A Healthy Blog

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

Health Care Market

Baltimore Fed Court Strikes Down Maryland's Wal-Mart Tax

A federal court today invalidated Maryland's mandated health benefits law, otherwise known as the Wal-Mart tax, passed in January over a gubernatorial veto. The law requires employers with more than 10,000 workers to pay at least 8% of payroll on health benefits or pay the difference to the state -- Wal-Mart is the only affected employer of the law. Click here to get the court decision. The decision will almost certainly be appealed by the State of Maryland, and will have many more twists and turns, and may end up at the US Supreme Court. Read more »

Money, Medicine and Reform

On today's Wall Street Journal editorial page, Andy Stern, President of the Service Employees International Union, makes an offer or throws down a gauntlet (take your pick) to America's corporate leaders on the need for thorough national health system reform. Definitely worth a read. Wonder how many CEOs are reading? If they're not reading Andy, I hope they don't miss the revealing piece in today's New York Times (click here) showing medical device manufacturers getting sage advice from hospital CEOs on how to peddle their drugs, devices, and financial services to hospitals. Guess who ends... Read more »

Getting "Granular" with Health Savings Accounts

Has anyone noticed the increasing use of the word "granular?" I'm starting to hear it more and more, and wondering if I just missed some cultural milestone. Anyway, in the interest of joining and spreading this trend, check out this "granular" look at real life consumer experience with Health Savings Accounts provided by United Health Care. Story provided courtesy of Joe Paduda and his excellent Managed Care Matters blogsite. An $800 dollar medical charge, discounted to $250 by United, still costs the consumer $800 when paid as part of the deductible obligation. The reader comments are... Read more »

Does US Have Most Advanced Health System? Apparently Not

We know the US health system is the least efficient on the planet, the costliest, and the least equitable. The one thing I always thought was true was that we have the most technologically advanced health system on the planet. Wrong again. Boy, am I dumb. An article in the May/June Health Affairs (subscription required) by Gerard Anderson et al concludes: "The United States lags as much as a dozen years behind other industrialized countries in Health Information Technology [HIT] adoption -- countries where national governments have played major roles in establishing the rule, and health... Read more »

The Limits of Transparency

One other fascinating article in the May/June Health Affairs (subscription required) offers a sobering judgment to folks who think "transparency" is a silver bullet for cost and quality problems in our health system. Ashish Jha and Arnie Epstein from the Harvard School of Public Health took a look at the 15 year old New York Cardiac Surgery Reporting System -- "arguably the gold standard for the public reporting of hospital and physician quality." Their conclusions: 1. "... users who picked a top-performing hospital or surgeon from the latest available report had approximately half the chance... Read more »

High Deductibles -- Not Such Good News

The business page in today’s Globe features a Jeff Krasner story on high deductible health plans, predicting MA health reform will increase the availability of these plans in Massachusetts to the cheers of insurers and state officials. The consumer perspective was not presented in the article, so we’ll give it to you here. Read more »

Enzi Bill to Gut Insurance Protections Dies in US Senate

Very good news from our friends at Families USA: Thanks to the thousands of e-mails and phone calls from advocates like you, the Enzi Bill--the Health Insurance Marketplace Modernization and Affordability Act (HIMMA, S.1955)--went down in defeat last night on the Senate floor. The Senate leadership needed 60 votes to end debate on the bill--known as a vote for “cloture” in Senate jargon. But thanks to your efforts, the cloture vote failed, 55-43. One Republican, Senator Lincoln Chaffee (RI), voted against cloture, while two Democrats, Senators Ben Nelson (NE) and Mary Landrieu (LA), voted for... Read more »

Where Is Health Care Heading? A National Look

Paul Fronstein runs the Health Research and Education Program at the Employee Benefits and Research Institute (EBRI) and has been a thoughtful commentator on national health care directions from a nonpartisan perspective for many years. He did a Q&A for Managed Care magazine recently that contains lots of provocative and important insights -- click here for the whole interview. Some insights: The erosion in employer sponsored coverage is tied to rising health premiums and also to the overall economic environment. Low unemployment kept businesses in the health insurance game in the late... Read more »

ew Massachusetts Advocacy Resource on Medical Debt

HCFA's crack public interest law firm, Health Law Advocates, has just published a new booklet, Medical Debt: A Guide for Massachusetts Advocates. Click here to obtain it for free. It was written by HLA in partnership with the Volunteer Lawyers Program. Medical debt is a growing problems. HCFA and HLA hear from many people needing help to address unpaid medical bills -- both uninsured persons and insured persons with high cost sharing requirements. The guide is a resource for advocates representing persons with medical debt, explaining how people accrue medical debts and strategies to assist... Read more »

A Business Voice for Guaranteed Issue

I've previously recommended the Health Business Blog written by Boston-based David Williams at MedPharma Partners. One of the best of a good crop of health policy blogs. In response to Monday's Healthy Blog on Gov. Romney, the Wall Street Journal, and "guaranteed issue," David offered his own thoughts on this topic, well worth a read and a visit. Thanks for the great posting, David! Keep checking out this useful and well written site. "Guaranteed issue and community rating are attacked by critics as left-wing ideas, which drive up costs and interfere with the market. But in my own experience... Read more »


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