"Health Care For All" in lights on a bridge

A Healthy Blog

Massachusetts health care – wonky with a dose of reality

October 2, 2005

Double congrats to our sister agency, Community Catalyst, for two honors they received this past week.

First, Deputy Director Susan Sherry was named in Modern Healthcare’s 100 Most Powerful People in Healthcare. Ms. Sherry made the list at 65. This annual list is a who’s who of health care power players. Ms. Sherry was one of three consumer advocates named. Catalyst was the only consumer advocate group mentioned that is based outside of Washington, DC.

Most on the list are people who hold purse strings to large organizations or politicians. These include HHS Secretary Mike Leavitt who topped the list at number one, George W. Bush, who at 4, U.S. Sen. Edward Kennedy followed at 5, and U.S Sen. majority leader, Bill Frist, at 7. Catalyst uses grassroots tools to build power from the bottom, giving consumers a seat. "Doctors don't go out individually and take positions-they've got organizations that have lawyers, policy analysts, media and communications people to speak for them," Sherry says. "When consumers get organized and when they have the same kinds of support systems as doctors and hospitals, well ... that's when they'll start developing their own power. And that's when they'll really be able to make a difference."

Second, the Mass. Health Data Consortium has recognized Community Catalyst's Real Benefits program by awarding its annual Investing in Information Award to RB. "Real Benefits" is a web based, public benefits eligibility and application program that assists lower income families in determining their eligibility for a host of federal and state benefit programs and then produces completed, ready-to-sign applications for each program for which the family qualifies. It's now being used in MA, Illinois, and Maine.

Since 1996, the MHDC Awards have honored organizations and individuals who invest capital, knowledge and leadership to use traditional and state-of the art technologies to promote efficient and effective communication of health information.

September 30, 2005


Two noteworthy events this week -- one on camera and one off (well, sort of).

On Tuesday, Sen. Kennedy and Gov. Romney met in DC with Mike Leavitt, US Secretary of Health & Human Services about the fate of Massachusetts' Medicaid waiver -- worth about $770 million to the Commonwealth. Critical issues -- such as the status of Boston Medical Center as a public entity -- were discussed and unresolved. Left is a picture from the meeting -- with Sen. Kennedy, Sect. Leavitt, and Gov. Romney. In the very back is Dennis Smith who runs Medicaid for the federal Centers for Medicare and Medicaid Services, and who is in charge of the waiver negotiations.

Sometime this week, Smith sent an undated letter to Tim Murphy outlining their expectations that "beginning on July 1, 2006, the Commonwealth must find an alternative financing arrangement ... to provide health care services to uninsured individuals ..." You can read the full letter on HCFA's site by clicking here.

What the heck does all of this mean? Briefly, the Romney Administration sold the Bush Administration on their health reform plan, and now is using the potential loss of federal dollars to pressure the Legislature to approve their proposal. The Smith letter was more than likely solicited by the Romney Administration. We are seeing in states across the nation -- most recently Vermont -- the Bush Administration colluding with Republican governors to compel recalcitrant state legislatures to remodel their Medicaid programs to set limits on available federal dollars. In Massachusetts, the process is being used to promote the Romney plan for limited benefit insurance plans.

On Thursday, Gov. Romney testified for about an hour before the Legislature's Joint Committee on Health Care Financing and Joint Committee on Financial Services. The topic was his health reform legislation filed last July. Click here for a news account. The centerpiece of the plan involves private insurers offering low cost insurance plans with a target premium of $200 per month for a single person in his or her 20s (higher for older adults and families). Lower income folks would get subsidies to support their premiums. I presented written and oral testimony. Click here to read it.

Key point -- after 10 months of bragging across the nation about his health reform plan, to date not one insurer has come forward with a plan they are willing to offer at the target price. If there are no private plans, there is no Romney plan. Yet this is what the feds are trying to compel the state to adopt.

Stay tuned...

September 29, 2005

From NewsDay (Long Island) 9/28:

Suffolk County, New York lawmakers overwhelmingly passed a bill requiring large non-unionized grocery retailers to set aside money to pay for employee health-care costs. If it becomes law, Suffolk would be the first municipality in the nation with such a requirement. The measure passed 17-1, with more than enough votes to override a veto if Suffolk County Executive Steve Levy chooses not to support it.

Companies such as Wal-Mart say the law would be unfair and would drive up the cost of doing business. Those costs, the store said, could be passed on to consumers. "We are concerned that the health care bill passed today, which does nothing to provide health care to those people without insurance, is a kind of hidden tax that runs counter to Wal-Mart's commitment to everyday low prices," Philip Serghini, a Wal-Mart spokesman.

The measure requires companies to allocate at least $3 for every hour an employee worked and the money would go to pay employees' health care costs. Although some expect a court challenge, Paul K. Sonn, a lawyer at the Brennan Center for Justice in Manhattan, said the law was crafted so it doesn't run afoul of a federal law prohibiting local and state governments from requiring private employers to purchase health insurance for their employees.

How companies spend the money is up to them. The measure affects retail stores with 25,000 square feet or more devoted to groceries, or those that have 100,000 or more square feet with at least 3 percent used for groceries, or more than $1 billion a year nationally in revenue, with 20 percent coming from groceries.

Sponsors say that would include Wal-Mart, Walgreens, Kmart, CVS, Target and BJ's Wholesale Club. Stores with unionized workers, such as King Kullen and Stop & Shop, would be exempt.

Allan Binder (R-Huntington), the only legislator who voted against the bill, criticized his Republican colleagues for supporting the measure, which he says would cause businesses to move out of the county or not come at all, reducing sales tax revenues. "We are acting more like Democrats. We don't know who we are anymore," Binder said yesterday in an interview after the votes were cast.

September 29, 2005

From Tuesday's Washington Post:

Everyone knows that Boston Red Sox fans endured decades of pain and suffering waiting for their team to win the World Series. But it turns out that Boston area residents literally put off taking care of real medical emergencies so they could watch last fall's climactic games.

A study in the Annals of Emergency Medicine reported yesterday that emergency room visits in six greater Boston hospitals were significantly affected by the seven American League Championship Series games between the Red Sox and the New York Yankees and the subsequent four-game sweep of the St. Louis Cardinals in the World Series.

During the biggest games, emergency room visits declined precipitously -- as much as 20 percent below the historical average. In the less important games -- and especially in ones in which it looked as though the Red Sox might lose the series -- emergency room visits were 30 percent higher than during those sudden-death matches.

The researchers, from Children's Hospital Boston and Harvard Medical School, looked at Nielsen ratings for the 11 games to see how many people were watching in the Boston area (more than 1 million households per game, on average). They then collected from six hospitals the average number of emergency room visits while those games were in progress and looked at the correlation.

The result, they said, was a "dose response" in emergency room use: The bigger the game, the less likely people were to seek immediate medical help. "These findings suggest that timing of [emergency room] utilization has a strong discretionary component," they wrote. Especially if an 86-year-old curse is on the line.

September 28, 2005

From Associated Press:

Consumer groups sued Pfizer Inc. in federal district court Wednesday, alleging the drug maker issued misleading advertising for its top-selling cholesterol drug Lipitor, a day after the company received Food and Drug Administration approval to market the drug for additional populations. In the purported class action complaint, advocacy groups Community Catalyst and Health Care For All allege that Pfizer marketed Lipitor to reduce cholesterol in patient populations that had not been covered in clinical trials.

Specifically, the suit alleges that Pfizer claimed Lipitor prevented heart disease in women or people over 65 who did not have heart disease and diabetes when no studies existed to back up the claims. However, Pfizer announced Tuesday that the Food and Drug Administration approved the drug for patients - Type 2 diabetics and non-diabetics - who did not have heart disease, but who had one or more risk factors for the condition other than high cholesterol, such as high blood pressure, family history, being over 55, smoking and obesity. The approval was based on two clinical trials involving more than 13,000 patients, Pfizer said.

Pfizer reported Lipitor sales of $10.86 billion in 2004, accounting for nearly 21 percent of the company's total revenue. The consumer groups allege that Pfizer's advertising of the drug resulted in billions of dollars in unnecessary drug spending among the two patient groups and pointed to a study of 2,000 women concluding that those taking Lipitor developed 10 percent more heart attacks than women taking a placebo.

The lawsuit, filed in the U.S. District Court in Boston, alleges that Pfizer violated state consumer protection laws against deceptive advertising and seeks reimbursement for women and seniors and third-party payers who bought Lipitor "unnecessarily." Representatives for Pfizer were not immediately available for comment. Pfizer shares fell 3 cents to $24.77 in afternoon trading on the New York Stock Exchange.

September 28, 2005

Democratic Gubernatorial Candidate Deval Patrick today released his health agenda and included in it an endorsement of the Moore-Blumer Affordable Care Today's legislation (S738/H2777). Here's the relevant statement:

"Expand Affordable Care. As governor I will work with the legislature to enact the Health Access and Affordability Act, a credible, achievable means to bring immediate progress. Through a combination of changes in the eligibility requirements of MassHealth (Medicaid) and reasonable assessments from employers who do not provide health insurance, the plan substantially expands access to affordable health care to Massachusetts residents."

See the whole statement by clicking here. To read the Boston Globe story on Patrick's health plan, click here.

September 26, 2005

Results from a new State House News Service poll of 400 voters conducted by Gerry Chervinsky:

“Though it contains a sizeable tax hike - 60 cents a pack on cigarettes and a new payroll levy on employers - a question that would expand health coverage in Massachusetts by underwriting insurance with the new tax revenue won a wide margin of support, 62.1 to 33 percent.”

That’s the MassACT Ballot Initiative, they’re talking about. We had nothing to do with this poll – and the results are not too shabby.

Other provocative results:

Voters opposed the proposed constitutional amendment to ban gay marriage, 51.9 to 42.6 percent.

Voters split – 46.2 percent in favor to 46.7 percent opposed - on an initiative that would order the governor to call Massachusetts National Guard troops home from Iraq.

Voters support an initiative legalizing the sale of wine in food stores, 76.4 - 22.3 percent.

The survey included hypothetical matchups of Lieutenant Gov. Kerry Healey against the most likely Democratic nominees. Healey lost to all three of the likely Democratic candidates: Reilly, Deval Patrick and Secretary of State William Galvin.

September 25, 2005

On Thursday at 10:30am in Gardner Auditorium at the State House, two legislative committees will hold a public hearing on Gov. Romney’s health reform legislation which he filed last July. Expectations are that His Excellency will testify in favor of his plan. This will be the only public discussion of RomneyCare, which the Governor has promoted since his Boston Globe op-ed last November. Two committees: the Joint Committee on Health Care Financing (Chairs – Sen. Dick Moore and Rep. Pat Walrath) have principal jurisdiction over the health reform debate, especially matters relating to Medicaid and the Free Care Pool; the Joint Committee on Financial Services (Chairs – Sen. Andrea Nucifuro and Rep. Ron Mariano) have jurisdiction over issues related to private health insurance – a key ingredients of all three health reform plans (Romney, Sen. Pres. Travaglini, and the ACT Coalition). Also coming up this week – a BIG meeting on Tuesday in Washington DC involving the Governor, Sen. Kennedy, and major federal officials including Health and Human Services Secretary Leavitt concerning the much-delayed renewal of the Massachusetts Medicaid Waiver, worth over $1.1 billion in essential federal revenue to Massachusetts. Expect news on Wednesday whether Massachusetts will keep or lose essential federal dollars – a key component of health reform financing. The next major date in the legislative health reform process – on Friday October 7th, House Speaker Sal DiMasi will give the keynote address as a JFK Library forum on Massachusetts health reform – and the Speaker is expected to tip his hand about the much anticipated House version of health care reform. Expectations are now that the House and Senate will enact their own versions of health reform legislation prior to the legislative recess on November 16. Whether they will be able to conference the two versions is a big question, though there is no doubt both chambers would like to do this. Meanwhile, the MassACT coalition is on the streets collecting signatures in every corner of the state. If you have not signed yet, go to massact.org and download the ballot petition, sign it, and mail it in. (Collect a few other signatures if you can.) Be there or be square. The petition is the way citizens can add their voices and signatures to this process now designed for insiders only.

September 24, 2005

What kind of "choice" do we really value when it comes to health care? A new Commonwealth Fund study gives several important findings:

"Proposals to expand the individual health insurance market and promote health savings accounts are intended to provide consumers with more "choice." The types of choices people prefer, however, are not well understood. This analysis of survey data finds that having a choice of health care providers matters more to people than having a choice of health plans. Dissatisfaction among adults with no choice of providers was more than twice as high as among those with no choice of plan. Moreover, a large majority of Americans who have had experience with employer-based health insurance believe that employers do a good job of selecting quality plans. Two of three preferred an employer-selected set of plans over an employer-funded account that they would use to find coverage on their own. Thus, policymakers should be cautious about embracing the individual market and health savings accounts as a way to improve satisfaction in the system."

Surprise, surprise -- Americans are resistant to change, and are not ready to dump the current employer sponsored structure. Like it or not, we need to remind ourselves of this fact as we pursue reform plans that would change coverage arrangements many people have now.

September 22, 2005

Government officials and business leaders on Wednesday (9-14) attended a summit meeting in Washington, D.C., to discuss ways to control health care costs and improve health care coverage, CQ HealthBeat reports. Participants at the summit included Virginia Gov. Mark Warner (D); Massachusetts Gov. Mitt Romney (R); Sens. Max Baucus (D-Mont.) and Richard Burr (R-N.C.); and executives from Verizon, Costco, Pittney-Bowes, Starbucks and Honeywell.

According to Starbucks Chair Howard Schultz, Starbucks has faced double-digit health insurance cost increases each of the last four years and expects to spend $200 million on health care for its U.S. employees -- more than the total amount it spends on coffee. He said the increases are "nonsustainable," even for companies that "want to do the right thing." Starbucks provides health insurance to all employees who work more than 20 hours weekly. Schultz said the U.S. is "on a collision course" as health care costs rise. He added, "I would hope congressional leaders put this at the front of their agenda".

Pages