FactCheck.org visited Pioneer’s office a couple of weeks ago to learn more about the Massachusetts health reform law. Without a doubt this will be a big issue in the 2012 presidential campaign. A few thoughts on the article:
1. More Research Needed: There are still a lot of unknowns in Massachusetts. The data in the state is improving but much is still unclear. Pioneer has attempted to capture key metrics in its Report Card Series. Interim Report Cards on Massachusetts Health Care Reform
2. Cost Containment:
the national law included many steps aimed at decreasing the growth in health spending, while the law Romney signed purposefully did not.
The Romney bill laid some of the ground work for cost containment, most of it revolving around transparency in prices and quality. However, the Legislature and current Administration gutted staff/funding for the agency responsible for these efforts, and have only recently restored some of it. Many folks, including myself, think that the proper use of data could help contain costs because it empowers consumers, tracks utilization, and informs better insurance product design. The 2006 reform certainly did not go far enough on cost containment, but it did have latent elements. As supporters of the federal law will tell you, the “solutions” in the federal law are pilots and experiments on cost containment, they don’t really know if they will work (See Gruber at minute 58.)
3. Implementation: Implementation changes in Massachusetts played a major role in leading the state to where it is today. Huge policy decisions have taken place in implementation that moved reform away from some of the original vision behind the bill. These should be attributed to Governor Patrick and the Connector, instead of being linked to the original bill. If you don’t, it would be similar to looking at a final mural once a second artist has taken the brush for 4 years, and trying to figure out what the first artist did. You really need to look back at the original plans (or in this case the bill) to see what has changed over the last four years, and who has made those decisions.