THE PIONEER BLOG

Scott Walker’s double

The biggest danger that the teachers’ unions, and really all public sector employee unions, face is that of “copycat” Walkers. But let’s be clear: The Wisconsin battle over collective bargaining is not going to play out in Massachusetts like it has in the Badger state. The fact is that there are important differences between our states. Our major collective bargaining issues are local in the short-term and in the longer-term both state and local. In the near-term that means we need to focus on giving local municipal leaders the same ability that the state has to purchase health care benefits in bulk and without negotiating collectively on the benefit packages put forward. But lest unions take the wrong lesson—that Massachusetts […]

What does the Madison catfight mean for teachers?

The public debate in Wisconsin over the effort by Governor Scott Walker to curtail collective bargaining rights for public employees has all the stuff of a great teaching moment. It has the governor of a state that is known for and has a long history of progressivism. The president of the United States has lined up against the governor. Thousands of workers are swarming into the State House, and legislators exiting across state lines. The story also has the benefit of being about something we all understand—we are broke. We’re broke as states and a nation, and how are we going to work through this. The story has the added benefit of being something familiar to all of us: We […]

Good Stuff in Transportation

It’s easy to be cynical in this day and age, so we’ve put together a transcript of our May 2010 transportation forum to restore your faith. In it, we get to hear from three transportation innovators doing great work with limited resources. I urge you to give it a read. We hear from Jon Davis from the MBTA who explains how their Open Data Initiative has spawned a number of privately-developed applications. The MBTA’s strategic approach is a subtle, but crucially important one — rather than decide what their customers want, then slog through an in-house software and hardware procurement and development process — the T cleaned up their data and made it available to private developers. The result? A […]

Governor Patrick Found the Silver Bullet for Cost Containment?

Thoughts on Governor Deval Patrick’s speech this morning about phase II of health reform in Massachusetts: cost containment. Without seeing the bill language these are my thoughts—however, it sounds like much “fussing over the details” will remain even after he files the bill. Broad themes He deserves credit for putting the first bill on the table. As has been the case for almost a year, the devil is still in the details.  The speech did not do much to illuminate, but it did serve to take a few things off the table. Much of the implementation of this bill will play out in the regulatory space anyway. This is a longer term play. There are real problems happening now, especially […]

Blame Game in Massachusetts Health Care

An interesting piece from Paul Levy over at Not Running a Hospital.  He beat me to putting words on paper, but I had some of the same thoughts and feelings he did while reading a recent Globe article about the average premium increases from insurers this coming year. I will quote at length so you can get a full picture of his reasoning. Catharsis is not policy-making If you ever needed an indication of why the public remains confused about the issue of health care costs and insurance premiums, look no further than a story in today’s Boston Globe entitled, “Insurers seeking smaller rate hikes.” It is not that the reporter has done a poor job. Quite the contrary. The […]

“For small businesses, a hesitancy to hire”

An illustrative piece in the Boston Globe today by Megan Woolhouse about the high cost of running a small business in Massachusetts. This is an issue that Pioneer has been researching for years. Pioneer has released numerous papers discussing possible reforms to the programs that are most burdensome. The most recent was “Creating Jobs: Reforming Unemployment Insurance in Massachusetts.” From my perspective, one of the most expensive costs was only mentioned in passing in the article. Struggling to survive in 2008 and faced with rising health care costs, the Olsons eliminated health care coverage, offering employees a one-time payment of up to $5,000. The reform passed in 2006 promised to help small companies afford health insurance. During implementation, policy decisions […]

Real Competition at the Health Connector?

The Connector Board yesterday moved forward with plans to introduce “competition” into the bidding process for insurers selling to those buying coverage within Commonwealth Care (CommCare). CommCare: more than 160,000 residents – individuals who earn less than $31,000 a year or families of four that earn less than $66,000 and have no access to insurance through an employer or through Medicaid – obtain fully or partially subsidized health care at a projected cost of $822 million to taxpayers this fiscal year. (adapted from SHNS, 2/10/11) For some, myself included, a chuckle escapes whenever the word competition is raised as a novel cost saving method, and we shrug our shoulders wondering why this is new concept to the Connector. Simultaneously, we […]

The Changing Face of Boston Schools

Jamie Vaznis reports today on the possibility that there will be 12 new charter public schools in Boston, even as the superintendent of Boston’s district public schools is seeking to shutter a number of underperforming schools under her purview. Of the 20 proposals for new charter schools, 12 seek to locate in Boston. The Boston applications aim to create more than 6,000 seats over the next five years, but the state law caps new seats in the city at about 4,500 — meaning state education officials will have to reject some applications even if the proposals have merit. Of course, the Board could also simply reduce the number of seats made available in the charter school proposals. And my guess […]

Man versus Superman

Movies like Waiting for Superman have done a great public service by focusing the country’s attention on the now-or-never challenge of making sure all kids have access to a decent school. A broad swath of the public and, importantly, the philanthropic community, has made education a priority. That is fantastic news. But where there is Superman, there is kryptonite. And the Achilles Heel of the WFS set is that the superhero commissioners and superintendents’ records of success are not as stellar or sustainable as you might think. I have written skeptically (here and here, for example) on the view that a heroic reformer armed with foundation dollars can cure what ails our schools. That there has been improvement in NYC, […]

Israel as First Stop?

Obligatory Throat-Clearing: There are a number of excellent reasons for public sector officials to visit Israel. The point of this column is to question the Governor and the Mass Competitive Partnership’s prioritization of Israel as his first stop on a Massachusetts Trade mission, not to engage in any broader discussion. Today’s Globe discusses the Governor’s potential trade missions and reports that Israel is his first planned trip. (To be fair, it notes the Governor Romney planned a trip and that Governor Weld made 3 trips to Israel). Here’s my question: Why would you pick Israel first as a trade mission (note the qualifier ‘trade’, not political or cultural). Israel is Massachusetts’ 25th largest import and export partner. Based on the […]

Governor’s Budget & Plan for Cities

When it comes to the aspects of the Governor’s agenda that impact cities, the press has focused on two elements: 1) Cuts in local aid in the budget and, 2) The push to lower the union threshold in order to allow, or perhaps force, municipalities into the state’s Group Insurance Commission. While those certainly are newsworthy, there are two smaller intiatives that move the Commonwealth in the right direction on two fronts: A) local performance management and B) regionalization. Pioneer has been a vocal advocate for the state to be more aggressive in promoting these policy goals. Our Middle Cities Initiative has worked with 14 municipalities to improve data collection, to drive accountability and transparency– in order that local officials […]

Governor Patrick’s Budget on Health Care: Playing Around the Edges

Medicaid (MassHealth) The Administration is feeling the heat with the increase in Medicaid (MassHealth) spending. Without a doubt something needs to be done—as spending now accounts for almost 40% of the overall budget. That’s less money for schools, for cops, and for roads. I, among others, think the Administration is being too optimistic on how much they can save by tweaking things on the edges. Will they really get almost $10 billion from rebidding Medicaid contracts? The budget grants the MA Secretary of HHS authority to change benefits and eligibility in MassHealth when possible— however her actions are restricted by the many constraints placed on the state by the federal government in the stimulus and Obamacare. 33 Governors sent a […]

Implications of the Harvard Pilgrim-Tufts Merger

Today’s news brings word of a potential merger between Tufts and Harvard Pilgrim. For this observer, it raises the question of how much more concentrated the health insurance market will become if the #2 and #3 insurers are merged? The standard measure of market concentration is the Herfindahl-Hirschman Index, which is the total of the squares of each participant’s market share. In a pure monopoly, the 100% market share translates to an index score of 10,000. In an almost total atomized market (100 participants each with 1% shares), you get an index score of 100. To give a sense of perspective, the Federal Trade Commission considers a market with an HHI of between 1500 and 2500 to be moderately concentrated. […]

Ever Met A Tax Incentive You Didn’t Like?

Remarkable to read the Globe’s endorsement today of the latest ‘flavor of the month’ tax credit. The latest (remember nanotech, cleantech, life sciences, film production?) favored industry is video game production. Given the implosion of the Evergreen Solar deal, one would think that targeted tax incentives aimed at specific niche industries would have to pass a pretty high bar at this point. But the Globe apparently thinks the policy remains sound, despite the Evergreen setback. Their reasoning? The Globe falls back on its mantra-like recitation of ‘clean energy’. Clean energy is important, but it doesn’t justify high risk investments and its not going to signficantly move the employment needle. PS — In case, you were wondering — the Globe is […]

Feds plug the Money Hole in Massachusetts Health Reform?

To close the loop from an earlier post on federal money being sent to safety-net hospitals in Massachusetts to balance their budget sheets, the State House News Service had this piece recently. FEDS OKAY $157 MILLION FOR MASS. HOSPITALS Massachusetts is due to receive $157 million in federal funds that will help trigger the release of $230 million in payments to hospitals that serve disproportionate shares of low-income and uninsured patients.  The funds are expected to provide state matches and free up the flow of funding to Boston Medical Center and hospitals in Brockton, Dorchester, Lawrence, Holyoke and Springfield.  Cambridge Health Alliance has already received about half of the $486 million in funds approved last October by federal government health […]