Made in Massachusetts - The Lessons of Health Reform Make the New York Times Editorial Page

Today's (4/21/2010)  New York Times Editorial lays out the strength of Massachusetts first-in-the-nation health reform program and its greatest accomplishment: near universal coverage. In many ways, the Massachusetts approach was a model for the national reform package that became law recently. Where the national reform went beyond Massachusetts in part, was in the creation of a series of pilot programs for testing new models of cost containment. Several years after reform in Massachusetts there is no sign despite the warnings of many that reform was a budget buster for the state. But it is clear that healthcare costs are a complete budget buster for small business and frankly all business, as well as for small groups and individuals in a variety of circumstances. The solution? A short-term legal battle is taking place over whether or not the state can refuse to authorize insurer rate increases it deems "unreasonable." The genesis of this battle is clear--rates are high, and the increases being contemplated or proposed, high as well. But insurers say the rates reflect provider costs. And providers say their costs reflect doctor and patient practices pursued in the name of trying to give and get the best healthcare--and that transparency along with payment reform are a must. So where do we go? As the Times editorial says: it is indeed fundamental payment reform - via dramatic changes in how we pay for our healthcare. PBLN has endorsed the findings of a Special Commission that laid out a 5 year framework for getting this done. The devil is, as they say, in the details. But there is no doubt as the Times lays out: People like their healthcare, they like the idea that pretty much everyone has it and likes it, and cost containment is the next frontier.

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