Politics

What are the lawmakers, and other state and federal officials, up to when it comes to health reform laws?

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Minimum Age For Buying Tobacco In Worcester Raised To 21

The new regulation would go into effect on Sept. 1. (Charles Rex Arbogast/AP)

The new regulation would go into effect on Sept. 1. (Charles Rex Arbogast/AP)

The Worcester Board of Health has unanimously voted to increase the minimum age for purchasing tobacco products in the city from 18 to 21.

The Telegram & Gazette reports that the new regulation, which goes into effect Sept. 1, was among several tobacco proposals the board had been discussing internally.

Local retailers opposing the measure say the new minimum likely won’t have much of a difference on teens who seek out tobacco products.

Chairwoman Abigail Averbach says it has long been a mission of the board to limit Worcester residents’ exposure to nicotine.

Dr. Lester Hartman, co-founder of the Tobacco 21 movement, says the new age restriction creates an important “social distancing” effect where young teens can no longer count on fellow students to buy them tobacco.

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Deal Would Take Controversial Hospital Pricing Question Off Ballot

It was to be a game of high stakes politics with hundreds of millions of health care dollars on the line. But on Wednesday the players negotiated a truce — with help from unified leaders on Beacon Hill — to prevent a November ballot question on hospital prices.

“It is my hope that this plan will avert a costly and divisive ballot initiative and lend assistance to our community hospitals,” said House Speaker Robert DeLeo in a statement.

The ballot initiative that brought DeLeo, Senate President Stan Rosenberg and Gov. Charlie Baker together aimed to close the gap between high and low cost hospitals. It proposed cutting $463 million in payments to the state’s more expensive hospitals and redistributing that money to struggling community hospitals and to consumers through lower premiums.

The Massachusetts Hospital Association opposed the plan. MHA President Lynn Nicholas is relieved to hear voters won’t be asked to adjust price differences between her members.

“The most important aspect of this resolution is not doing complicated public policy through a blunt instrument at the ballot box,” Nicholas said.

The ballot question was proposed by a health care workers union, 1199SEIU. Estimates showed the state’s largest private employer, Partners Healthcare, would have lost more than $400 million a year.

The influential union and the top employer have been in and out of offices on Beacon Hill for weeks, negotiating roughly a half dozen different plans that would have legislators instead of voters settle the hospital price gap problem.

“The most important aspect of this resolution is not doing complicated public policy through a blunt instrument at the ballot box.”

– Lynn Nicholas

The consensus deal announced Wednesday includes some more money for community hospitals — at least $20 to $25 million a year, divided between several dozen hospitals. Some hospitals would benefit and some would lose if an additional hospital assessment of $250 million is approved and distributed through Medicaid payments. The union says it is pleased. Continue reading

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Opinion: Pending Mass. Paid Leave Bill Targets An Issue Of ‘Human Dignity Violated’

Author Kate Mitchell with her newborn son, Mateo (Courtesy)

Author Kate Mitchell with her newborn son, Mateo (Courtesy)

Ten days after giving birth to my son, Mateo, I was able to walk, but not much more than a few careful steps from couch to bathroom.

I was still bleeding. I was fighting mastitis, a breast infection that delivered a high fever and the worst chills I have ever experienced. Did I mention I was breastfeeding nearly every 45 minutes around the clock? I was totally in love, and completely exhausted.

Luckily for me, I didn’t have to go back to work right after Mateo’s birth. But the same is not true for far too many American women. In fact, about one quarter of mothers in the United States have no choice but to return to work within 10 days of having a baby — many of them still bleeding, still trying to establish breastfeeding, completely exhausted, and often traumatized by leaving their newborns at a time when they need their mothers most.

“At times I feel deeply disappointed that I couldn’t manage to fight harder for what every mother, including me, deserves: time and space to heal and to bond with her new baby.”

– Katey Zeh

In an effort to learn more about the issue, I put together an informal survey that I shared on Facebook and Twitter. One respondent, Katey Zeh, a maternal health advocate with the United Methodist Church, shared her story of lacking access to family leave: In 2014, she gave birth on a Monday, returned to work emails on a Friday, and fully returned to work the following Monday.

Paid parental leave is “partially about economic justice, but it’s also about my parenting — and my family — being affirmed by our society,” Zeh said. In a blog post, she describes in a bit more detail what the lack of leave meant to her:

Now that my daughter is six months old I look back on that time with a lot of regret. If I couldn’t advocate for myself, what kind of advocate was I anyway? If I couldn’t advocate for my kid, what kind of mother did that make me? At times I feel deeply disappointed that I couldn’t manage to fight harder for what every mother, including me, deserves: time and space to heal and to bond with her new baby.

Another respondent, a Catholic school teacher from Ohio who asked that her name not be published, said she loved her work but knew she would not be ready to return to its long hours only four weeks after giving birth — the amount of partial pay leave her employer offered. She also knew that her husband’s work would not allow him to share the home responsibilities, as his job required even longer hours and offered no paternity leave benefits. She left the job she loved. Continue reading

Policies For Transgender High School Athletes Vary From State To State

Justin Bonoyer stands in the athletic fields at Ponaganset High School in North Scituate, Rhode Island. Justin was Elise to his coaches until a few weeks ago. (Jesse Costa/WBUR)

Justin Bonoyer stands in the athletic fields at Ponaganset High School in North Scituate, Rhode Island. Justin was Elise to his coaches until a few weeks ago. (Jesse Costa/WBUR)

Crack. A bright pink aluminum bat connects with a fluorescent yellow softball, sending it toward woods that border Ponaganset High School in northwest Rhode Island. The left fielder runs in and makes the catch.

“Two down ladies, two down,” a player calls.

This is home field for Ponaganset’s Lady Chieftains, except, it seems, the team is not all ladies.

Justin Bonoyer, a stocky 5-foot-5-inch player with a shock of blonde hair, plays right field. Justin was Elise to his coaches until a few weeks ago, although he’d already come out as transgender to most of his teammates.

“I’m a guy,” Justin says. “It’s the same as if a guy who’s not trans went and played on a girl’s softball team.”

Well, sort of. There are separate rules for transgender athletes. Rules so different from state to state that some high school athletes like Justin can try out for any team they choose while others need sex reassignment surgery before they can sign up.

There’s a lot of attention on bathrooms in the debate about transgender rights. The next battleground may be locker rooms, basketball courts and soccer fields. For high school students, the debate centers on Title IX, the federal law that bans discrimination based on gender. Does it also ban discrimination based on gender identity?

We’ll lay out the arguments in a minute. First, a little more about Justin. Continue reading

Sudders: Combating Mass. Opioid Crisis ‘Is Going To Take Us Time,’ Even With New Law

Secretary of Health and Human Services Marylou Sudders speaks about the opioids legislation signed into law just moments earlier by Gov. Charlie Baker on Monday. (Jesse Costa/WBUR)

Secretary of Health and Human Services Marylou Sudders speaks about the opioids legislation signed into law just moments earlier by Gov. Charlie Baker on Monday. (Jesse Costa/WBUR)

A new law designed to stem the deadly opioid drug abuse crisis in Massachusetts was signed into law Monday by Gov. Charlie Baker. On Tuesday, the governor will also meet with his opioid working group to discuss implementing the new law.

Massachusetts Health and Human Services Secretary Mary Lou Sudders is part of that group and joined Morning Edition to discuss the new law. Continue reading

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Baker Signs Compromise Opioid Bill Into Law

Surrounded by lawmakers and health and public safety officials, Gov. Charlie Baker signs the opioid bill into law on Monday at the State House. (Jesse Costa/WBUR)

Surrounded by lawmakers and health and public safety officials, Gov. Charlie Baker signs the opioid bill into law on Monday at the State House. (Jesse Costa/WBUR)

Massachusetts Gov. Charlie Baker has signed into law a compromise bill that seeks to alleviate the state’s opioid crisis.

The Republican governor signed the legislation Monday morning at the State House, surrounded by a bipartisan group of lawmakers and various health and public safety officials. The Democratic-led state House and Senate both unanimously passed the measure last week.

The bill includes a seven-day limit on first-time opioid prescriptions, new efforts to evaluate patients within 24 hours after an overdose and addiction screening for middle and high school students.

“This is a very important day here in the commonwealth of [Massachusetts]. Today, I just signed the most comprehensive measure in the country to combat opioid addiction,” Baker said to applause from the audience.

The governor delivered an emotional speech following the signing, choking back tears as he spoke about the stories he’d been told by those affected by the state’s opioid addiction epidemic. Continue reading

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Ballot Initiative Seeks To Limit Cost Ranges For Medical Care At Mass. Hospitals

In Massachusetts, it can cost you or your insurance company two or three times more to deliver a baby at one of the big Boston teaching hospitals than at small- or medium-size facilities outside the city.

Is this a problem? Should the state try to fix it? That’s what you may have to decide when you vote in the fall. WBUR’s Martha Bebinger explains the issue for Morning Edition.

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Compromise Opioid Bill Caps First-Time Prescriptions At 7 Days

Update March 9 at 3 p.m.: The House has unanimously passed the compromise bill (PDF). The Senate is expected to take it up Thursday.

Our original story:

BOSTON — A Massachusetts House and Senate compromise bill on how to tackle the state’s opioid epidemic includes new limits on first-time opioid prescriptions, a push to evaluate patients after an overdose and addiction screening for middle and high school students.

The provisions are not as dramatic as those proposed by Gov. Charlie Baker, but a spokeswoman said the Legislature is taking a strong step in the right direction.

Baker ignited controversy last fall when he proposed a three-day limit on first-time opioid prescriptions. The House took a step back and suggested seven days, and seven is the number in the compromise bill House members are expected to vote on Wednesday.

Liz Malia, chair of the House Mental Health and Substance Abuse Committee, said this restriction, coupled with the expectation that doctors and dentists will talk to patients about the dangers of addiction, will shift the thinking about opioids.

“We’re changing some of the culture, and in my mind that’s of the things that really has needed to to happen,” she said.

The seven-day limit includes an exception for adults with chronic pain. It has the support of the Massachusetts Medical and Dental societies.

“I think seven days is a lot more reasonable than the original three days,” said David Lustbader, an oral surgeon who is also vice president of the dental society. “That generally is enough time to get people through the acute period of pain, post surgically.”

Continue reading

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U.S. Health Care Is Less Private, More ‘Socialist’ Than You Might Think

The extent of the government's role in health care has become a key issue in the Democratic presidential primary. Here, candidates Hillary Clinton and Bernie Sanders are seen in a debate on Jan. 17 in Charleston, S.C. (Mic Smith/AP)

The extent of the government’s role in health care has become a key issue in the Democratic presidential primary. Here, candidates Hillary Clinton and Bernie Sanders are seen in a debate on Jan. 17. (Mic Smith/AP)

By Richard Knox

Readers, a pop quiz:

The proportion of U.S. health care paid by tax funds is (a) less than 30 percent, (b) about half or (c) more than 60 percent.

If you picked “more than 60 percent,” you’re right — but you’re also pretty unusual.

“Many perceive that the U.S. health care financing system is predominantly private, in contrast to the universal tax-funded health care systems in nations such as Canada, France or the United Kingdom,” David Himmelstein and Steffie Woolhandler write in a new analysis of U.S. health spending in the American Journal of Public Health.

They find that 64.3 percent of U.S. health expenditures are government-financed. And they project the tax-supported proportion will rise to 67.1 percent over the coming decade as the baby boom generation ages and retires — nearly as high as Canada’s 70 percent.

“We are actually paying for a national health program, we’re just not getting it,” Woolhandler says.

tax dollars for U.S. health spending

Now, Himmelstein and Woolhandler have an agenda. For decades, they’ve been perhaps the leading researchers promoting the kind of single-payer health system that Socialist and Democratic presidential candidate Bernie Sanders has put on the debate agenda. One recent poll suggests more than half of Americans (and 30 percent of Republicans) support the idea.

But even if you disagree with the Himmelstein-Woolhandler ideology, their research is generally regarded as sound, and their method is straightforward.

They added up what federal and state governments spend on health through Medicare, Medicaid, the Veterans Health Administration, government employees’ health care premiums, tax subsidies and other programs. They argue that accounting by government agencies (the Center for Medicare and Medicaid) undercounts the real tax burden because it leaves out major pieces of the pie — such as government employees’ care ($156 billion a year) and tax subsidies for private, employer-sponsored coverage (nearly $300 billion).

And whatever you think about Medicare-for-all, it’s a good idea to see the present U.S. health care system for what it is — an increasingly government-funded financing scheme. Continue reading

Mass. House Approves Bill Aimed At Combating Opioid Overdoses

Massachusetts House lawmakers have approved a bill aimed at addressing the state’s alarming spike in opioid overdoses and deaths, while rejecting a proposal that would have allowed doctors to involuntarily commit those suffering from overdoses to drug treatment facilities for up to three days.

The bill, which passed Wednesday on a unanimous vote, would limit initial opiate painkiller prescriptions to a seven-day supply and set an evaluation requirement within 24 hours for overdose victims seeking help at hospital emergency rooms.

State Rep. Jeffrey Sanchez said there has been a change in the public perception that no longer sees individuals struggling with opioid addiction as “junkies” and “crackheads” but rather as individuals with an illness who need help.

“With this bill, we’re trying to help people not get to the lowest of their low and never reach that trap door,” said Sanchez, a Boston Democrat and House chairman of the Joint Committee on Health Care Financing.

The House bill has significant differences from a bill filed by Republican Gov. Charlie Baker.

Continue reading

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