The main entrance of Massachusetts General Hospital, in Boston
From Robert Whitcomb’s “Digital Diary,’’ in GoLocal24.com
Massachusetts continues to lead the nation on health-care reform. It has long had among the greatest concentrations of medical care and research in the world, in large part because of its universities and associated hospitals. And the health-insurance law nicknamed “Romneycare,’’ after then-Gov. Mitt Romney, who helped lead it into law, morphed into the national Affordable Care Act, aka “Obamacare.’’
And now Gov. Charlie Baker, a former long-time CEO of the insurer Harvard Pilgrim Health Care, has come up with a big bill to further improve care in the commonwealth while trying to limit price increases.
Before I go on, consider the “super users’’ – the 5 percent of patients whose care comprises about half of America’s health-care costs. Some almost seem to live in hospital emergency rooms and many have mental illnesses and/or substance-abuse issues that sent them there.
The governor’s bill would require hospitals and insurers to increase by 30 percent over the next three years their spending on primary care and behavioral health, but without increasing overall spending. Given how many illnesses and injuries are made inevitable by thin primary care and often difficult to obtain mental-and-behavioral-health treatment, that makes sense. The governor says that less than 15 percent of percent of total medical expenses are spent on the combination of primary care and behavioral health. Instead, the big money goes to treat severe and chronic illnesses, many cases of which could have been prevented and/or at least diminished with much more available – and promoted -- primary care and mental-and-behavioral-health coverage. Mr. Baker’s package would also simplify insurance paperwork for mental-and-behavioral-health providers to help expand coverage in this sector, which is still woefully low compared to so-called “physical health,’’ as if the brain isn’t an organ.
American health care is pretty good at rescuing people in extremis but mediocre at preventing what they need to be rescued from.
There are other fine things in the package, including boosting state monitoring of drugs and their prices -- including those drugs bought through the private market and not just Medicaid -- that cost more than $50,000 per person per year – and expanding telemedicine, which cuts expenses in a number of ways.
I hope that other states, and the Feds, try some of these ideas, too. As usual, Massachusetts is a beacon for those seeking to build better health systems.
