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Wednesday, October 01, 2008

What Constitutes Health Care Reform?

The Massachusetts program for extending health insurance to the uninsured was billed as a health care reform package when enacted during the governorship of Mitt Romney and still is. According to an article appearing in the October 1 issue of The Boston Globe, a federal commitment to provide $10.6 billion of federal support during the next three years assures funding for the program. I also heard about it on the radio and the person interviewed mentioned that efforts to contain cost would continue. The newspaper article made no mention of that.

I looked up the story on The Globe’s web page, which has provision for reader comments. There were four, all critical of the program as being a windfall for insurance companies and hospitals. One lamented the absence of any effort to control cost.

In the same issue of The Globe was a letter to the editor commenting on a recent story about the shortage of family physicians in Massachusetts. The letter called attention to recent Massachusetts legislation requiring health insurance companies to recognize nurse practitioners as primary care providers, becoming the 25th state to do so. There are 5600 nurse practitioners in Massachusetts. There was no indication that the writer saw this as a part of health care reform.

I think that was an important omission. As we undertake to reform health care, changing the way care is provided is as important as changing the way it is paid for.

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