Dickson’s plan for greater health care equity
Dr. Eric Dickson, the CEO of UMass Memorial Health Care and the chair of the board of the Massachusetts Health and Hospital Association, says the health care inequities that have surfaced during the coronavirus pandemic can be addressed through policies that help hospitals like his that cater to some of the poorest people in the state.
On The Codcast with John McDonough of the T.H. Chan School of Public Health at Harvard and Paul Hattis, formerly of Tufts University Medical School, Dickson outlined three key policies to improve health care equity – stop the expansion of Mass General Brigham into Westborough, Westwood, and Woburn; raise Medicaid payment rates; and make Medicare available to more people by steadily lowering the age of eligibility.
All three policies center around the way hospital care is paid for, with Medicaid, the government insurance program for the poor and elderly, paying lower rates than commercial health insurers. The disparity in payment rates means hospitals that cater to the poor rely more on Medicaid funding and can only survive if they are cross-subsidized by higher payments from commercial insurers.
As it is, UMass Memorial is just breaking even, Dickson said. “We can keep the lights on but having dollars to invest in new buildings and technologies, that comes really hard to us,” he said.
“If you let the most expensive, largest health care system in the state expand to one of the wealthiest regions of the state and neighborhoods of the state, we just all have to go in eyes wide open and say, boy, that’s going to have a negative effect on the health care systems that were cross-subsidizing their care before, and in Westborough that’s us,” Dickson said.
Dickson also wants to see Medicaid rates increased, and he says the best way to do that is to impose a tax on health providers that care for a greater percentage of patients with commercial insurance. The tax revenue could be used to buttress Medicaid rates, which health care providers that cater to the poor rely on.
The financial impact on the state would be minimized because Medicaid costs are split between the state and federal government, so a large chunk of the increase would be paid for by the federal government. “You can get there with almost no impact on state coffers,” Dickson said.
Dickson is a fan of Medicare for All, a single-payer health care system. He believes Medicare for All would do away with the complex gyrations health care systems go through to survive today and wring a lot of waste and inefficiency out of the system. He said businesses might see their health care costs drop 20 percent.
But he also recognizes that, politically, Medicare for All is a big political lift. So he is recommending that the nation move slowly toward that goal by reducing the age of eligibility for Medicare over time, allowing the system to adapt gradually. Without action, he says, the system will not survive.
“It is unsustainable. Something is going to happen,” he said. “And then you start to talk about equity. Can we really feel comfortable living in a society where women of color are getting mammography at a rate half that of Caucasian women? Getting diagnosed for cancer later because they don’t have the basic health care? … You want to be a part of that society?”
Call it history’s impact. Municipal boundaries set long ago often separate cities and towns with broad demographic differences. Residents of Lawrence, for example, earn a median household income of $44,613. In next-door Andover, however, the median income is more than three times higher, at $151,334. Lawrence is about 53 percent white; Andover is 80 percent white. Only 1 in 10 adults in Lawrence has a bachelor’s degree or higher; in Andover, 3 out of 4 are college graduates. Read more.
The national NAACP is investigating allegations of financial impropriety involving the president of the New England Area Conference of the NAACP. Michael Curry, a member of the national NAACP board of directors, revealed the investigation of Juan Cofield, a longtime Boston activist, in an email he sent Thursday to the Boston Teachers Union and the education advocacy group Massachusetts Education Justice Alliance (MEJA) seeking information from them. Read more.
Amid growing national awareness of the problems of racially biased policing, the Supreme Judicial Court will have a chance to weigh in on a tactic that is increasingly drawing scrutiny: the designation of someone as a gang member. Read more.
Huge new swaths of land will now be available to hemp growers, after a state agency last week removed one of the major legal barriers to growing hemp in Massachusetts and agreed to let hemp be grown on land that is part of the state’s agricultural preservation restriction program. Read more.
The Massachusetts economy grew at a much faster pace than the national economy in the first quarter and the economic analysts at MassBenchmarks see that trend continuing over the coming months. Read more.
Charlie Hipwood, the CEO of MassVentures, believes deep tech is the next frontier in the Massachusetts innovation ecosystem. Read more.
FROM AROUND THE WEB
Dirt bikes and ATVs are riding roughshod through Franklin Park, Boston’s largest park, a situation a neighbor says would never be tolerated on the Boston Common or Public Garden. (Boston Herald)
The combination of vaccine resistance that may cap vaccination rates and coronavirus variants is leading experts to conclude that the US may never achieve “herd immunity” against COVID, which will instead become an ongoing “manageable threat” to health. (New York Times)
Nearly two-thirds of Massachusetts nursing homes that receive federal funding are lagging behind in getting their annual health and safety inspections. (Salem News)
New Bedford officials are worried that the remaining unvaccinated people in the region are showing little interest in getting the COVID vaccine. (Standard-Times)
A US court of appeal today hears a case challenging Idaho’s transgender sports ban, a law passed a year ago. (NPR)
Globe columnist Adrian Walker decries an effort by developer Richard Taylor to push Andrea Campbell out of the Boston mayor’s race, calling it the “latest verse in a very tired song” premised on the idea that there should be just one Black candidate in any race. (Boston Globe) His column was based on this CommonWealth story from last week reporting on Taylor’s effort.
A set of thorny problems involving the Boston Police Department may define acting Boston Mayor Kim Janey’s tenure — and serve as a main focus for the race for the open mayor’s seat that she’s one of six candidates vying for. (Boston Globe)
Republican are making big gains among Hispanic women in South Texas, part of the shift that saw Donald Trump improve his numbers among Hispanic voters from 2016 to 2020. (New York Times)
Local education leaders say President Biden’s proposal for free universal preschool would have a huge impact in Massachusetts, one of the most expensive childcare markets in the country. (Boston Globe)
A Russell teen finds what appears to be an old cannonball on a hillside, and historians speculate it could date back to the Revolutionary War or the French and Indian War. (MassLive)
The SJC will decide whether the state’s whistleblower law protects the former head of the Sex Offender Registry Board who was fired by former Gov. Deval Patrick, partly due to her handling of his brother-in-law’s rape case. (Salem News)
Fall River’s police chief says it’s getting harder to recruit new officers. (Herald News)
Players and staff of the Massachusetts Pirates indoor football team witness a fatal shooting at a Wisconsin casino. (Telegram & Gazette)PASSINGS
Olympia Dukakis, at 89, the actress who won an Oscar for her role in Moonstruck. She was also the cousin of former Massachusetts governor Michael Dukakis. (Associated Press)