Entries by Editorial Staff

Here’s why Sarah Palin’s ‘death panels’ are now being debated in Massachusetts

This op-ed by Shira Schoenberg appeared in MassLive on April 25, 2019. The debate over former vice presidential candidate Sarah Palin’s inaccurately named “death panels” has come to Massachusetts. The debate centers on a measure of cost-effectiveness for health care, which assigns a value to a life that changes based on whether a person is healthy. The Affordable Care Act – after public outcry – bans the use of the measurement in Medicare. Now, Rep. Angelo Puppolo, D-Springfield, is trying to ban its use by MassHealth or private insurers in Massachusetts. “I don’t think rationing care, in particular prescription drugs, to the sickest and oldest patients should be a formula that’s used,” Puppolo said. Puppolo’s amendment was not included in […]

Issue Brief: Problems With The Institute of Clinical and Economic Review (ICER) and the QALY Methodology

This article by Chris Rochester appeared in The MacIver Institute on April 23, 2019. “What’s a year of life worth?” That compelling question was posed by Dr. William S. Smith, a visiting fellow at the Boston-based Pioneer Institute in a recent op-ed questioning the merits of a metric that is increasingly used to make life-and-death decisions about the value of certain drugs – and whether a sick person deserves to receive a new, potentially effective medicine. The metric is called the quality-adjusted life year (QALY) and it is being pushed by an organization called the Institute of Clinical and Economic Review (ICER). Essentially, the quality-adjusted life year attempts to calculate how much an additional year of life for a sick person […]

Commentary: Proposed Drug Price Caps Would Stall Advances in Health Care

This op-ed by William Smith and Adam Crepeau appeared in the Portland Press Herald on April 23, 2019. Imagine if the Maine Legislature decided that large pickup trucks were becoming too expensive for the working class people who drive them.  Then imagine that legislators established a commission designed to study the costs to manufacture and sell these trucks. After careful study, the commission then concluded that large pickups produce a $3,000 profit per truck for their manufacturers.  Finally, the commission then established an “upper price limit” on pickups sold in Maine that was $3,000 below the average price at which pickups were currently being sold. Lastly, suppose 45 other states, seeing Maine’s attempt to make pickups more affordable, also established […]

HHS Secretary Alex Azar doesn’t want drug access to become an equation

This op-ed by William Smith appeared in the Washington Examiner on April 18, 2019. On April 8, at a Harvard Medical School forum hosted by Pioneer Institute, President Trump’s secretary of health and human services was asked whether it was advisable for state Medicaid programs to use “cost-effectiveness reviews” that have become common in Europe. These systems use an economic methodology called Quality Adjusted Life Years, or QALYs, to rate treatments according to their ability to extend and improve the quality of life. New treatments that do not meet certain “cost-effectiveness” benchmarks on that basis are denied to patients. For HHS Secretary Alex Azar, this was a controversial question to consider at the moment when the Affordable Care Act has […]

New Study Urges State to Slow Down, Rethink Proposal to Protect Students from College Closings

Board of Higher Education proposal risks “false positives” that could doom colleges, creates potential conflict, and ignores ongoing federal process Read coverage of this report in the Chronicle of Higher Education. BOSTON – The Baker administration and the Massachusetts Board of Higher Education (BHE) should slow down a fast-tracked proposal to protect students from sudden, unexpected college closings such as what occurred at Mt. Ida College, and use the time to rethink its proposal from top to bottom, according to a new study published by Pioneer Institute. “This is a serious problem that will only get worse.  By 2017, the rate of closures or mergers among non-profit private colleges was twice the 2004-14 average,” said Greg Sullivan, author of A Risky Proposal […]

ICYMI: U.S. HHS Secretary Alex Azar’s Remarks on Healthcare Price Transparency, Opioid Crisis, HIV Epidemic & More

This past Monday, Pioneer held the 13th annual Hewitt Healthcare Lecture to honor our longtime chairman (and chairman of Beth Israel Deaconess) Colby Hewitt, Jr. The crowd of 250 enjoyed a substantive and fun night — the two can go together! — at Harvard Medical School’s Joseph B. Martin Conference Center.  The 2019 Hewitt Keynote Speaker, U.S. Health and Human Services Secretary Alex M. Azar II engaged in an open-format conversation with Pioneer Senior Fellow Josh Archambault, and he covered a lot of ground. In the clips below, you’ll hear noteworthy remarks on a number of fronts: price transparency, opioids, HIV/AIDs, pharmaceutical pricing, protecting Medicare, and much more. We hope you enjoy the discussion. The full fireside chat with Secretary Azar is available below. You can […]

U.S. HHS Secretary Alex Azar to Be Featured Speaker at Pioneer Institute’s 2019 Hewitt Healthcare Lecture

BOSTON – Secretary of the U.S. Department of Health and Human Services Alex M. Azar II will be the featured speaker at Pioneer Institute’s 2019 Hewitt Healthcare Lecture tonight (Monday, April 8th) on “the Future of Healthcare in America.” Secretary Azar will share his vision for value-based care transformation and how it will impact healthcare in the state of Massachusetts and discuss his ambitious reform agenda. Secretary Azar has spent his career working in senior healthcare leadership roles in both the public and private sectors.  From 2001 to 2007, he was general counsel and then deputy secretary at the Department of Health and Human Services.  Earlier in his career, Azar clerked for U.S. Supreme Court Justice Antonin Scalia and then […]

Prepare for Town Budget Season with MassWatch

Online tools to understand your community’s financial condition &  so much more! Town budget season is upon us. Pioneer Institute’s MassAnalysis makes it easy to be well-prepared with the right questions to ask! MassAnalysis is one of Pioneer’s suite of online databases, known as MassWatch, that provide the tools you need to better understand your state and local government. MassAnalysis provides you with historic financial information on your community and allows you to benchmark your town’s performance against its peer communities. The site provides you with information on education, employment, crime, transportation, and demographics that you can use for benchmarking, as well. For sample questions for municipal departments and budgeting tips, download Pioneer Institute’s Guide to Sound Fiscal Management for Municipalities for […]

Some Public, Private MA Universities Adapting to Rise of Tech in Finance Industry, but Students Still Insufficiently Prepared

New report recommends establishing additional coursework, certification and degree-program tracks addressing fintech Media inquiries: contact Micaela Dawson at 617-723-2277 ext. 203 or mdawson@pioneerinstitute.org BOSTON – A new report by Pioneer Institute shows that while the finance and insurance industries are changing rapidly, course requirements and skill-building opportunities at Massachusetts higher education institutions are still evolving to meet job demands, presenting an opportunity for state higher education institutions to create programs that give Massachusetts students a competitive edge in the age of fintech – diverse digital technology changes impacting banking, insurance, and other sectors of the finance industry. In Preparing Students for a Future in Fintech, Eamon McCarthy Earls argues that colleges and universities must adapt their business and computer science […]

State DPH Continues to Deny Private School Students Millions in School Nurse Services

State should establish a fund to provide partial support for health services for private and parochial schools     Media inquiries: Contact Jamie Gass, 617-723-2277 ext. 210 or jgass@pioneerinstitute.org BOSTON – Private and parochial school students in Massachusetts have been denied well over $10 million in school nursing services to which they are entitled under state law, according to a new study published by Pioneer Institute. In 1993, the state Department of Public Health (DPH) established the Essential School Health Services (ESHS) program, which provides competitive grants to local school districts. Since 2002, districts should have then allocated a proportional share of the grant to private and parochial schools within their boundaries, based on enrollment. Video: Authors of New Pioneer Report Discuss […]

Public Statement: A Responsible Reply to the Fall River Superintendent’s Comments

In a recent opinion piece, Charlie Chieppo, a Pioneer Senior Fellow, and Jamie Gass, the director of PioneerEducation, argued that Massachusetts state government should consider requiring that it be able to appoint school committee members in underperforming districts in a number proportional to the percentage of state funding contributed to a district’s school budget. The idea was floated because, more than 25 years after the passage of the Education Reform Act and the state’s investment of over a hundred billion dollars, a number of larger urban districts have not significantly improved the quality of their public education. In response to Pioneer’s op-ed, former Massachusetts Education Secretary and current Fall River Superintendent Matt Malone noted on Twitter: Blah Blah #Bozos big […]

Pioneer Institute Celebrates Sunshine Week 2019

Sunshine Week is dedicated to bringing greater awareness to the importance of government transparency and to highlighting areas where improvement is needed. After all, a healthy democracy is unsustainable unless people are fully informed and can meaningfully engage in the democratic process. To celebrate Sunshine Week, each year Pioneer reviews some of its recent work to bring greater public accountability to Massachusetts government. Our objective is for the Commonwealth to rank among the nation’s most transparent states. Sadly, in its latest rankings, the Center for Public Integrity placed Massachusetts among the worst states for public records access. While there has been some progress since then to bring sunshine to Beacon Hill, many would say a persistent gray cloud looms over […]

Study Finds Massachusetts Lagging on Transparency of Public Official Statements of Financial Interest

A few simple changes would update system, improve transparency Read coverage of this report in State House News Service. BOSTON – Despite some recent progress, a new policy brief published by Pioneer Institute finds there is more to do if the Commonwealth is to make the Statements of Financial Interest (SFIs) that public officials file annually truly accessible to Massachusetts citizens. “With just a few critical changes, Massachusetts could progress from maintaining one of the least transparent and least constituent-friendly financial disclosure regimes in the nation to becoming a national leader in the accessibility and usefulness of its public officials’ Statements of Financial Interest.” Said Mary Connaughton, co-author of “Outdated and Obfuscated:  The State of Public Financial Disclosure in Massachusetts.” All […]

New Study Finds Multiple Problems with Push for Social-Emotional Learning in K-12 Education

Little research evidence for, or objective, reliable way to measure SEL’s efficacy; raises significant concerns about student health and privacy BOSTON – Social-emotional learning (SEL) has been billed as a transformational tool that will propel students to greater academic achievement and personal fulfillment.  Unfortunately, as a new Pioneer Institute study makes clear, the research evidence to back up these claims is thin and unpersuasive. Moreover, the risks SEL poses to student privacy and health are significant. Proponents of SEL call for focusing less on academic content and knowledge in schools, and more on student attributes, mindsets, values, and behaviors. Not only are the goals of SEL ill-defined, but they also raise significant, unanswered questions about what attitudes should be promoted. […]

Teacher Unions Support Progressive Taxation, but Maintain Flat-Rate Membership Dues Structure

Study shows lowest-paid teachers can pay up to 140 percent more of their salary than highest-paid teachers in membership dues BOSTON – A new study published by Pioneer Institute finds that despite backing progressive taxation initiatives, Massachusetts teacher unions use regressive methods to collect revenue from their own members. “The Massachusetts Teachers Association (MTA) was the top contributor to a failed initiative to establish a graduated income tax in 2018,” said Pioneer Executive Director Jim Stergios.  “They have been part of similar efforts numerous times in the past and are again supportive of a new effort to do so this year.  Yet their members all pay flat dues, regardless of annual salary.” In “Unions Are Not Progressive When It Comes […]

Whistleblowers Were Proven Right: MBTARF Was Underreporting Its Unfunded Pension Liabilities

In a new brief, Pioneer shows that whistleblowers’ 2015 claim that the MBTA Retirement Fund (MBTARF) had been underreporting its unfunded pension liabilities has proven to have been accurate. In their study, Boston University Professor Mark T. Williams and Bernie Madoff whistleblower Harry Markopo­los outlined three specific ways in which the T pension fund was underreporting its liability. Pioneer’s scorecard shows that they were right on all three counts, adding up to a total of $280 million in underreported pension liability. At the time, MBTARF vigorously refuted the validity of the findings. Spokesman Steve Crawford said, “The fund stands by its reported investment returns and by its asset and liability calculations,” and that “MBTA retirees and beneficiaries can be confident that […]

Pioneer Institute Public Statement on the MBTA’s Proposal to Increase Fares by 6.3 Percent

While Pioneer Institute opposed the 2016 MBTA fare increases, the Institute believes that the T has earned an increase in fares of 6.3 percent, provided it is committed to introduce differential pricing, address chronic fare non-collection, fix the T’s faltering pension system, and focus investments on key service upgrades.  These commitments would modernize fare-setting and mitigate the negative impact of fare increases, ensure that the additional fare revenues are actually going to service improvements, and lay the groundwork for greater fare revenue generation through increased ridership. In opposing the 2016 fare increase of 9.3 percent, we noted: “Fare increases should be linked to demonstrable service improvements. The customer must also come first when it comes to fare increases. The T […]

Study Finds Patient Cost for MRI Largely Unrelated to Overall Price or Insurer Contribution at 14 MA Hospitals

Read coverage of this report in WCVB-TV, Boston Herald, the Boston Business Journal, the Worcester Telegram and Gazette, and FierceHealthcare. Authors recommend greater transparency and financial incentives for patients to choose lower-cost, high-value providers BOSTON – There is little correlation between a patient’s out-of-pocket cost and either the amount insurers pay or the overall price of a procedure at 14 representative Massachusetts hospitals, according to a new study published by Pioneer Institute. “Even if patients don’t see differences in out-of-pocket prices among hospitals, higher utilization of more expensive providers drives up the cost of care, which puts upward pressure on insurance premiums,” said Barbara Anthony, co-author of “Wildly Varying MRI Prices at Massachusetts Hospitals: Why We Need Access to Healthcare Prices […]

The U.S. shouldn’t use the ‘QALY’ in drug cost-effectiveness reviews

This op-ed by William Smith appeared in STAT News on February 22, 2019. What’s a year of life worth? That question is at the heart of a metric called the quality-adjusted life year that is increasingly being used to make decisions about paying for new drugs. If I was asked that question about one of my children, my answer would be “limitless,” and no one could persuade me otherwise. But others are putting a discrete price tag on it. Answering how much a quality-adjusted life year (QALY) is worth isn’t a theoretical or philosophical exercise. A number of European health care systems use so-called cost-effectiveness reviews that depend on QALYs to make decisions about which drugs to cover. Since these […]

Majority of Dues Paid by Mass. Public Higher Education Faculty Goes to State, National Union Affiliates

At state colleges and universities, portion that stays on campus as low as 1 percent BOSTON – Only a small share of annual union dues paid by faculty at the University of Massachusetts, state colleges and universities and community college campuses that make dues data publicly available remain with local union affiliates to cover the costs of collective bargaining and grievance procedures, according to a new study published by Pioneer Institute. “Last year’s U.S. Supreme Court ruling in the Janus case gives public employees the right to make informed decisions about joining or remaining in the union,” said Pioneer Institute executive director Jim Stergios.  “As faculty make determinations about the value of union membership, it’s important for them to know […]

Study Says State Unfunded Pension Liability Rising Despite Recent Reforms, Overall Strong Economy

More responsible assumptions about pension fund investment performance partially responsible for increase BOSTON – Despite several reform bills targeted at the Commonwealth’s public pension system in recent years, the unfunded actuarial accrued liability (UAAL) has continued to rise and is drawing closer to a crisis level, according to a new study published by Pioneer Institute. “The Commonwealth’s public pension system is in deep trouble and liabilities have nearly tripled since 2003,” said Greg Sullivan, co-author of “Massachusetts’ Skyrocketing Unfunded Pension Liability.”  “This is occurring despite repeated efforts to eliminate provisions that allowed rampant abuses and have increased current costs and future obligations.” Despite numerous reform efforts, Massachusetts ranked 11th among the states in 2016 in unfunded pension liability per capita ($5,642 per […]

Study: After Janus, Public Employees Should Only Pay Union Dues, Fees After Knowing, Intelligent Waiver

Public Employers Should Immediately Stop Collecting Agency Fees from Non-Union Members Unless Employees Effectuate Valid Waiver of First Amendment Rights BOSTON – In the wake of the U.S. Supreme Court’s 2018 Janus decision, public employers should inform all employees of their right not to pay union dues or agency fees, and such dues and fees should be paid only after a knowing and intelligent waiver of their First Amendment rights, according to a new study published by Pioneer Institute. In Janus v. American Federation of State, County and Municipal Employees (AFSCME), the Court ruled that an Illinois public employee who chose not to join his union could not be required to pay an “agency fee” that covers collective bargaining costs […]

Study: Financial Impact of Charter Schools Depends on Percentage of Funding Districts Receive from State

“Foundation” districts unaffected, but charter tuition may cause strain for fast-growing “above-foundation” school districts Contact Jamie Gass, 617-723-2277 ext. 210 or jgass@pioneerinstitute.org BOSTON – At a time when the funding of charter schools is widely debated, a new Pioneer Institute study finds that foundation districts are largely unaffected by students who choose to transfer to charter schools. “So-called foundation districts receive most of their funding from the state, which means that the state effectively pays the tuition when students choose charters,” said Dr. Cara Stillings Candal, who co-authored “Charter School Funding in Massachusetts: A Primer” with Professor Ken Ardon. “But they can impact ‘above-foundation’ districts, particularly those that experience rapid enrollment growth.” Watch: Dr. Cara Stillings Candal, Pioneer Institute Senior Fellow, explains […]

Baker’s Orwellian drug pricing policy

This op-ed by William Smith appeared in Commonwealth Magazine on February 3, 2019. THE BAKER ADMINISTRATION recently released its budget proposal for one of their most high-profile issues: drug prices in the Medicaid program. To the surprise of many in the biopharmaceutical industry, there are some promising initiatives in the proposal from an administration that is thought to be hostile to the industry on drug prices. By far the most important provision in the proposal is the governor’s request for the authority to negotiate so-called “supplemental rebate payments” that are “based upon the value, efficacy or outcomes of the drug.” This is an extremely promising development for the Massachusetts biotechnology industry, which is churning out many new drugs for rare and life-threatening diseases […]

Our Government Transparency Resolutions for 2019

Government transparency has already suffered two major blows in 2019. First, a special legislative commission charged with making recommendations on the legislature’s and governor’s exemptions from public records law failed to reach consensus on a long-awaited report on improvements.> Second, Mr. Transparency himself, State Comptroller Tom Shack, the driver behind CTHRU, the state’s highly acclaimed spending transparency website, announced he was leaving state service. The recent state police overtime scandals came to light when journalists reviewed CTHRU. Historically, Massachusetts has ranked at or near rock bottom nationally in terms of open government, with one of the chief reasons being the legislature’s exemptions from open meeting and public records law. It’s time to change that and it will be up to the […]

Study Urges Caution Before Adopting ICER Reviews to Determine Cost Effectiveness of Treatments

Review methodology could negatively impact elderly, the disabled, cancer patients and those with rare diseases Media inquiries: Contact Micaela Dawson, 617-723-2277 ext. 203 or mdawson@pioneerinstitute.org BOSTON – As states continue to grapple with prescription drug costs, a new Pioneer Institute study lays out the key ethical, methodological and disease-specific questions policy makers should address before deciding whether to contract with the Institute for Clinical and Economic Review (ICER) to conduct cost effectiveness reviews used to make decisions about the purchase of medicines and other medical innovations. ICER utilizes Quality Adjusted Life Years (QALYs), a controversial evaluation technique that assigns an economic value to the longevity and quality of human life. “The use of the QALY standard in the United Kingdom resulted […]

Saluting a Fine Public Servant

State comptroller isn’t a job that’s very familiar to the average Massachusetts resident, but during his tenure, Tom Shack has shown just how important and impactful the position can be.  As he departs the office, he deserves kudos for his good work. Soon after his appointment in 2015, Tom recognized the need to improve state government transparency.  Although providing a transparency site wasn’t a statutory responsibility of comptroller, he felt compelled to research solutions to provide the Commonwealth’s citizens with a state of the art, intuitive, and user-friendly platform to get more eyes on state data. In September 2016, CTHRU successfully debuted.  It took just seven months to develop and cost far less to procure and maintain compared to its […]

Public Statement on Alma del Mar Charter School Expansion

Last night, Jeffrey Riley, the Massachusetts Commissioner of Elementary and Secondary Education (DESE) made a recommendation concerning Alma del Mar Charter School’s application to serve 1,188 more students in New Bedford. Commissioner Riley is recommending that Alma be expanded to serve 450 more students, that the school accept students from a neighborhood rather than through the usual district-wide lottery system, and that the New Bedford district make one of its underutilized buildings available to Alma. As these maneuvers are outside the bounds of the Department’s power and the statutes related to charter school approvals, they will require approval by the city and state legislature. Should the politicos fail to get behind the necessary compromises, the Commissioner will likely have to put […]

Study: After-School Programs Can Help Improve Flat or Declining Math Achievement

Philanthropic, other organizations should consider providing financial assistance to allow programs to expand into lower-income communities BOSTON – At a time of declining state and national math proficiency, after-school math programs offer a viable option for quickly increasing the number of mathematically competent students, according to a new Pioneer Institute study that profiles two such programs: Kumon and the Russian School of Mathematics (RSM). “Given the disappointing state of math education in American public schools, after-school math programs could play a particularly important role,” said Ze’ev Wurman, co-author with William Donovan, of “Axioms of Excellence: Kumon and the Russian School of Mathematics.” For the first time since 1990, fourth- and eighth-grade math scores fell on the 2015 National Assessment of Educational […]

Press Release: Pioneer Institute Filed Amicus Brief in Case Applying Supreme Court’s Janus Ruling to MA

BOSTON – On January 8th, the Massachusetts Supreme Judicial Court will hear oral arguments in the case of Ben Branch v. Commonwealth Employment Relations Board, in which the SJC will decide how the United States Supreme Court’s June 2018 decision in Janus v. American Federation of State, County and Municipal Employees (AFSCME) will affect Massachusetts law. Pioneer Institute, through its public interest law arm, PioneerLegal, has filed an amicus curiae brief in the case prepared by WilmerHale’s Mark Matuschak and Robert Kingsley Smith. Professor Ben Branch has taught for 38 years at UMass Amherst’s Isenberg School of Management. For decades, he has objected to having to pay compulsory service fees. To stop having to pay without consent, Dr. Branch and three other non-union educators brought the lawsuit now before […]