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Senate Passes Health Care Cost Control Bill With Few Major Changes

BOSTON — In a near-unanimous vote — 35-2 — the Massachusetts Senate on Thursday night passed a major health care bill that legislators estimate will save $150 billion over the next 15 years.

“This bill will reel in health care costs without harming our number one industry or patient care,” said Senate President Therese Murray in a statement, “and remove a major roadblock to long-term job growth and essential investments in education and transportation.”

In two days of debate, the Senate made dozens of large and small adjustments to this complex health care bill. Members set a health care cost-control goal that’s more aggressive than in their original bill. The bill would allow costs to grow 0.5 percent more than the gross state product (GSP) through 2015 and then drop to level with GSP indefinitely.

The Senate bill would also create standards as more public and private insurance plans switch to global payments. Senate Democrats rejected a Republican amendment that would have gotten rid of a new surcharge to fund electronic health records and prevention programs.

“We know it’s less expensive to keep disease from starting in the first place than to treat someone after they’re sick,” said Brian Rosman, policy director at Health Care for All. “And we know that community prevention lowers health care costs along with keeping people healthier.”

But not everyone is celebrating passage of the bill.

“The amendments, as I watch them, many of them really do add to the cost rather than contain the cost of health care,” said Bill Vernon, with the National Federation of Independent Businesses in Massachusetts.

Vernon is skeptical that the bill, with new fees, boards and commissions, will save the estimated $150 billion over 15 years.

“I have a very hard time believing that it’s actually going to reduce the cost of health care for small businesses and the people who work there,” Vernon said.

The Senate saved one of the more controversial items for last.

Late Thursday, as cleaning crews hauled trash and mopped the marble halls, Sen. Barry Finegold rose to argue for an amendment that would make hospitals with the highest prices justify those costs to a new independent board.

At least four recent reports from Attorney General Martha Coakley and an agency in the Patrick administration have concluded that high prices, based on top hospital market clout, are driving up health care costs.

“And the thing about it is,” Finegold said, “there’s no correlation between price and the quality of care.”

Finegold says that while community hospitals generally deliver the same quality of care as their big, wealthier counterparts, they are struggling to make it on much lower payments.

A special commission that met for six months last year came up with a remedy that Finegold tried to add to the Senate bill.

“Now I understand that there is not a majority will to do that,” Finegold said, wrapping up his speech on the Senate floor. It was mostly for show — Sen. Finegold withdrew this controversial amendment, avoiding debate and a possibly difficult vote.

The more expensive hospitals and many of the state’s business leaders lobbied hard against a government board that would decide if high prices are justified. The House bill has a similar measure that these groups say is also unwarranted.

“At this point we don’t believe that increased government regulation is the right approach to deal with price disparities,” said Associated Industries of Massachusetts President Rick Lord.

Lord says he’s hopeful that consumers who are paying more of their health care costs will drive down prices by using lower cost hospitals.

“That’s the approach we believe, at least in the short term, is the appropriate course to follow,” Lord said.

Lord and others now turn their attention to the House, which takes up its version of the latest Massachusetts health care overhaul at the end of the month. The two branches will appoint a conference committee to negotiate a possible compromise on their differences and will likely deliver a bill to Gov. Deval Patrick in July.

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  • paja

    Our health system is OUT OF CONTROL. Pharmaceuticals, hospitals and doctors charging more and more for less and less and I don’t even see the charges after a medical visit! There is no transparency. 

  • Lillee

    One of the biggest barriers to hiring new help is the astronomical health insurance prices. In the small company I work for I’ve watched prices double in maybe five years. (Having someone hit 50 in a small group of employees costs everybody. No wonder nobody wants to hire an older person.) High premiums I think makes people want to see doctors more–they’re paying for it (employers make employees pay more and more into their premiums) so why not go to see a doc about every ache and pain and internal worry? Everybody is at PT. Everybody is on some anxiety med. I can count on one hand the number of times my parents went to see a doctor. My friends go every time they twist a knee, pull a muscle or worry about their bills. The cost has to be contained on both ends: The price of care needs to come down and those personalities that love to see the doctor for every little thing should pay a higher individual premium. (Chronic issues–like diabetes or heart conditions–are not the same as ”frequent flyers” and those patients should not pay a surcharge.)
     But the idea presented in this article that people will go to the local hospital because it’s cheaper? No way. A recent study showed that wealthier communities (Newton area say) go to the really nice facilities while people who live in Brockton go to the cheap local clinic. Odds are the Brockton guy pays more in premiums because he’s got high blood pressure, is likely to be overweight and has a lousy job so more comes out of his pocket. And the Newton child is more likely to go to a concussion clinic when he gets bumped on the head under the night lights at the soccer field while the Brockton kid who gets kicked in the head is more likely to get a bag of ice. So the poor have been subsidizing the wealthy for a very long time when it comes to health care. But I think the issues are too complex, special interest too powerful and too much money is involved for the problem ever to be solved. 

    • paja

       I agree whole heartedly… out of control.

  • phoulden

    Sounds a lot like the approach taken by Mass Chapter 409 and later by Mass Chapter 372. Any historians out there who care to lay out the differences?

  • Mcion

    Its too bad that the Finegold amendment was obstructed by special interests. Rick Lord’s comment that “consumers will drive down prices at the high cost hospitals by using lower cost hospitals” is laughingly disingenuous. Everyone who has ever worked in the health care system knows quite well that consumers don’t give a hoot about the cost when their insurance company is paying the bills and everyone who is ill wants “the best medical care”, which means to most people in our state the MGH, the Brigham, etc., even though studies have shown that there is not much of a correlation between cost and quality of health care. The special interest and their   lobbyists have again pulled the wool over the public’s eyes. When are our legislators going to tell these special interests to get lost? Let’s throw the bums out in the next election.

    • http://www.facebook.com/people/Jeremiah-Meyer-Oday/100001324404741 Jeremiah Meyer-O’day

       “Laughably disingenuous” aptly describes most of what AIM has to say. But, since the vast majority of Massachusetts legislators are terrified of AIM cutting off the flow of campaign contributions and/or issue ad money, laughably disingenuous, coming from AIM, is accepted as a legitimate point.
       

  • Jumper999

    The headline should state whether this is the US senate or the state senate or the Federation senate – poor journalism.  I’m no Jedi, but I think if I wrote the article, I would have been more specific.

  • paja

    It is right there in the first sentence… i don’t think we are used to reading about out State
    Legislature and health care… but here it is. TGIF.

  • Nancy

    One of the great fallacies posited by opponents of healthcare for all is the notion that we are all just dying to examine dozens of alternate plans, policies and now hospitals to find the cheapest! People have neither the time nor the inclination for examining the plethora of alternatives when they’re sick, or even just looking for a job. The only REAL solution is for all of us to kick in according to our ability (i.e. taxes) and all to reap the benefits. We need to understand that we are all in this together. I’m happy and proud to support my community hospital, but glad that MGH and Brigham are there if I need them as well.
    nancha

  • Gtooker

    Three cheers for the Massachusetts Senate and  their pragmatic approach to health care cost containment.  Recognition that wellness promotion and medical information efficiency are critical elements in this effort is to credit.

    G. Tooker

  • GKoenig

    First of all, I think it’s creepy to even call what we have a “Health Care” system.  It’s a “Medical Services Industry” so get used to it.  Like the Military Industrial Complex, here in Massachusetts it’s a confluence of government and industry, with the public holding vast misconceptions about what’s going on.  It has a life of its own by now.  The Medical Industry practically owns state government at this point.
    So, no, I don’t expect this legislation to be effective.  In Shannon Brownlee’s book “Overtreated” she clearly lays out what is wrong with what we’re doing and at least some ways forward.  In the long run, the best policy is to “not get sick.”  Which brings us to actual Health!  What can an individual do?  Use the medical system as little as possible.  Take charge of your life and encourage those around you to do the same.  And that includes emotional health as well as the old familiar diet and exercise.  The more we disconnect our lives from processed food, ‘sit in a stupor’ entertainment (in front of the TV), and move away from the constant commercials that are trying to turn us into shopaholics (no, amassing more things will not make you happier), the better!

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