"My Crystal Ball" by Dolores Mitchell

This article is more than 12 years old.

Writing about what’s next in health care and health insurance during the next five or six months is going to be pretty much of a crap-shoot (If that’s a swear — sorry — I think of it as a gambling term) and most of us would be wise, not to do it. Who knows how bad the economy will get, or what help we will get from the next Congress and the next administration — or what that help will accomplish. And who knows what will come of the various health reform packages — Senator Baucus’s, Senator Kennedy’s or Secretary Daschle’s. And of course, in the great parlor game of musical chairs, we’re all waiting to see who gets on the short lists for CMS, for AHRQ, for CDC, for FDA, for Surgeon General — who from Massachusetts will get the nod — which incumbents get to stay — and who goes — what will it all mean for us in the Commonwealth as we watch the state’s revenues sink, along with those of our sister states. Misery doesn’t particularly enjoy this kind of company.

Although we can see the future only dimly, the one thing we know is that things will be different in Washington — and in Boston. So, with absolutely no inside knowledge to guide me — my predictions are the following:

- There will be a stimulus package, and it will pass quickly.
- There will be a health reform bill and it will pass during the first year of the new Congress.

- There will be a tax increase for some, and tax relief for others, as promised by then Candidate Obama.
- The pressure on Massachusetts health care providers to lower their costs will gain momentum, but it will be an uphill struggle. Redistribution of income is always the highest hurdle of all, but it will have to come.
- The excruciatingly slow adoption of Information Technology in medicine will accelerate as it becomes an expected standard of care.
- We won’t equal the Japanese, but the gap between the CEO pay and hourly workers pay will begin to narrow — ever so slightly — and it’s about time.
- Health plans and purchasers will continue to push providers to do better by measuring their performance and reporting the outcomes, as the most effective way to improve the quality of medical care.

Does this sound Pollyannaish? Well, maybe, but despite the grim economic news there is a breath of fresh air as we change administrations in Washington. With change, there is hope. With hope anything is possible. Tune in a year from now and see how many of my predictions come true.

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 300,000 State employees, retirees and their dependents.

This program aired on December 4, 2008. The audio for this program is not available.