A Healthy Blog

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

Health Care Market

Will More Physicians Cure the Physician Shortage? Maybe Not...

Important article in this past week's New England Journal of Medicine on the physician shortage and what to do about it -- "Physician Workforce Crisis? Wrong Diagnosis, Wrong Prescription" by Drs. David Goodman and Elliott Fisher from the Center for Health Policy Research at Dartmouth: The situation in Massachusetts reflects the problem with focusing narrowly on the physician workforce. Massachusetts has seen its supply of physicians per capita more than double since 1976, and it now has the highest physician-to-population ratio of any state, in primary care as well as overall. Yet the... Read more »

Senate Unanimously Approves Cost Control Legislation

The hallway leading to the Senate chamber was packed with lobbyists yesterday afternoon as the Senate debated and unanimously approved legislation to control the growth of health care costs. (see this blog report for background, and here for a list of all amendments adopted and rejected, including rewritten amendments). Before getting to 54 amendments, Minority Leader Richard Tisei, Health Financing Chair Richard Moore, and Ways and Means Chair Steven Panagiotakos discussed health reform's rising costs and the need to address overall rising costs. Tisei set the stakes: “We’ve been successful... Read more »

Senate Debates Cost Control Today -- 54 Amendments

The State Senate meets today at 1pm in full formal session to debate Sen. President Murray's cost control legislation. Click here to see the full text all 54 amendments filed by yesterday's 5pm amendment deadline. Read more »

Health Reform 2.0 Moves Out Of Beta

The Senate Ways and Means Committee released its version of the Senate President’s cost control bill today. The bill, S. 2650, An Act to Promote Cost Containment, Transparency and Efficiency in the Delivery of Quality Health Care (click here for text), positions the Commonwealth to take major steps forward in both reducing costs and improving health quality. HCFA commends the Senate President, Senate Health Care Financing Chair Moore, and the Senate Ways and Means Committee for showing leadership in advancing a strong bill. The bill will be debated on Thursday. Read more »

Murray Cost Control Bill Moves on ... Unchanged

Today the Legislature's Joint Committee on Health Care Financing favorably reported S2526, Senate President Murray’s Cost Control Bill. No changes were made and 52 other bills were attached (list will be posted here tomorrow). State House News Service reports the Senate is planning floor action on the measure on April 17. Sen. Dick Moore, Committee Co-Chair, said the bill was being reported to Senate Ways & Means so the Senate could work on the bill while the House does the FY09 budget. Moore assured Committee members that staff are looking at all testimony and will find ways to... Read more »

On Costs, Rep. Walrath Keeps Us Guessing

From State House News Service: On Senate President Murray's Cost Control legislation, Rep. Walrath keeps us guessing: The House leader of the committee examining Senate President Therese Murray’s health care cost control bill said the committee was working to affix a price tag to each section of the bill. “I’ve got staff working on it, but we’ve got to do section by section how much this bill is going to cost,” said Rep. Patricia Walrath, co-chair of the Committee on Health Care Financing. On announcing the bill, Murray noted that a provision to promote electronic medical records would cost... Read more »

“Confessions of a Former Drug Rep”

Shahram Ahari, former Eli Lilly drug “detailer,” shared the tricks of the trade on NECN this week (two parts): Shahram, who now travels the country testifying to legislatures considering measures to regulate pharmaceutical marketing and speaking to doctors and medical students, provided an insider view to the manipulative tactics that drug companies use to sell their products. According to Ahari, drug reps are hired based on good looks and congeniality – no science background required. They are then encouraged to exploit sexual tension and to ply docs with gifts to foster a friendship and... Read more »

Primer on One of the Next Big Things -- Preventable Hospital Readmissions

Check out this great Commonwealth Fund series of articles on preventable hospital readmissions. Right on the heels of conversations about hospital acquired infections (or "healthcare associated infections" as others like to call them), one of the next big quality/cost conversations, we predict, will focus on hospital readmissions that would not occur if care were done right the first time. Some folks suggest all readmissions are preventable. Our advisers tell us no, and tell us that a whole heck of lot of them are. And the cost implications are serious: Read more »

Medical Inflation Made Simple

In Tuesday's New York Times, Dr. Sandeep Jauhar, M.D., explains medical inflation from his perspective in real terms: Not long ago, I visited a friend — a cardiologist in his late 30s — at his office on Long Island to ask him about imaging in private practices. “When I started in practice, I wanted to do the right thing,” he told me matter-of-factly. “A young woman would come in with palpitations. I’d tell her she was fine. But then I realized that she’d just go down the street to another physician and he’d order all the tests anyway: echocardiogram, stress test, Holter monitor — stuff she... Read more »

Notes from a Hearing on Sen. Murray's Cost Control Bill

Here's the State House News Service account of today's hearing in Gardner Auditorium: Senate President Therese Murray's health care cost control legislation received mostly positive reviews during a public hearing on it Wednesday afternoon, although some said it didn’t go far enough and others warned of unintended consequences. With health care costs gobbling up larger portions of government, business and household budgets, those who turned out for the hearing said cost control is critical and that while the legislation could be improved, it sets the state off in an important and correct... Read more »


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