Patrick wants health bill faster

Gov. Deval Patrick amped up the pressure on the Legislature today to move faster on  health care reform, saying recent statements by House Speaker Robert DeLeo and a top lieutenant that action on Patrick’s cost containment bill will likely not happen until next year were unacceptable.

“It’s got to come sooner than that,” Patrick said outside a State House forum on his administration’s plans to reel in costs for public and private workers. “The speaker and (Majority Leader Ronald Mariano) don’t have to answer to me; they have to answer to all the premium payers. The speaker and the leader get that this is a problem but. . . we can’t be defeated by that complexity anymore.”

The forum in Gardner Auditorium featured members of the administration fielding questions from health care industry and public and private sector officials as well as single payer advocates. It focused on a wide range of issues, including the spiraling costs that are crippling municipal budgets,malpractice reform, and Patrick’s bill that would reform payment and delivery methods.

Earlier in the morning, The Boston Foundation released a study it cosponsored with the Massachusetts Taxpayers Foundation that examined 14 municipal health care plans and found, on average, the cost was 37 percent higher than comparable private plans and 20 to 33 percent higher than plans offered by the state Group Insurance Commission and the federal government.

The report found that municipalities pay more because their employees don’t pay deductibles, have low copays, and pay a smaller share of premiums. The report said bringing municipal health plan benefits more in line with those of state and private sector workers would help reduce the communities’ health care burden.

“One of the key factors driving municipal premiums is the virtual absence of any cost sharing in the form of deductibles or copayments for office visits and other basic medical services,” says the report, which calls for the Legislature to give cities and towns plan design power free from collective bargaining. “With cost sharing, employees have a financial incentive to be more selective in using medical services; when services are virtually free, there is no impact on consumer behavior.”

Patrick has filed a bill to give cities and towns some control over plan design with unions at the table but with a cap on the length of time for negotiations. If the community is unable to come up with a plan that has comparable savings to the Group Insurance Commission, then that community would be moved into the GIC. Patrick said he understood DeLeo would include a similar plan in the budget he is planning to unveil later this month. Patrick said he has spoken with Senate leaders about possibly breaking the measure out of the budget process to try to act on it sooner.

“My hope was to have had it done, frankly, by now so cities and towns would have some time for transition so they get the full fiscal year value for it,” Patrick said, chiding legislators for “wringing their hands” in the never-ending debate over health reform.

A spokesman for the speaker said he could not confirm or deny the municipal reform measure would be part of budget deliberations but emphasized DeLeo’s commitment to give municipalities some relief from the growing portion of their budgets.

“The speaker has made tackling municipal health care costs his priority,” said DeLeo spokesman Seth Gitell.

At an appearance at the Greater Boston Chamber of Commerce last month, DeLeo said he thought it might take “this two-year cycle” of the Legislature to hammer out a compromise measure. Mariano, at a forum on global payments sponsored by MassINC, said he could not see any action until the end of the year or early next year because of the scope of the issue.

State Rep. Steven Walsh, House chair of the Committee on Health Care Financing, said the committee is planning to hold the first hearing May 16 in Gardner Auditorium and four others around the state. Walsh said he appreciates Patrick’s advocacy but said the breadth of the reform is too big and its consequences too far-reaching to rush through a measure that does little but satiate a desire for action without substance.

“It’s a significant bill and I think the governor is certainly within his responsibility to advocate for the bill,” said Walsh. “We’re going to come up with a product that works. We don’t know how long it’s going to take but I don’t think the timeline laid out (by DeLeo and Marinao) is unreasonable.”

Sen. Richard Moore, the committee’s co-chair, said in an email response that Patrick’s proposal is merely the starting point and it’s now in the Legislature’s hands.

“The issue of health reform – especially in the area of affordable, accountable, high quality delivery of care – is too important,” Moore said in his email. “We certainly don’t want to be reckless in reforming health care since this issue is so important to the health of our state economy and to the health of our citizens.  The governor has filed his proposal for reform. It’s a starting point for the discussion. We’re not ‘wringing our hands,’ but we’re rolling up our sleeves to do the important work ahead.”

At the forum, Patrick, pounding on the lectern to emphasize what he said was his impatience and frustration, declared “Massachusetts will be the place where we crack the code on cost containment.”

He acknowledged his battles with health insurance companies because of his cap on premium hikes. He said industry officials dissect his words and actions “like the ancient Greeks used to leave entrails.” He said using the complexity as an excuse to put off action should not be tolerated.

“We are moving,” he said. “We are not going to debate this to death.”