65 do not have health insurance. 948,000 adult and children dependents of those veterans are uninsured. This is an issue that needs to be addressed and quickly.

Insuring Those Who Served

So today as we solemnly remember those who we have lost, let us not forget those who we serve. Each other.

If you want to learn more about veteran’s benefits or want to get involved with our work on behalf of veterans and families, contact Paul at pwilliams@hcfama.org.

-Paul Williams

September 11, 2012

Today we remember the attacks on the World Trade Center and the Pentagon. As we remember these events, let us also remember the men and women who are serving and their families. For the last 11 years, military personnel and their families have served all of us.  As we begin to transition as a nation away from war time, let us be mindful of the transition these men and family have to make to civilian life. 

The Massachusetts Department of Veterans Services has recently launched a website to address any question that may arise for veterans or their families regarding their benefits. This resource is incredibly helpful and easy to use.  

Our work, however, is far from done. As you can see from the below infographic, 1 and 10 veterans do not have health insurance. 948,000 adult and children dependents of those veterans are uninsured. This is an issue that needs to be addressed and quickly. 

<div class='visually_embed' data-category='Health' rel='infographic'>
<img class='visually_embed_infographic' src='http://thumbnails.visually.netdna-cdn.com/insuring-those-who-served_5029...' rel='http://thumbnails.visually.netdna-cdn.com/insuring-those-who-served_5029...' alt='Insuring Those Who Served' />
<div class='visually_embed_bar'>
<span class='visually_embed_cycle'>Browse more <a href='http://visual.ly'>data visualization</a>.</span>
</div>
<a id='visually_embed_view_more' target='_blank' href='http://visual.ly/insuring-those-who-served'></a>
<link rel='stylesheet' type='text/css' href='http://visual.ly/embeder/style.css' />
<script type='text/javascript' src='http://visual.ly/embeder/embed.js'></script>
</div>

 

So today as we solemnly remember those who we have lost, let us not forget those who we serve. Each other.

If you want to learn more about veteran’s benefits or want to get involved with our work on behalf of veterans and families, contact Paul at pwilliams@hcfama.org.

September 11, 2012

Today a group of Massachusetts business leaders spoke in DC on the Impact of Health Reform on Business in Massachusetts. Speakers included Jack Connors, Chair Emeritus, Hill Holiday; Richard Lord, President and CEO, Associated Industries of Massachusetts; and Michael Widmer, President, Massachusetts Taxpayers Foundation.

Simultaneously, Associated Industries, the Mass Business Roundtable, the Greater Boston Chamber of Commerce and the Taxpayers Foundation released a report, Business Community Participation in Health Reform: The Massachusetts Experience (pdf).

Excerpt from report on impact of health reform on business in Massachusetts

The report includes statements from a number of business owners, both large and small, speaking about the impact of health reform on their firm. It also summarizes recent research on the impact of reform, including data on impact on insurance coverage, the state budget, and employer-provided coverage (see excerpt above). The report highlights the strong participation by business in implementation, and credits chapter 58 with setting the stage for the cost control discussion culminating in this year's chapter 224.

Employers play a crucial role in the shared responsibility construct of health reform. Today's forum and this report will let their counterparts in other states know about the value they received.
-Brian Rosman

September 9, 2012

We've been optimistic about the promise of payment and delivery reform, despite all the challenges ahead in implementing chapter 224. Is that justified?

This week, the Institute of Medicine issued a detailed report, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America:

[T]he knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at lower cost...

The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. The committee calculated that about 30 percent of health spending in 2009 -- roughly $750 billion -- was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state.

Incremental upgrades and changes by individual hospitals or providers will not suffice, the committee said. Achieving higher quality care at lower cost will require an across-the-board commitment to transform the U.S. health system into a "learning" system that continuously improves by systematically capturing and broadly disseminating lessons from every care experience and new research discovery. It will necessitate embracing new technologies to collect and tap clinical data at the point of care, engaging patients and their families as partners, and establishing greater teamwork and transparency within health care organizations. Also, incentives and payment systems should emphasize the value and outcomes of care.

We fully agree. The IOM released this fabulous infographic to illustrate their findings. A piece of it is below - click to see the full version:

Excerpt - IOM Best Care Infographic Click for the full graphic
September 4, 2012

That was fast.

Governor Patrick signed Chapter 224 into law on August 6.

On September 2, a group of national health policy