A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Reactions to Tom Reilly's Health Plan

Reactions to Tom Reilly's Health Plan

May 11, 2006

AG and Gov. candidate Tom Reilly released his health platform back on April 27 and I've yet to see any media attention to it. While most voters ignore issue platforms, they represent the consensus opinion among a candidate's advisors, and indicate the candidate's comfort zone on an issue. In short, they matter. And because Tom Reilly is striking harder than anyone to identify the "sensible middle," his positions can be seen as a barometer of the current health care "center of gravity." So let's treat Tom Reilly's effort with respect and check it out. Click here to get access to the actual document and campaign generated reacs. (By the way, the campaign website is messed up, and you can't get to this page from the candidate's home page. Worth fixing, TR folks.)

Let's start with the good. Repeated emphasis on racial and ethnic health disparities, community based care and patient navigators. Appropriate focus on cost control, prescription drugs, health workforce issues. Worthwhile focus on an array of public health interventions. Admirable prioritization of children's health. Good stuff.

Deficiencies? Let's mention two:

First, access. Though the statement makes mention of the new MA health reform law ("As Governor, Reilly will keep the Commonwealth on track to achieve universal access to quality, affordable health care..."), there's not a word about paying for it. We know from legislative documents the plan will begin running in the red by year three (FY09), less than halfway into the new Governor's second year in office; so it's germane. Not a word pro or con about the reform law's assessments on employers. Does Reilly think they're too much, too little, or just right? No way to know. So when the cost crunch arrives in 2008, what will Gov. Reilly do about it? Can't tell.

Second, costs. "As Governor, Reilly will ensure that Massachusetts offers the highest quality health care in the world, at a price all of our residents can afford..." How? According to the document:

1. Benchmarks for improving care for racial and ethnic minorities.
2. Pay for Performance systems.
3. Targeted state investments in health care technology.
4. Providing patients with up-to-date, accurate and understandable information about doctors and hospitals.
5. Culturally competent community-based care coordinators and patient advocates.
6. Making prescription drugs safe and affordable.
7. Building a high quality health care workforce.
8. Making the long term care system better meet elderly and disabled persons needs.

Depending how you count the bullets, as many as 25 specific ideas. Every one of them good and worthy of implementation. Do they add up to a realistic plan to control the relentless surge in health costs? Not by a country mile.

First of all, a lot of these interventions -- pay for performance, electronic health records, computerized prescription ordering by physicians -- are already well into implementation.

Second, both politicians and health care industry leaders have an urgent need to make the public believe that the solutions to medical care inflation are in hand and already under way. Were they to admit the truth -- that there are no politically acceptable cost control solutions on the horizon -- the public might gravitate toward genuinely effective and genuinely threatening solutions.

No diss to Tom Reilly. No other gubernatorial candidate is embracing realistic and effective cost control either. The center of gravity isn't ready for real solutions. In spite of the destructive effects of health care inflation, our society -- state and national -- isn't ready to embrace what's necessary to make a difference.

And what's that? It's what every other advanced nation recognizes and embraces -- some form of market control. Tom Reilly's plan just confirms the obvious.

Jon Keller's recent gubernatorial debate (no mention of health care) and the non-reaction to TR's plan suggest that health care might be a non-issue in the upcoming campaign. That would be a real shame.