The Download: The sprawling health care story

Now that nearly everyone in Massachusetts has health insurance, Gov. Deval Patrick is filing legislation to rein in its cost. It’s one of those big, complicated policy stories that few in the media do well anymore.

The legislation, unveiled yesterday by the governor at a Greater Boston Chamber of Commerce breakfast, has two key parts. First, it would give the state’s Insurance Commissioner the power to reject a health insurer’s premium increase if the underlying costs (specifically the plan’s payments to hospitals and doctors) are deemed excessive. Second, state workers and people with state-subsidized health care would move to a system where their health care providers would be paid set fees for each of their patients rather than for each test or service they provide. The private insurance market would be encouraged to adopt a similar approach, but it’s not mandated.

Patrick’s staff gave The Globe a sneak peak of the legislation for Thursday’s editions and the paper follows up today with a thorough summary and reaction from all the key players. The consensus is that no one quite understands it yet. Is the governor moving toward price controls? Who will set the fees health care providers will be paid for each patient? And how will those fees be determined? As Senate President Therese Murray says: “It’s very complicated and we’re going to take our time and go through it.”

TV stations don’t have that kind of time, so they largely reported what the governor said or summarized the bill. WBUR offers a good Q&A with reporter Martha Bebinger and its CommonHealth blog asks why Andrew Dreyfus, the president and CEO of Blue Cross Blue Shield of Massachusetts, was smiling at the Chamber breakfast.

The governor’s legislation is hard to summarize in 500 words, so the Boston Herald instead gives voice to some opponents under the headline “Deval Patrick’s health plan called bad medicine.” The Lowell Sun customizes its story on the governor’s proposal with information on a global payment project (that’s the term for paying health providers on a per-patient rather than a per-service basis) under way at Lowell General Hospital. The Boston Business Journal says hospitals dodged a rate cap bullet and raises questions about how the state Division of Insurance would use its new powers.

Paul Levy, in his blog, calls Patrick’s proposal rate-setting through the back door. He also wonders how consumers will react to it. “Unless consumers are confident of getting the same or better quality of care from the restricted network serving them, there will be extreme negative feedback in the future,” he says.

The editorial pages of the Globe and the Herald both back the governor’s approach. The Globe says the legislation is pushing cost drivers out of the system while the Herald notes  “there is a certain fudge factor built into this somewhat amorphous plan, and plenty of unanswered questions.”

One other tidbit. The bill would change medical malpractice law by allowing a doctor to apologize to a patient or a patient’s family for a mistake without that admission being used against the doctor in a lawsuit. It’s an interesting idea, and one that CommonWealth explored in a What Works feature called “Saying Sorry” last summer.

                                                                                                                                                                                        –BRUCE MOHL


Lynn’s city council votes 11-0 to reinstate Richard Fortucci as chief financial officer. Mayor Judith Flanagan Kennedy had been highly critical of his performance. The Lynn Item has the story.

The United States Postal Service has put its Union Square, Somerville branch up for sale, and is planning on consolidating the facility into Chelsea. The Wall Street Journal reported last month that the Postal Service was looking to close thousands of branches in an ambitious cost-cutting effort. 

Gloucester is freezing municipal spending to cope with the expenses of dealing with ice and snow removal, the Gloucester Times reports.

People posing as Haverhill Water Department workers tried to gain entrance to three homes over the last few days, the Eagle-Tribune reports.


Advocates for the sexually abused are lining up behind Sen. Scott Brown, but the Herald‘s Peter Gelzinis wonders why Brown was so quick to brush off claims that former state Rep. Jeff Perry let a fellow Wareham police officer sexually assault a teenager. During a fundraiser for Perry, Brown said “voters don’t want to hear” allegations that Perry turned a blind eye to the assault. “They want to get back to the issues.” At the Atlantic, Wendy Kaminer examines the path from George H.W. Bush’s “real men don’t get on the couch” to Brown’s candid tell-all.


Ellen Zane, credited with bringing Tufts Medical Center back from the near-dead, is retiring as the hospital’s CEO in September, the Globe reports.


State Education Commissioner Mitchell Chester recommends that 17 schools, including 10 in Boston, be granted charters, WBUR reports.

A Pennsylvania teacher who calls out “whiny” kids starts a national debate about working conditions…and “whiny” kids.


The vote by the US House to cancel funding for a backup engine for a jet fighter will have a big impact on GE but also a host of other companies on the North Shore, the Salem News reports.

CommonWealth’s Paul McMorrow, in his weekly Globe column, breaks down what’s going on with the busted mortgage giants Fannie Mae and Freddie Mac.


John Boehner‘s freshmen are giving their speaker headaches.

Federal funding for public broadcasting radio and TV stations could be a think of the past if House Republicans get their way, reports the Globe.


The Globe reports that the Roman Catholic Archdiocese of Boston is paving the way to sell or convert to other uses seven church buildings whose closure has been the subject of long-running protests by parishioners.


Wisconsin‘s budget fight took another turn yesterday, when Democratic lawmakers fled the capital to block a bill restricting collective bargaining for public employees. The Wall Street Journal compares the situation in Madison to welfare state riots in France and Greece. Meanwhile, President Obama speaks out on the growing protests by public employees in Wisconsin who have mobilized thousands of people to protest Gov. Scott Walker’s plan to nullify collective bargaining agreements as well as other budget cuts. Other states could face similar protests.


With the poor response by National Grid to power outages during December’s blizzard as the driving force. state Rep. James Cantwell of Marshfield is planning to file a bill that would give cities and towns some of the money from fines levied against utilities.


Sen. John Kerry asks federal officials to approve Cape Wind’s financing plan, which includes federal loan guarantees. Via Associated Press.


LNewton Mayor Setti Warren insists again that he is not going to run against Sen. Scott Brown. But Newton Tab blogger Greg Reibman explains how Warren could win a Senate seat without beating Scott Brown.

Sarah Palin says she is “still thinking about leading this country.” Via Andrew Sullivan’s Daily Dish.

Unsuccessful GOP congressional candidate Sean Bielat, who’s making himself available to comment over every perceived announcement and misstep by Rep. Barney Frank, is irritiated over reports about his drawing a salary from campaign contributions because he says he’s just a private citizen now.


Everybody was Kung Fu fighting: A Randolph illustrator has filed suit against movie giant DreamWorks contending the characters in “Kung Fu Panda” were based on characters he created in the 1990s.

Peter Lucas, in a column in the Sentinel and Enterprise, calls the state’s film tax credit a blockbuster for Massachusetts.

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