THE PIONEER BLOG

Steve Poftak

Here We Go Again… Now It’s Medford

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Several months back, the egregious abuses at the Chelsea Housing Authority showed the weaknesses in oversight of municipal housing authorities. The fact that it got away with that abuse for so long, even after federal and state audits, should give one pause. Now, the Medford Housing Authority is under scrutiny. This time, its not the Executive Director’s salary that’s in question. Rather, its his habit of hiring underqualified political favorites and widespread ‘irregularities’ in contracting. In addition, there are allegations of improper usage of funds by other employees. And, once again, we have the troubling spectre of the entity which is supposed to provide oversight — the Board of Directors — unable or unwilling to do its job properly. This […]

Jim Stergios

Self-dealing among education officials

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I’m conflicted about how to say this. Getting stuff done is about building relationships and trying to find ways to get along and in fact pulling the right people together toward a goal. But it is also about saying things straight and pulling no punches when what’s being debated matters a lot. I often write about education standards because, unlike some other ed policy choices, standards impact the entire landscape of education. If used effectively to drive reform, they set the contours of classroom content, they constitute the basis for student tests, and they define the basis for teacher tests that ultimately play a bigger role on the quality of teaching in the Commonwealth than any professional development program afterward. […]

Joshua Archambault

If Only Governor Patrick Knew What His Medicaid Office Was Up To

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While Governor Patrick has been pleading with the Legislature to act on his February 2011 payment reform bill that would move our health care system towards global payments and accountable care organizations, his MassHealth (Medicaid) office has moved in the opposite direction. (You can read my testimony on the Governor’s bill here) In March 2011, the MassHealth program changed their default enrollment policy for new enrollees that did not affirmatively select a managed care option–either one of the 5 Medicaid managed care organizations (MCO) or the Primary Care Clinician Plan (PCC). Before the switch, if an individual, after being determined eligible for Medicaid, did not affirmatively select a managed care option, the MassHealth office would auto-enroll them into either one […]

Jim Stergios

Conflicts of Interest in MA’s adoption of national standards

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“No man is allowed to be a judge in his own cause, because his interest would certainly bias his judgment, and, not improbably, corrupt his integrity.” – James Madison, Federalist #10 In this season of US Supreme Court decisions we’re reminded that independent and objective judgment on key legal and public policy matters has been an aspiration in Anglo-America law and justice (not to mention scientific inquiry) for centuries. In America, it was John Adams in Massachusetts and James Madison of Virginia who were best at articulating the importance of independent judgment. The push for national education standards has brought to light a variety of troubling questions about the legality, cost, and academic quality that has been discussed here and […]

Joshua Archambault

Is Romneycare A Budget Buster?

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The Massachusetts Taxpayers Foundation (MTF) put out a report late last week on the cost of Massachusetts health reform. The number from the report that has gotten the most media attention has been– $91 million. Over the five full fiscal years since the law was implemented, the incremental additional state cost per year has averaged $91 million… This is a very strange way to interpret the cost data. Here is the breakdown from the report: The better number to highlight would be the incremental increase each year over the 2006 baseline. 2006 2007 2008 2009 2010 2011 Over 2006 baseline (millions) – $268 $645 $1,037 $834 $906 If you add this up and divide by 5, you come up with […]

Steve Poftak

HOT(High Occupancy Toll) Lanes in Massachusetts?

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Toll hikes are a tough sell in this area, but what if tolls were optional? And what if you were getting a premium level of service in return for your money? That’s the basic idea behind HOT (High Occupancy Toll) Lanes. These are segregated lanes that are tolled (usually at variable rates to keep traffic flowing) and run alongside ‘free’, untolled lanes. Think the HOV lanes on I-93 except they charge an open-road toll for vehicles that aren’t carpools. The toll would vary according to the time of day in order to keep traffic flowing (e.g. the price would be high during rush hour and decline during times of lighter traffic). Lots of other places are trying this concept out […]

Joshua Archambault

News Flash: Gruber and McDonough are Political

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Jonathan Gruber and John McDonough are widely quoted in the media on both Romneycare and Obamacare. Without question they are both extremely intelligent, I have a deep respect for their commitment to health policy and enjoy the frequent interactions I have with them. However, I have wondered for months when the media will finally acknowledge that they both have a political angle.  This week President Obama’s campaign made it official by putting them into a video: Will this put an end to the neutral observer status afford them in most media stories?

Joshua Archambault

How Much Do Same-Sex Marriage & Health Care Overlap Constitutionally?

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Socially liberal commentators opine against some conservative’s preference to nationalize the issue of marriage when they argue so strongly for a federalist impulse in many other areas of policy including health care. On display this past month has been the exact opposite positioning by Massachusetts’ Attorney General Martha Coakley. It is interesting to juxtapose her two recent high profile affairs in the federal court system. First up was her amicus brief in support of the President’s Affordable Care Act (Obamacare) which argued that the federal government has the right to regulate health insurance because it is an example of interstate commerce. Weeks later she entered a federal appeals court leading the charge to uphold her earlier victory in court to overturn the federally passed Defense of […]

Joshua Archambault

Applying Finance to Health Care: ROI of Wellness Programs

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A new report from Health Fairs Direct, a corporate health and wellness events provider, asks the very important question: What is the most effective way to control rising healthcare costs? While they might be somewhat self-interested given their line of work running health and wellness events, the return on investment analysis should inform any company tackling this issue. The Connector has launched a wellness program recently and should examine this study for any best practices. The report analyzed 50 studies of the wellness programs offered at different organizations including Johnson and Johnson, Citibank, DuPont, Duke University and The California Public Retirees System. Here are the six best wellness initiatives Health Fairs Direct identified as producing the the greatest ROI: Health […]

Steve Poftak

The Hidden Transit Enemy? Dwell Time.

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Transit riders (like me) love to complain about how long certain trips take. We wish trains, trolleys, and buses could go faster. But a lesser known factor making trips longer is dwell time — how long you spend at stops and stations waiting for people to board. New York City has instituted a “Select Bus Service” strategy on several key routes, instituting a couple of tactics to reduce trip time by reducing dwell time. (Its also worth noting that this type of bus-rapid-transit-like service is incredibly low cost to implement relative to almost any other transit expansion or enhancement). Most importantly, this service lowers dwell time by taking fare payment off the bus. Each station on the route has fare […]

Steve Poftak

If the State Takes the MBTA’s Debt, Then…

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Multiple voices have suggested during this debate that the state take over the MBTA’s Big Dig Debt. Just today, MassDOT Sec’y added his voice to the debate noting that a debt transfer was not “a bad idea”. Administration and Finance Secretary Jay Gonzalez responded that this was “not a realistic solution”. (SHNS, sub req’d.) This space has noted before that the term “Big Dig Debt” can be misleading, as it refers to transit projects funded as part of a side agreement to the Big Dig (and not funding of projects related to the roadway itself). But let’s play along with idea, if we transfer the $1.7b in debt associated with the Big Dig transit projects, what are the implications. In […]

Jim Stergios

Food For Thought on Saving Schools Money in Massachusetts

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Yesterday, the Globe’s Deirdre Fernandes reported on the spat between Newton North High School’s food contractor and the student-run Tiger’s Loft Bistro. The contractor, Whitsons Culinary Group, was sore about the school allowing a competitor to serve food in the building. After all was said and done, the school and the contractor made up, and the student-run bistro will re-open and be able to serve students once again. There are two lessons to learn: Businesses may like to talk about the need for competition, but they never like it when there is a direct competitor. That’s why for over a year, Whitsons sought a clause in its contract that barred competition. Not much of a news flash there, but it […]

Steve Poftak

The Political Elegance of the MBTA’s Deficit Solution

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If you want the details of today’s MBTA deficit solution, take a look for yourself. Slide 4 is the key breakdown of the total solution. Service reductions account for only about 8% of the deficit reduction, fare increases account for almost 40%, and the rest is a series of budgetary nips, tucks, and rummaging through available pockets of cash. The fare increases total $72.9 million (below the $87 million to $135 million range in the original two scenarios). And they appear to have gained widespread acceptance. Imagine if the T had lead with just a request for a fare increase. It would have been ugly. Instead, they gave people a rough choice between service cuts and a fare increase. And […]

Steve Poftak

Sigh. Another MBTA Procurement Snafu?

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As a sometimes commuter rail passenger, it’s depressing to contemplate that a plan to replace almost 20% of the commuter rail’s passenger cars is now at least a year or more behinds schedule. The need for an upgrade to the fleet was brought home to me in sharp relief during a recent trip to the Danbury Railway Museum. Among the old trains from the golden age of rail on exhibit was a passenger coach whose interior would have been indistinguishable from some of the older commuter rail coaches (that date back to the ’70s and ’80s). In procurement, hindsight is always 20/20. The MBTA took a much lower bid from a far less experienced manufacturer. And it looks like at […]

Joshua Archambault

WSJ on “The Great Experiment” in Health Care

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Kim Strassel of the Wall Street Journal($) wrote on Pioneer’s health care book today, and  she highlights a very important historical point. Major entitlement reform is only possible when some level of national consensus has been achieved around end goals. In The Great Experiment: The States, The Feds and Your Healthcare we examine welfare reform in the mid-1990’s as a perfect example of this paradigm. Excerpt from The Wall Street Journal column: The more conservatives have been forced to think about health care, the more they’ve understood the merits of state experimentation. Jim Stergios, executive director of the Pioneer Institute—a free-market think tank in Boston that has published a book on ObamaCare and RomneyCare titled “The Great Experiment: The States, the Feds, […]