The latest roundup of Massachusetts gubernatorial candidates’s positions on health care comes from the Boston Globe here. The Globe asked each: “If elected, how will you control health care costs?” WBUR’s similar roundup is here and the Massachusetts Medical Society’s is here.
But let me save you some time. Here’s a single word or phrase that seems to sum up what each candidate emphasizes most:
Jill Stein, Green-Rainbow Party: Single-payer.
Charlie Baker, Republican: Transparency.
Tim Cahill, independent: Competition.
Deval Patrick, Democrat: Payment reform.
Given the size of the problem, last night’s final gubernatorial debate included surprisingly little about health care and its ever-spiraling costs. But there were a few choice bits. Nancy Turnbull, associate dean of the Harvard School of Public Health, and Jon Hurst, president of the Retailers Association of Massachusetts, kindly agreed to share their reactions with CommonHealth.
Democratic incumbent Deval Patrick: “Small businesses make up 85% of the businesses here. Their two biggest complaints are the cost of health care and access to capital. And we’ve done more in these areas than any other administration in a very, very long time…in permitting small businesses to buy their health insurance in aggregate through cooperatives to get the same buying power that bigger businesses do.”
“In terms of health care, I like and am proud of our hybrid system — it’s a public-private reform. But I think the next big frontier is cost control, and payment reform is the way to get there, and that will take political courage.”
Nancy Turnbull: Health cooperatives were just authorized in Chapter 288 and are not up and running yet, so no small businesses have saved any money from this approach. And it’s not sure that such cooperatives will result in lower premiums. If they do, it’s quite likely that savings for the cooperatives will come at the expense of higher premiums for other small employers and individuals, which is why many health policy people and consumer groups opposed this provision of the legislation, including me.
Jon Hurst: The cooperatives legislation is a reform the small business community has pushed hard for ever since mandated health insurance passed in 2006. And for good reason. Small businesses have been hammered with 73% increases (about 3 X the rate of big business & big government) since the law passed, and that doesn’t include the increased out of pocket deductible and co-pay costs which have ballooned during this recession. The cooperatives still need implementing regulations which will determine whether small businesses will indeed have equal rights with big employers, allowing them to use cost saving tools including self insurance and more flexible rating systems to encourage wellness and better choices among providers. The legislation was certainly a political compromise and will in fact only allow 85,000 lives to join the cooperatives—representing 10% of the merged marketplace. Perhaps the most important outcome of the cooperatives effort will be whether the results show that the antiquated community rating system used in Massachusetts for groups of 50 and under is indeed discriminatory, as well as counterproductive to the important goals of achieving a healthier and more educated consumer of health care services. Continue reading
The issues are complex. But today, WBUR’s Martha Bebinger skillfully distills the four Massachusetts gubernatorial candidates’ stands on health care into easy-to-digest positions.
Read or listen here.
And here are the Cliff Notes:
Jill Stein, Green-Rainbow Party: Supports a single-payer system, a “Medicare for All.”
Deval Patrick, Democratic incumbent: “No major changes to the landmark coverage law, but big changes in how we pay doctors and hospitals,” toward a “global payment” system.
Charlie Baker, Republican: “Less expensive, but probably less comprehensive health insurance and posting prices to drive down the cost of care.”
Tim Cahill, independent: More choice on insurance; revamp the coverage law so fewer people are subsidized; slow spending on health care without losing jobs.