Yesterday’s Globe brought news of an initiative by the City of Boston to move folks out of emergency rooms and into Community Health Centers, for treatment of non-acute conditions. That’s a laudable goal, but it brings to mind the inconsistency of the city’s full-throated opposition to another group of non-acute healthcare providers just a few years back. Back in 2008, the mayor warned of dire consequences, saying that permitting these health care providers to operate “jeopardizes patient safety” and that they “will seriously compromise quality of care and hygiene.” As a result, Boston didn’t get any MinuteClinics. Lots of other Massachusetts communities (including Newton, Braintree, Quincy, Cambridge, and Medford) have them. Did you miss the stories about the utter collapse […]

I had the pleasure of doing Bradley Jay’s radio show on WBZ a few weeks back. We talked about the MBTA, but what really lit up the phone lines was our discussion of potential savings from reform of the T’s Ride paratransit program. Most of the callers were concerned that eligibility reforms would take away their transportation. But it appears that the MBTA could save a lot of money just by restructuring the service, before even dealing with eligibility issues. The state’s Inspector General has come out with a report that analyzes the Ride alongside other paratransit programs operating within in the state and determined that a key difference in business practices between the Ride and other paratransit providers results […]

The back-and-forth over the MBTA finances has seen a great deal of attention to the MBTA’s $5.2 billion in debt. A portion of that debt has been tagged with the nearly toxic label ‘Big Dig Debt’, and it’s important to be precise about what that actually means. The MBTA’s debt comes from three sources — $1.85 billion from spending since the 2000 start of forward funding, $1.65 billion that was transferred to the MBTA under forward funding and was related to previous transit projects, and $1.7 billion in funding for projects mandated under a Big Dig-related agreement. (N.B. All above figures are from the MBTA Advisory Board’s Budget and Fiscal Analyst Brian Kane’s invaluable Born Broke report. Kane, of course, […]

Education spending is one of those things that makes everyone feel good — we all want the best for kids, right? But that good feeling begins to fade when you see that many of the drivers of increased spending aren’t directly related to classrooms. In the (laudably detailed) proposed budget for FY13, Superintendent Johnson notes that health insurance is flat for the upcoming year but will increase by $7.7m in FY14 (on a base of $127.7m in total benefit spending). As noted in a 2010 research report, spending on health benefits increased by more than the increase in state education aid from 2000 to 2007. In other words, all the additional tax dollars the state spent on education during that […]