A Healthy Blog

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


Uphill Climb for Maine's Health Reform Law

Valuable article in today's NYT on the sluggish progress of Maine's Dirigo Health Plan -- click here. Dirigo (Latin for "I lead" -- the state's motto) started with great national fanfare in 2003 as Maine's "universal health care law." The Dirigo program was projected to have 31,000 enrollees by 2005 and up to 130,000 by 2009. As of now, it trundles along with about 13,000 enrollees. One of the politically attractive features of the original law was its voluntary nature. No one is coerced to do anything -- it's all free choice. In this case, what makes it politically attractive makes it... Read more »

Keeping Track of State Health Reform

Lots of news nuggets from states on the progress of state health reform. Overall, the news is mixed – some progress, some setbacks, and nothing dramatic. This takes time – MA’s reform law took a good two and a half years before enactment. Still, if there’s a new wave of state health reform – as we like to suggest – we need more encouraging news: Pennsylvania: Republican State Senator Jake Corman predicted Gov. Ed Rendell’s proposal to impose a pay-or-play payroll tax on employers who don’t cover their workers is going nowhere fast. “I haven’t met a legislator yet who’s going to vote for... Read more »

MA Malpractice Rate in '06 -- We're #38

These data look interesting. Kaiser website lists number and rate of medical malpractice claims paid in 2006 (rate is per 1,000 practicing, non-federal physicians: US: 12,513 claims, and 13.3 claims per doc MA: 261 claims, and 8.0 claims per doc MA has the 38th highest rate among the 50 states. Here's the link if you want to check for yourself. Here's a surprise -- people talk a lot about California's tough malpractice law that makes it hard to win a claim ... CA's rate is 8.9. Go figure. Any comments? Read more »

Double Trouble in Maryland

Two recent setbacks in Maryland on the health access front: First, our allies at Maryland's Health Care for All launched a vigorous campaign to increase the state’s tobacco tax by a buck and use the funding to expand Medicaid eligibility for about 200,000 uninsured folks. The Assembly approved the measure and the Senate refused to take it up, thus killing the proposal for this year. Second, MD Attorney General Douglas Gansler on Monday said that the state would not appeal a second federal ruling against a state law that would have required Wal-Mart to increase spending on health care for... Read more »

Health Reform Travelogue: Learning in OK What Might Have Been

Friday at the University of Oklahoma on a MA health reform panel: yes, they want to understand what we did. Oklahoma has about half the MA population (3.4 million) and more than 600k uninsured (over 20%). Hosted by UofO President David Boren. Health policy trivia – how many remember Sen. David Boren and the Boren Amendment? Answer below. Four speakers at the Forum: me, former MA HHS Sect. Tim Murphy, Georgetown Health Policy Dean Judy Feder, and Cato Institute Michael Tanner. Here was the most interesting part for me. Murphy gets to ask me a question, and he notes that in Romney’s... Read more »

The Young Invincibles

Check out this first rate piece in New York Magazine on "The Young Invincibles: They’re young and healthy, and insurance is expensive. As long as they don’t catch the flu, slip on the ice, crash a bike, snowboard into a tree, rupture an appendix, or get hit by a bus, everything will be fine. Right?" Outstanding journalism by David Amsden. Best treatment of this issue I've ever seen. Great comments by Karen Davis from the Commonwealth Fund. Interesting contrast between New York and Massachusetts (two highly regulated insurance markets). New York's individual insurance market is based on "pure... Read more »

Why Do We Spend So Much on Health Care in Massachusetts?

Out in Chicago this weekend at a conference for new state legislators and legislators new to health care policy – organized every other year by Nat. Conf. of State Legislatures and the Agency for Healthcare Research and Quality. Rep. Steve Kulik, new House vice chair of Health Care Financing Committee, was there for MA. Interesting session on healthcare workforce with state-by-state professional data. See if you can observe a trend: (Data is federal from 2002-05.) 1. Category/2. MA Rank among 50 States (low # equals highest) / 3. MA Rate Per 1,000 Pop./ 4. US Rate Per 1,000 Pop. Physicians... Read more »

A Primer on the MA Medicaid Waiver

Beth Waldman, who left in January as Director of the MA Office of Medicaid and is now with Bailit Health Purchasing, did an overview of the MA Medicaid 1115 Waiver for folks in California late last month. For folks looking to understand the basics of the MA waiver, it's a fine introduction, as well as a way to understand its relevance to California. Click here to view. Read more »

California's First Health Reform Hearing

Check out the Health Access California blog for an account of the first legislative hearing on Gov. Schwarzenegger's far-reaching health plan. Sen. Sheila Kuehl, chief sponsor of the CA single payer legislation, chaired the hearing. While many states are now engaged in vigorous health reform conversations, none is more significant than California's efforts. Worth staying on top of this. Read more »

Washington State Joins the Access Expansion Wave

State of Washington was an access innovator in the early 1990s with the creation of the Washington Basic Health Plan, which is many ways is an early model for Commonwealth Care. Washington has an innovative governor and some really savvy legislators. Take a look at one of the their key objectives, mentioned at the bottom of the clip -- "prevent health care spending from increasing faster than personal income growth" -- now there's an ambitious objective. Wonder how they plan to pull this off? Read more »


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