The Tortoise and the Hare by Dolores Mitchell

Readers of the New York Times picked up their Tuesday paper to read that at least three governors are struggling with the clash between their desire to cover their uninsured citizens and the ever rising cost of health care. Pennsylvania’s Ed Rendell is learning, as the article says – “that to contain costs is eventually to pluck dollars from someone’s pocket. His plan has incited protest from hospitals, doctors, insurers and small businesses, each of them finding something to detest”. Governor Schwarzenegger, the author notes, says that making insurance mandatory will have to include “stringent reductions in health care spending”. But before we in Massachusetts can assert that we have solved the problems that our fellow states have failed to solve, a word of caution is perhaps in order. We are an expensive medical community to begin with, and we are far from immune from the cost pressures that affect every community. Our groundbreaking health reform rests on responsibility shared by taxpayers, individual citizens, and business owners large and small. But the shared responsibility has to include providers as well, if health care is to be affordable over time. The Quality and Cost Council is just beginning to address these issues, first by getting cost information to the public. My own agency, the GIC, is measuring cost effectiveness of specialists. There are other efforts by the federal government and others to focus on cost as well as quality and access. But if Massachusetts is to keep on leading the pack, we’re going to have to keep our eye on the cost issue and be willing to do what it takes to put on the brakes. Slowing down may be the only way to get to where we’re going.

Dolores L. Mitchell, Executive Director of the Group Insurance Commission of the Commonwealth of Massachusetts, the agency that provides life, health, disability and dental and vision services to over 285,000 State employees, retirees and their dependents.