T-minus 14 days until the end of the legislative session and one of the largest and most controversial pieces of legislation has moved with almost no media attention.
The promises for the new cost containment/ payment reform bills (or health reform 2.0, as some are calling it) — now being considered by a joint House-Senate conference committee — are historic, according to the rhetoric of the elected officials who authored it. It “completely alters the landscape of our delivery system,” and “will result in an estimated $150 billion in savings over the next 15 years.” “It is going to work because it is well thought out … It is not going to hurt our best hospitals… We will be the first state in the country to manage the cost-quality conundrum.”
Sounds like a good idea, but what specifically in the bill gets us these promised savings? No one on Beacon Hill knows. I have asked dozens of times to dozens of legislators and staff, and no one gives me more than platitudes.
Perhaps it is because the House passed the bill in one day without any debate on the actual bill. To be fair, five of the 275 amendments were debated, but the 188-page, 51,731-word bill was apparently unworthy of discussion beyond that. One would think a major piece of legislation that impacts 18 percent of our state economy would get more than 30 minutes or so of public discussion. Instead it is now down to six elected officials behind closed doors to decide the future of the health care system here in Massachusetts.
As illustration of the rushed nature of this bill, there hasn’t been a cost estimate done for how much new spending is in the legislation. Yet a quick review of the proposal reveals hundreds of millions of new surcharges, assessments and penalties that will be passed along to consumers.
Once the curtain is pulled back, the exposed wizard is underwhelming just like in the old Judy Garland movie, and the reality of the bill is not pretty. Here is my best calculation of the cost of the House bill so far:
Will gauzy promises of cost savings plus concrete new fees really equal billions of dollars in savings?
If that were not enough, a new mega division/agency is created and given tremendous control over how our health care system will be set up and the method by which medical professionals will be paid. This bureaucracy will control what facilities get built where, why and when. It will have power over the future of medicine, with controls over medical innovation. And state officials are given tremendous latitude to take “appropriate actions,” or establish when something is “deemed to be excessive.” This is ripe for political influence and future lawsuits, adding cost to our health care system.
I would encourage everyone to call their Representative and Senator and simply ask them what is in the bills. You deserve to know not only as a taxpayer, but also as an individual that utilizes the health care system.
Find more analysis of the health reform 2. 0 bills on Pioneer’s blog.
Find me on twitter: @josharchambault