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Bill urges 'comprehensive view of health care'

By Jon Brodkin
News Staff Writer

With health advocates across Massachusetts decrying cuts in state spending, it might seem a strange time to debate major initiatives like reducing medical errors and implementing universal health care. 

But a bill that would make those official state goals and create a council to oversee their possible implementation is being hailed by health advocates as a critical step toward ensuring long-term quality in health care. 

The bill, titled An Act for a Caring Commonwealth, grew out of Sen. Richard Moore's frustration that the Romney administration and previous administrations have not had a "comprehensive view of health care." 

"The state doesn't have a policy for health care. We're making decisions to cut programs...without any framework of what we want to accomplish," said Moore, an Uxbridge Democrat who is co-chairman of the Joint Committee on Health Care. 

The bill, introduced in June last year, is gaining steam. The health care committee last Wednesday gave the bill a favorable report. Moore hopes it will be enacted as either a stand-alone bill or as part of next fiscal year's budget. 

Though the bill would not provide additional money for health care, its implementation could create major benefits over time, said John McDonough, executive director of Health Care For All, a Boston-based advocacy group. 

"Imagine you have an airplane without a pilot or a large business without a management structure. That pretty much gives you a view of our health care system," McDonough said. "There's no place, particularly on a state level, where the health care community, public and private, comes together to figure out what's going on." 

The plan outlines 10 goals, and would create a Health Policy Coordinating Council to oversee their implementation. Besides guaranteeing insurance for every resident, goals include strengthening emergency medicine and preparation for bioterrorism and natural disasters, improving end-of-life care, guaranteeing health funding during economic downturns, and promoting safety, effectiveness, efficiency and equity in health care. 

The goals are lofty given the Legislature's immediate health focus is likely to be Romney's proposed health budget. When Romney unveiled his spending proposal he said it increases funding for Health and Human Services by $500 million, or 5 percent, but health advocates warn the plan would cut social service programs and decrease payments to providers. 

State budget problems have already resulted in a cap on enrollment for the Children's Medical Security Plan and cuts in some areas of MassHealth. 

The current fiscal situation increases the importance of Moore's proposal, said John Fromson, vice president for professional development for the Waltham-based Massachusetts Medical Society.

"In light of the fiscal realities, one document we all can focus on increases the likelihood of significant change," Fromson said. "It's a focal point for debate and consensus." 

Rep. Deborah Blumer, D-Framingham, argues now is the best time to go forward with Moore's proposal because of recent cuts to health programs. 

"This is the best time to do that," she said. "We're at a juncture where we have to make some longterm decisions and set the stage for the future." 

The proposal has also gained support from the Romney administration and the Massachusetts Association of Health Plans. 

Moore's proposed council would be required to report to the Legislature annually on progress toward achieving each goal, he said. 

Rep. David Linsky, D-Natick, said he hopes the proposal, if passed, does not go the way of other well-meaning but ultimately unsuccessful state initiatives. Its success is important given the numbers of hospitals and nursing homes that have closed in recent years, and the numbers of uninsured residents, he said. 

"Certainly the government establishes too many commissions that don't end up with any meaningful results," Linsky said. "But I think everyone is in agreement that we need to do something about health care. The problem is there is no agreement on what that something should be." 

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