Governor Mitt Romney was determined to provide a healthcare plan that served all the citizens of the Commonwealth of Massachusetts. On April 12th, 2006 Governor Romney signed the bill into law. Regardless of what you might think about the plan it was well conceived, implemented with the appropriate bumps along the way, and delivered on its intent to cover the citizens of Massachusetts.
The Commonwealth Care Health Insurance Program was designed to provide health insurance to those individuals that were not covered prior to its implementation, and who were at different levels of income below the poverty level. It was a bold and comprehensive plan to meet the growing needs of the citizens of the Commonwealth and it had an immediate effect on the number of citizens covered by health care in the Commonwealth.
However, the unintended consequences of the Program began to surface almost immediately. On January 11th, 2007, only 9 months after signing it into law, a meeting was held by the Board of the Commonwealth Health Insurance Connector Authority. At this meeting the new Governor Patrick Deval, the Board’s chair Leslie Kirwan, and its Executive Director heard from Patrick Holland. It was Patrick Holland’s comments that at the time may not have set off alarms but were certainly the pre-cursor of the bloom coming off the rose.
From the minutes of the meeting, the following was noted:
- I. Commonwealth Care Trust Fund Projection: Patrick Holland reviewed the projected cost for state fiscal year 2007. Mr. Holland explained how some differences in the actual demographics of enrollees compared to initial assumptions, has resulted in a higher average composite capitation rate. The population enrolled is older and more are located in the Greater Boston area than expected. Each MCO receives a specific payment based on its demographics. BMC and Network Health, being lower priced, represent 81% of the enrolled population. Mr. Holland told the board that he will get back to them with more information on SFY 2008. (BMC is Boston Medical Center, MCO is Medical Center Operator)
The Boston Globe reported that in February 2008 the Commonwealth Care Program covered 169,000 citizens at a cost of $618 Million. Projections are that by 2011 342,000 citizens will be covered at a cost of $1.35 Billion. The original projections were for the program to cover 215,000 citizens at a cost of $725 Million.
An article by Alice Dembner in the Boston Globe of February 3rd, 2008 stated the following: “The state has asked the federal government to shoulder roughly half of the program’s cost from 2009 through 2011, but there is no guarantee of that funding.”
Which bring us to today.
An article from the New York Times by Abby Goodnough stated the following, “The new state budget in Massachusetts eliminates health care coverage for some 30,000 legal immigrants to help close a growing deficit, reversing progress toward universal coverage just as Congress looks to the state as a model for overhauling the nation’s health care system.”
And finally, this article also from the New York Times by Abby Goodnough, where the BMC (Boston Medical Center) is suing the Commonwealth of Massachusetts. The article states, “The hospital, Boston Medical Center, faces a $38 million deficit for the fiscal year ending in September, its first loss in five years. The suit says the hospital will lose more than $100 million next year because the state has lowered Medicaid reimbursement rates and stopped paying Boston Medical “reasonable costs” for treating other poor patients.”
So how did the state respond to the lawsuit, “State officials have suggested that Boston Medical could reduce costs by operating more efficiently. The state has also pointed out that the hospital has reserves of about $190 million, but Tom Traylor, the hospital’s vice president of federal and state programs, said the reserves could only sustain the hospital for about a year.”
If I read the comment above correctly, the Commonwealth of Massachusetts officials have basically stated that BMC should spend all of its own money to provide for the healthcare of the citizens, that the state has foisted upon BMC.
BMC is one of the finest Medical Centers in the country. Its research capabilities and medical school are second to none. Its inner city geography provides some of the most superior medical care found in Massachusetts for those who for the past upteen decades couldn’t afford health care insurance. BMC serves the inner-city unlike it’s cross town rival for foreign and domestic dignitaries MGH.
If the state of Massachusetts is a microcosm of what to expect from a national health care plan. How will the prescription heal the patient?
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