BMC chief backs Medicaid for all

Kate Walsh says she favors Medicaid for all, not Medicare for all.

It’s not a political slogan you hear much these days, but Walsh, the president and CEO of Boston Medical Center, has a unique perspective since so many of her hospital’s patients are on Medicaid.

“I actually think Medicaid is the most important insurance plan in the country,” she said, noting that it covers roughly 79 million mostly poor and elderly Americans and provides them with coverage for long-term care, medicine, behavioral health, and substance abuse. Every state offers Medicaid, so there is opportunity for local customization of insurance offerings.

“Why I’m a Medicaid for all person is it’s a public option that works for the public,” she said.” I think Medicare for all is a much better political slogan and I’m afraid it’s just that.”

On the Health or Consequences Codcast with John McDonough of the T.H. Chan School of Public Health at Harvard University and Paul A. Hattis of Tufts University Medical School, Walsh said the issue that keeps her up at night is “the dissatisfaction most Americans have with our health care system.”

She said the decision by MassHealth, the Massachusetts Medicaid program, to shift hundreds of thousands of patients into 17 accountable care organizations is the right strategy. Boston Medical Center is a key player in the ACO movement, which incentivizes health care systems to live within a budget as they provide total care for patients.

“We are on the right pathway here by basically aligning the incentives between the people taking care of the patients and the people who are paying for it,” Walsh said. “But we’re up against poverty. Getting a low income population healthy is really a big job. It’s a challenge.”

Walsh agreed that there is no plan B. “We have to get this right because, if we don’t, healthcare costs are going to continue to go up and then we’ll be faced with choices we don’t want to make about how we take care of the patients we serve. I guess, to quote Apollo 13, failure is not an option here. We have to make it work.”

Hattis asked Walsh what she thought about some preliminary research findings released recently by the Health Policy Commission suggesting many hospitals are inflating the severity of patient diagnoses to secure higher insurance payments.

Walsh was skeptical, suggesting a key factor in the increase in patient diagnoses severity may be the rise in out-patient treatment (which means the remaining patients in hospitals would be facing more serious illnesses) and questioning the proxy the commission used to suggest actual illness severity has not increased.

Hattis recently wrote his own analysis on the issue, and reached a different conclusion. “It seems much more like gaming of the system,” he said.

BRUCE MOHL


BEACON HILL

A Boston Globe editorial joins the chorus of criticism targeted at the Legislature for its inability to reach agreement on a hands-free driving bill.

With Gov. Charlie Baker’s position on the education bill unclear, lawmakers begin a PR offensive. Rep. Alice Peisch and Sen. Jason Lewis, the chairs of the Legislature’s Education Committee, extol the virtues of the bill. (CommonWealth) Sen. Sonia Chang-Diaz says the legislation will change the game for disadvantaged students. (Boston Globe)

Two views of the House’s vote on campaign finance legislation last week. House Speaker Robert DeLeo says the bill makes perfect sense and laments the weaponization of bipartisanship. Paul Craney of the Massachusetts Fiscal Alliance calls the bill a partisan power grab. (CommonWealth)

The Department of Children and Families has made some progress, but House Speaker Robert DeLeo is launching a legislative effort to improve oversight of the agency. (Boston Globe)

MUNICIPAL MATTERS

Police trade fire with a man at a Jamaica Plain bed and breakfast and the man ends up dead. (Boston Globe)

The attorney general’s office is looking into Dracut Town Manager James Duggan’s decision to hire a Hooksett, New Hampshire, firm to build a fence for several thousand dollars more than the bid from a local firm. (Lowell Sun

Local Cambodian refugees with criminal convictions from decades ago are being ordered to report to US Immigration and Customs Enforcement to begin the deportation process this week. (Boston Herald) 

WASHINGTON/NATIONAL/INTERNATIONAL

In May 2017, President Trump told two top Russian diplomats that he didn’t mind Russia’s interference in the 2016 election because the United States does similar things, according to former officials. (Washington Post)

ELECTIONS

Sen. Elizabeth Warren’s selfie marathon has taken on a life of its own. (Boston Globe)

James Rooney says Sen. Ed Markey and Rep. Joseph Kennedy III should agree to a spending cap in their race. (CommonWealth)

Leaked audio shows Fall River Mayor Jasiel Correia plans to win the November election by transforming it into a “multi-person race” with the help of a write-in candidate. (Herald News)

BUSINESS/ECONOMY

The bankruptcy filing of Forever 21 signals a shift in consumer taste on clothing. (New York Times)

A Truro lobsterman says rules to protect right whales are having a financial impact on his business. (Cape Cod Times

EDUCATION

Harvard University President Larry Bacow apologizes for a slavery reference in fundraising talk. (Boston Globe)

HEALTH/HEALTH CARE

William Smith of the Pioneer Institute urges the state to stop the war on drug coupons. (CommonWealth)

Physician burnout is a threat to both doctors and patients, say Steve Strongwater, the CEO of Atrius Health, and Steve Adelman of the UMass Medical School. (CommonWealth)

ARTS/CULTURE

An old movie theater in the Fields Corner section of Dorchester is being turned into a performing arts cooperative. (Dorchester Reporter) In Peabody, meanwhile, a mother and daughter bought the former Strand Theatre and turned it into an event space. (Daily Item)

The Hingham Historical Society held a tour of homes where abolitionist Frederick Douglass, first lady Eleanor Roosevelt, and the first war secretary Benjamin Lincoln visited or stayed. (Patriot Ledger)

TRANSPORTATION 

A GateHouse Media analysis indicates airlines are increasing the travel time on many flights so it appears many jets are arriving early. (MetroWest Daily News)

Flight cancellations are higher than the national average at the Worcester airport. (Telegram & Gazette)

The fire that briefly shut down service on the northern part of the Orange Line last month was caused by a safety sign that somehow got between the train and the third rail, creating a high-powered spark. (WGBH

ENERGY/ENVIRONMENT

Al Gore says the climate crisis is the battle of our time and we have the tools to win. (New York Times)

Lawrence residents were allowed to return to their homes Saturday after a natural gas leak forced evacuations early Friday morning. (Eagle-Tribune

At a conference on Friday in Boston, a Trump administration official refused to provide any timeline for the government’s environmental review of Vineyard Wind. (CommonWealth)

A new study estimates that 6 percent of all fishing nets, 9 percent of all traps, and 29 percent of all fishing lines are lost or discarded at sea, where they can become hazards to marine life. (Gloucester Daily Times)

CRIMINAL JUSTICE/COURTS

A jury convicted Wes Doughty of two counts of first degree murder for his premeditated killing of Mark Greenlaw and Jennifer O’Connor, and for killing O’Connor with extreme atrocity and cruelty. (Salem News

Authorities have asked for the public’s help in locating Tony Massetti, a homeless man who often lives in Lowell and is suspected of killing a 51-year-old man on Saturday. (Lowell Sun)

MEDIA

Northeastern professor Dan Kennedy says former Vice President Joe Biden’s demand that Trump attorney Rudy Giuliani be silenced is an affront to the First Amendment. (Media Nation)

The GateHouse-Gannett merger clears a major hurdle. (Associated Press)