Friday, May 29, 2009

Health Care Reform in Massachusetts

A reader recently asked that one of my next postings provide an update on health care reform in Massachusetts.

While I claim no inside information, it happens that the lead front page article of May 28 issue of The Boston Globe dealt with the subject. The following is my summary of the contents:

- The article’s headline was “Costs snarling health overhaul.” The opening sentence read “Soaring healthcare costs, combined with the recession, are threatening to undermine the gains from Massachusetts’ 2006 healthcare overhaul.”

- An increasing proportion of the population is reporting problems paying medical bills.

- The program continues to enjoy the support of 70% of the people.

- 3% of Massachusetts residents are uninsured, compared with a national average of 15%.

- 91% of residents say they have a regular health care provider, up from 86% prior to the program.

- Use of hospital emergency rooms has not changed.

The May issue of H&HN, the journal of the American Hospital Association, also had an article on the topic. Here is one quote:

“Original budget projections for the Massachusetts program were $160 million in fiscal year 2007, $400 million in FY2008, and $725 million in FY2009. At $133 million, actual costs came in lower for 2007, but shot up to $625 million in 2008. The state funding request for 2009 was $869 million, with some estimating that actual cost could reach $1.1 trillion.”

One unanticipated effect discussed had to do with so-called safety net hospitals. Certain hospitals in Boston and elsewhere that care for a disproportionate number of the indigent and uninsured used to get support from a special state fund. That support was cut back in the reform program on the premise that those patients would now have insurance from which the hospitals would be able to collect. But many of those patients ended up being covered by insurance that paid at Medicaid rates which are seriously below cost. The result is that the safety net hospitals are in financial trouble.

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