THE PIONEER BLOG

Joshua Archambault

Will Government-Directed Healthcare in Mass. Really Contain Costs?

/4 Comments/in , , , /by

Governor Patrick signed a new healthcare law today aimed at cost containment, and the rhetoric soared assuring all that Massachusetts has “cracked the code on healthcare costs.” Unfortunately, with no debate on the underlying bill in the House of Representatives and only little debate in the State Senate, the 349-page statute, which was released just 14 hours before the legislative final vote, is little understood and brimming with unintended consequences. To mark the occasion, Pioneer released the follow infographic: Real cost-containment is only possible when we encourage patients to reward low-cost, high-quality providers with their business.  We’ve said it over and over again throughout this process. Instead, the law being signed today re-imagines and repackages so many failed top-down approaches […]

Joshua Archambault

Pioneer’s Statement on “Cost Containment” and Payment Reform Bill

/2 Comments/in , , /by

Another Lost Opportunity to Give Individuals and Businesses Relief on Health Care Costs Final Version of Conference Committee Bill Adds Hundreds of Millions to System BOSTON – After years of debate over how to contain health care costs, the Massachusetts Legislature is poised to approve a bill that burdens the entire health care system with more bureaucracy and hundreds of millions in increased expenses. “Real cost-containment is only possible when we encourage patients to reward low-cost, high-quality providers with their business,” says Josh Archambault, Pioneer’s director of health care policy. “Instead of providing financial incentives for individual patients to take charge of their own medical care, this legislation rearranges the system based on accountable care organizations (ACOs) and changes in […]

Jim Stergios

MA Goes For Top-down Health Care Policies

/0 Comments/in , /by Jim Stergios

Even as “Massachusetts Health Care 2.0” legislation moves to the Governor’s desk for signing, and with it the heavy hand of top-down policies, individuals and companies in many other states are adopting market-based solutions.

Jim Stergios

Happy 100th Birthday to Milton Friedman!

/1 Comment/in , , , , /by

Happy Birthday to Milton Friedman, who would have been 100 today. A great way to understand Friedman’s contribution to the field of education can be summed up in the following series of videos associated with his renowned Free to Choose series on PBS. This series of six YouTube segments covers (in the first three) the actual documentary/commentary of the Free to Choose on the idea of scholarship vouchers for students to attend K-12 schools, as well as a fantastic roundtable debate on the then controversial idea. The FTC special on education opens up with a look at a Hyde Park school that was in the 1980s already plagued by the need for uniformed police, metal detectors, and other safety features. […]

Joshua Archambault

ACA Impact on Mass, Part 1: Low-income Residents will Pay More for Healthcare and Insurance

/0 Comments/in , , /by

Affordability/ Subsidy levels for Low-income: How much will individuals pay for health insurance and health care under the federal law? Under the ACA, low-income individuals will pay more. Urban report I don’t recall supporters of the federal law in the Commonwealth highlighting this difference before it passed Congress or leading up to the SCOTUS ruling. Drilling down to look at cost-sharing as well along with the range of premium payment ranges: Mass vs Fed Diff in costs State Law – CommCare Federal Law – QHP Premium Cost-sharing Premium Cost-sharing 138-150% FPL $0 $29 $36-$54 $24 150-200% FPL $40 $29 $55-$114 $54 200-250% FPL $78 $43 $115-$183 $115 250-300% FPL $118 $43 $184-$259 $128 Source: Connector The State may have two […]

Joshua Archambault

How SCOTUS ACA/Obamacare Ruling Impacts Mass

/0 Comments/in , , /by

Most of the press coverage has focused on the political angle of the SCOTUS ruling, but the more interesting and complex questions lay at the policy level. Pioneer recently released a book to propose a new relationship between states and the federal government, and it has received considerable national attention. Even if Democrats or Republicans don’t talk about the law this way, the new healthcare law is a new entitlement program and will likely be reformed in some manner to address the federal deficit. [Learn more, and download a couple free chapters or buy a copy at Greatexperiment.org] But for now, and since the ACA was upheld, the policy questions refocus on individual state implementation. Locally, conventional wisdom would tell […]

Jim Stergios

Will New York Make Boston The Old Tech City?

/0 Comments/in , /by Jim Stergios

Neil Swidey had a wonderful article (N.Y. vs. Boston: The endgame) in the Boston Globe Magazine on the fabled Boston-NY (or is that NY-Boston) rivalry delving into the ever-timely question: “Where did all this nonsense begin?” What most intrigued me was his reference to New York’s plan to take “Roosevelt Island and a decrepit hospital that offers priceless views of the United Nations and the Chrysler Building” and turn it into “a new tech-focused graduate school that, in many ways, will be built in the image of MIT.” Swidey’s set-up is pitch-perfect in noting the pride Greater Boston takes “in our identity as College Town, USA, the egghead capital of the nation, anchored by Harvard and MIT and fortified with […]

Joshua Archambault

Pulling Back the Curtain on Beacon Hill’s “Healthcare Reform 2.0”

/1 Comment/in , , , /by

T-minus 13 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 […]

Jim Stergios

Are Teachers Changing Their Unions?

/0 Comments/in , /by Jim Stergios

The recent deal brokered by Stand for Children with the Massachusetts Teachers Association (and at the end supported by the AFL-CIO and the Massachusetts chapter of the American Federation for Teachers) made some progress in making student performance a larger consideration in evaluating teachers and lessened the role of seniority. The Globe editorial board put it this way: Stand for Children was plowing ahead with a tough ballot initiative that would have eliminated nearly all aspects of teacher seniority in the state’s public school systems. It went so far as to put non-tenured teachers with three years or less experience — so-called provisionals — on par with the most senior teachers during layoffs. With the 107,000-member Massachusetts Teachers Association gearing […]

Jim Stergios

The obvious lesson for innovation schools

/0 Comments/in , , , , /by

Two-and-a-half years have passed since the passage of the reform law (“An Act Relative to the Achievement Gap”) that will, over time, double the number of charter school students and established a new category of in-district reform called innovation schools. (The law also made virtual schools possible, but the state’s department of education decided two years ago to tie a few regulatory double-knots on that type of reform, as I’ve blogged here and here.) In districts where MCAS scores lagged in the bottom 10 percent statewide, the cap on the number of number of students who could attend charter schools was doubled from 9 percent to 18 percent. We saw an increase of 16 charter schools in year one and […]

Joshua Archambault

Jon Gruber’s RomneyCare/ObamaCare False Narrative

/1 Comment/in , , /by

This morning, Steve LeBlanc of the Associated Press has another Massachusetts focused story up titled “Mass. Health Law May Bode Well for Federal Law.” The piece is based on a common flawed assumption. The piece fails to mention Massachusetts’ pre-reform circumstances in contrast to other states now. It expects that the same actions and behaviors will play out in the same way in other states. To expand on my quote in the story, can we honestly suppose New Mexico with 20+% uninsured, no guarantee issue in their individual market, employer sponsored insurance rates of 48.6 percent, lower income levels, lower education level, low-medical infrastructure, and a geographically spread out state to see the exact same results as the Commonwealth? Contrast that with the  starting place […]

Joshua Archambault

Are Fewer People in MA Paying the Indiv Mandate Penalty?

/0 Comments/in , , /by

Since the Supreme Court upheld the ACA/Obamacare, there has been a renewed interest in the Massachusetts healthcare law. I have blogged many times before to caution readers and the media not to assume the two laws will lead to the same results, because they won’t, mostly as Massachusetts is not the same patient with the same ailments as New Mexico, or Michigan, or even Florida. I know I am fighting against the conventional wisdom,  but this issue warrants discussion as Congress passed a national program and modeled the behavior and cost estimates (incorrectly in my opinion) partially on our experience here in the Bay State. As a result of the national interest, I assume we will see more local reports […]

Jim Stergios

The SCOTUS ruling’s impact on education policy

/0 Comments/in , , , , /by

Internet traffic has been especially heavy for the past 32 hours as people across the US are trying to understand just what the decision yesterday by SCOTUS means. The Affordable Care Act (ACA) is an extremely complex piece of legislation famously weighing in at well over 2,000 pages and already a couple of years into implementation leading to thousands more pages of regulations and guidance to fill in the gaps left to the U.S. Health Secretary Sebellius. As people learned the news yesterday, of course, some had extra pep in their step; others required pepto-bismol. Such high-profile ruling with broad implications for federal-state relations is bound to touch on education policy — and it does. The discussion of the Commerce […]

Joshua Archambault

Pioneer Press Release on SCOTUS ACA Ruling

/0 Comments/in , , /by

The Way Forward: Despite Supreme Court Ruling, New Start Needed on Health Care Reform Pioneer Institute calls for Congress to replace most of the federal health law and clear the way for state-based reforms BOSTON – Despite the US Supreme Court’s decision to uphold the Patient Protection and Affordable Care Act (PPACA), Pioneer Institute for Public Policy Research calls for a new approach to solving the nation’s health care problems. “The fact that this decision was made in essence by a single justice highlights the need for real solutions that can gain broad consensus across the country. The Court’s decision today will set off further state and federal conflicts that will likely end up in the courts once again,” says […]

Jim Stergios

Making more than symbolic change in our schools

/2 Comments/in , , , , /by

Today’s lead story in the Globe relates the three years of “reform” by Sito Narcisse at English High: An extraordinary three-quarters of English High’s teachers and administrators have quit or been let go during the past three years, school records show, as headmaster Sito Narcisse pushed through one controversial initiative after another — from school uniforms to single-sex classrooms to eliminating the grade “D,” forcing students to earn a “C” or fail. Teachers who did not go along with Narcisse’s approach were “not the right fit,” in his words, and he sent 38 of them packing, while dozens of others retired or resigned. Given the continued drift in the school’s MCAS scores and observations of kids napping in class and […]