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Real Competition at the Health Connector?
/0 Comments/in Blog, Blog: Healthcare, Healthcare /byThe 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
/0 Comments/in Blog, Related Education Blogs /byJamie 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
/0 Comments/in Blog, Blog: Education, Blog: School Choice, Jim Stergios, Related Education Blogs /byMovies 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?
/1 Comment/in Blog, News /byObligatory 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
/0 Comments/in Blog, Blog: Healthcare, Middle Cities/ Urban /byWhen 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
/0 Comments/in Blog, Blog: Healthcare, Healthcare /byMedicaid (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
/1 Comment/in Blog, News /byToday’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?
/0 Comments/in Blog, News /byRemarkable 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?
/0 Comments/in Blog, Blog: Healthcare, Healthcare /byTo 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 […]
What we should we ask of the new UMass president?
/1 Comment/in Blog, Related Education Blogs /byWith former Congressman and current chancellor of the University of Massachusetts at Lowell Marty Meehan having pulled out of the running for the presidency of the overall UMass system, we are left with three finalists: Charles Bantz, the chancellor of Indiana University-Purdue University in Indianapolis, Robert Caret, the president of Towson University in Maryland, and Phillip Clay, chancellor of MIT IUPUI’s website trumpets that it is one of the top five “up and coming” American universities that U.S. News and World Report says people should be watching, and the 8th best public college in the Midwest according to Forbes magazine. IUPUI has a strong mix of undergraduate (22,000) and graduate and professional students (8,000). Its progress in raising the quality […]
MBTA Parking Proposal Should Go Further
/0 Comments/in Blog, News /byThe MBTA is proposing to securitize its parking revenues (roughly $30m per year) in order to fill a budget gap next year and pay down some debts, according to a Globe article. Also, the T will continue to run the lots and set prices. First, its not clear to me that this proposal creates value, except by solving a short-term fiscal problem (at potentially great expense). If this is just a pure securitization of a future stream of income (without the promise of operational improvements that would provide better service and/or generate more revenue), then its just taking money from the future to the present. Its even worse if the money goes to fund operating costs, then you’ve taken future […]
Troubling Cost Trends in Massachusetts Health Care
/0 Comments/in Blog, Blog: Healthcare, Healthcare /byTwo trends that might determine the long term success of health reform here in Massachusetts: 1) The Boston Globe ran an article about the immense upward cost pressure on the state’s Medicaid program. I blogged about the enrollment and cost increases in Medicaid about a week ago, here. In addition, under the federal law, at least 90,000 people will be moved from the current state subsidized privately run CommonCare plans into Medicaid. However, the double hit of enrollment increases are not the only issue: “The state is also being pushed by Washington, which is cutting back its support. The federal government, which had been paying 62 percent of the state’s Medicaid costs as part of the stimulus program, will pay […]
GLOBE OP-ED: Mass. cities need new deal with public employees
/2 Comments/in Better Government, Blog, Blog: Healthcare, Economic Opportunity, Middle Cities/ Urban /byThe Mayor of New Bedford– one of Pioneer’s Middle Cities– wrote an interesting op-ed that ran in the Boston Globe. He calls for a statewide task force to develop a new framework for public union contracts in the future. He outlines the fiscal mess that many local communities face, and advocates for immediate action to re-imagine how local governments are run. I wrote an op-ed giving some suggestions from the state level a few weeks ago. However, Mayor Lang’s strongest argument to support his call for action is that: “We cannot have a strong state unless we have strong municipalities. It is imperative that we find systemic and equitable solutions that will allow our cities to strengthen public safety, revitalize […]
Delivering a reality check
/1 Comment/in Blog, Related Education Blogs /byBack in October, a nasty teacher union v. school district battle came to a decision point in the Wrentham-Norfolk-Plainville area. Months had passed with the local union refusing to allow teachers to perform basic duties (writing letters of recommendation, providing parents access to updates online, etc.). As the Globe’s Brian McGrory noted, the unions were sore that the school committee didn’t want to agree to a new contract that would have given them a 28 percent raise over three years. Anyone who has been around the block in education knows the clout of the teachers unions and can easily twist his fingers in knots counting the obstacles and “actions” some local unions are willing to use to persuade school committees […]
VIDEO: Is Beacon Hill Rigged?
/0 Comments/in Better Government, Blog, Blog: Healthcare, News, Transparency /byOn a quiet Friday afternoon during the holidays, Beacon Hill gave members not returning next session a chance to give farewell speeches. The one that stood out was most was Rep. Matthew Patrick calling out the status quo for doing business in the Massachusetts State House. “If you play your cards right, vote the right way, keep your criticisms to yourself, you have a chance of becoming a chairperson of a committee,” he said, adding that eventually, “You find yourself not participating in debates, not even listening, because you and everyone else knows what the outcome will be. It’s preordained. You continue to play the game until one day you find out that some lobbyists have more influence than you, […]