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

US health policy

Federal Appeals Court Rules Against Maryland, Upholds WalMart

Click here for NYTimes article on today's decision by the 4th District Court of Appeals in Virginia upholding the Baltimore federal district court ruling that struck down the Maryland "Walmart Tax." The Maryland law, passed by the state legislature in January, 2006 over a gubernatorial veto, would have required all for-profit companies with more than 10K workers (only WalMart) to pay at least 8% of payroll on worker health benefits or pay the difference to the state. Since the 4th circuit appeals court is among the most conservative in the nation, many of us had hoped Maryland would not... Read more »

Why We Need Incentives to Fix Quality

In a 12/12 post, we talked about the growing, new controversy regarding Pay for Performance incentives to encourage doctors and hospitals to provide higher quality care. Democrats such as Rep. Pete Stark, conservatives at the Heritage Foundation, and others take issue with new approach for a variety of reasons. Yesterday's New York Times has a good piece describing why these incentives can be helpful and why we should not just rely on physicians and hospitals to "heal thyself." Excerpt: Read more »

Book Recommendation -- Chronic Crisis: Guide and Response to the Healthcare Debate for Regular People

We see lots of health policy books -- most repeating familiar themes and refrains. This one has something new: Chronic Crisis -- Guide and Response to the Healthcare Debate ... For Regular People. (Click here for the Amazon page.) It's by Dr. Selvoy Fillerup, an MD and public health service doc, who undertook his own comparative health policy study and came up with some interesting results. Read more »

More Details on Ron Wyden's Health Proposal

Sen. Ron Wyden's health plan proposal is even more interesting with further study. A national ban on medical underwriting by the insurance industry. We'll drink to that. A great discussion and presentation over at the Health Care Blog on 12/15/06. Check it out. Read more »

US. Sen. Wyden Proposes Universal Coverage With Individual/Employer Mandates

Interesting new proposal from US Sen. Ron Wyden released yesterday. Requirement for individuals to purchase insurance, and requirement on employers to contribute to workers coverage via payroll tax, and individual subsidies for folks up to 400%. Supportive statements from business folks, SEIU's Andy Stern, and FamiliesUSA's Ron Pollack. Looks more than a little bit like MA Health Reform, writ national. We've been skeptical of the ability to play this out as a federal measure -- this is a provocative first attempt. Read more »

Cracks Showing in the "Pay For Performance" Consensus

For several years now, the idea of “Pay For Performance” (paying physicians and hospitals extra to provide better quality) has enjoyed great, positive buzz in health policy circles. The idea was enshrined in Chapter 58, the MA health reform law – requiring physicians and hospitals to meet new PFP standards to win MassHealth rate increases in FY 08 and 09. All major MA insurers now incorporate PFP in their provider contracts. In California, PFP has become ubiquitous. Last weekend, Congress officially got into the act. Before adjourning, legislators enacted changes to Medicare to give... Read more »

More Details on SCHIP Relief

More details emerging re: Congressional Action over the weekend to provide stop-gap funding for states facing SCHIP (State Children's Health Insurance Program) shortfalls. 14 states face SCHIP shortfalls in this fiscal year totally just over $1B. MA is on the list facing a shortfall of $144M. The Congressional action enables redistribution of $271.6M in unused SCHIP funds in FY04 and 05. The money goes first to those states facing funding shortfalls most immediately. That's a total of only six states, including MA -- also GA, IL, MD, NJ, RI. Massachusetts is a big winner among these... Read more »

National Survey Shows Partisan Split over Individual Mandate

A rich load of interesting and useful information in the new Kaiser/Harvard School of Public Health Survey: The Public's Health Care Agenda for the New Congress and Presidential Campaign. Click here for access to the complete survey. Of many particular questions, we found a couple pretty surprising and interesting: Question: To achieve universal health coverage, one proposal would require that everyone have health insurance, the way all drivers are required to have automobile insurance. People with higher incomes who do not have coverage would be required to buy insurance, and the... Read more »

In Final Act, Congress Favors Tax Shelters for Wealthy and Ignores Kids' Health

My dear mother always taught me, if you can't say something nice about someone, don't say anything at all. So here's something nice about the soon-to-be-departed Republican Congress. THANK YOU for giving us yet another reason to celebrate your impending loss of power. Here's a statement from Robert Greenstein, Executive Director of the Center on Budget and Policy Priorities "It is stunning that as one of its final acts, Congress chose to attach to the tax extenders bill a provision making Health Savings Accounts more lucrative as tax shelters for wealthy individuals even as Congress... Read more »

Will the New Democratic Congress Challenge Bush on Medicaid?

Will newly empowered Congressional Dems rein in the Bush Administration's degrees of freedom in negotiating wide ranging waivers with state Medicaid programs? The topic is covered in The Hill and the answer is a definite "maybe:" “Democrats are concerned about the substantial changes in benefits and out-of-pocket costs that could be imposed on families under the new Deficit Reduction Act provisions. These matters will be explored in greater detail next Congress,” incoming House Energy and Commerce Committee Chairman John Dingell (D-Mich.) told The Hill in a written statement. ... Read more »


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