Health panel ventures into political arena

Health panel ventures into political arena

Altman: We’re providing information, not telling people how to vote

TOP OFFICIALS AT THE HEALTH POLICY COMMISSION privately began debating this summer whether it made sense for the watchdog agency to wade into the political arena and analyze the potential impact of a ballot question mandating nurse staffing ratios at the state’s hospitals.

Stuart Altman, the chairman of the commission, said the agency didn’t take a vote or hold public hearings on whether to get involved. Instead, Altman said, he discussed the idea with David Seltz, the executive director, and several other board members.

“We looked at our overall mandate and basically came to the conclusion that this is such an important issue and would have significant long-term impact on cost, quality, and access that we had to do it,” he said.

The commission sought input from the Office of Campaign and Political Finance, which raised no objections as long as the agency focused on providing analysis and information and did not recommend  how Massachusetts residents should vote.

“We did not and cannot get involved with telling people how to vote. That’s neither our mandate nor do we wish that to be the case,” Altman said. “People will have to decide. The important thing is they understand what they are voting on.”

During his comments at Wednesday’s hearing on the commission’s preliminary research on the ballot question, Altman indicated he had grave concerns about the cost implications of the initiative. He noted the commission’s analysis indicated the cost impact of the ballot question would be roughly half of the state’s overall benchmark for health care cost growth of 3.1 percent.

Yet Altman declined to say where he stood or how he would vote on the ballot question. “We want to separate what our analysis is from how you vote,” he said. “You could wind up saying, yes, this is going to cost a billion dollars but it’s worth it and vote yes.”

Julie Pinkham, executive director of the Massachusetts Nurses Association, which is pushing the ballot question dealing with nurse staffing ratios, said the group has filed a public records request for documents dealing with the Health Policy Commission’s decision to do the analysis.

“Early on in this process I was unequivocally told that they had no interest whatsoever in gravitating into this debate, and that made perfect sense to me. Why? Because the Health Policy Commission is the agency that actually is overseeing this,” Pinkham said, referring to the ballot question’s language, which designates the commission as the agency that would craft regulations to implement the proposed law.

Pinkham said the Health Policy Commission doesn’t usually get into the analysis of health policy. “We have over 340 different health care bills – some very large ones that came up recently – and never once has the Health Policy Commission endeavored into those analyses,” she said. “So they are breaking new ground, and I expect that everybody should take a careful eye and watch closely what happens in the future as a result of this.”

Seltz, the executive director of the commission, said the commission’s approach in this case was consistent with all the other research it conducts on health cost trends. He said the agency typically does not publicly announce it is exploring an issue until it determines whether the research is feasible.

“It was something we had to work through, and that took some time,” he said. “We do think of this just as any other research project we put forward.”

Sen. James Welch, the Senate chair of the Legislature’s Joint Committee on Health Care Financing and a supporter of the ballot question dealing with nurse staffing ratios, said he can understand why people would question whether it was appropriate for the Health Policy Commission to weigh in on the issue so close before the election.

But he said voters need information as they grapple with such complex issues. “We’re just entering into a different time, where voters, through the ballot measures, are being asked to make weightier and weightier decisions,” he said.

Meet the Author

Bruce Mohl

Editor, CommonWealth

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

Catherine Williams, a spokeswoman for House Speaker Robert DeLeo, said she welcomed the Health Policy Commission’s analysis. “It is within the purview of the HPC to examine factors relating to potential cost growth in Massachusetts,” she said in a statement. “The House welcomes input and analysis from a variety of independent groups to supplement the work of the legislative committees.”

Michael Jonas contributed to this story.