mass-governors-race-2014

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Where Baker, Coakley Stand On Health Care

Democrat Martha Coakley and Republican Charlie Baker, before a televised debate Tuesday in Boston (Barry Chin/Boston Globe/Pool/AP)

Democrat Martha Coakley and Republican Charlie Baker, before a televised debate Tuesday in Boston (Barry Chin/Boston Globe/Pool/AP)

It’s nearly half the state budget, almost 20 percent of the state’s economy and a perennial top concern for voters. The issue is health care, and so far, neither Democrat Martha Coakley nor Republican Charlie Baker has taken the lead on this topic with voters in the gubernatorial race.

“Coakley has perhaps a slight edge on the general health care issue, as well as the affordability issue, but neither campaign has really broken away” on health care, said Steve Koczela, president of the MassINC Polling Group. “It’s not like taxes, which go big for Baker. It’s not like education, which tends to go a bit bigger Coakley. It’s an issue that is still very closely fought.”

So where do the gubernatorial candidates stand on some of the key concerns in health care? Below is a summary of the candidates’ proposals for how to treat the health of the state.

On Making Health Care More Affordable:

BAKER: He argues that giving patients information about how much tests and procedures cost, in advance, will help us become informed consumers of care. We’ll spend less money, because we’ll choose to have a baby, for example, at the hospital with the lowest cost and best quality scores. As of Oct. 1, health plans in Massachusetts are required to post what they pay each hospital and doctor.

Baker would take a next step. “I’d like to get to the point where hospitals just post prices and people can see them plain as day,” Baker said. “As governor, I’m going to lean really hard on this.”

Some health care analysts say Baker’s strategy for reducing health care costs could backfire. Patients may assume that the most expensive hospital is the best even though that’s generally not true. And letting Brockton Hospital, for example, know that it is paid about half of what Massachusetts General Hospital receives for a C-section may mean Brockton Hospital demands more money, instead of MGH saying, “OK, I’m going to lower my prices to compete.” In addition, some of the expensive hospitals say their higher prices subsidize teaching and research.

COAKLEY: She argues she is uniquely positioned to tackle health care spending. She created a health care division in the attorney general’s office, issued the first detailed reports on health care costs and used her leverage to negotiate a deal that would limit the price increases Partners HealthCare could demand in the near future.

“The agreement that we have reached, to be approved by the court, caps costs and lowers costs as opposed to maintaining the status quo, which we all agree is too expensive,” Coakley said during a campaign debate on WBZ-TV. Continue reading

All 9 Candidates For Mass. Gov: Where Do They Stand On Health Care?

Two leading gubernatorial candidates: Martha Coakley and Charlie Baker (AP)

Two leading gubernatorial candidates: Martha Coakley and Charlie Baker (AP)

Kudos to the Health Business Blog for the first full scoop on the health care positions of all nine of this year’s candidates for Massachusetts governor.

Blogger David E. Williams is not a professional journalist — he’s a health-care consultant and president of the Health Business Group — but he certainly seems to be first out with a roundup sure to be of interest to many in health care, the state’s biggest employer.

I asked him whether he thought this November’s gubernatorial election could be a bellwether for the politics of health care. “I think so,” he said, “partly because we have so many people who are so knowledgable about health care, and not afraid to say things.”

The election could have national import, he added, because Massachusetts is at a very interesting juncture: ‘We’ve moved well beyond ‘Should we repeal the ACA or not?’ We’ve taken Romneycare and brought it to the next level with 224 [the latest health reform law aimed at containing costs]. So we’re already a full step ahead, and now you’ve got people who are really looking to say in their first term: What goes beyond that? Can we keep universal coverage and get cost under control and improve quality?”

“I don’t know that this election will be decided based on health care,” he said, “but I think the discussion that goes on and the debate will actually ready the residents of the state for some potentially very significant and important changes with the new governor.”

David is planning a broad analysis of the candidates’ positions for March 18, but I asked him in the meanwhile what had most struck him in the nine sets of responses. A few points:

• Since you have so many people with deep health-care expertise, they really do apply their own knowledge and have pretty firm views in some of the areas. One striking thing is you have certain topics that wouldn’t be on the table in the national debate. The single-payer system is one of them — you see that with [Donald] Berwick but also [Steve] Grossman talks about it, and I’m not sure everybody else has it off the table. Continue reading