THE PIONEER BLOG

Joshua Archambault

Payment Reform: No Government Mandate Needed

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The move in the health sector towards payment reform took a big leap forward as 1,800 doctors at Beth Israel Deaconess Medical Center signed a global budget contract with Blue Cross for HMO patients. In other words, doctors are given a fixed budget for the care for each patient during that year. Supporters of global payments hope that the quality of care will be improved. WBUR’s CommonHealth Blog posted an interview with Dr. Stuart Rosenberg about the move. What I found especially interesting was Dr. Rosenberg’s statement at the end of the video. 4:40 My idea is let’s just get on with the solution, and not wait for the government to pass a law. During a radio story carried on NPR, the […]

Jim Stergios

Full Disclosure

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AEI edu-wonk Rick Hess went blue in the face in his Education Week blog criticizing Pioneer’s call for an investigation of Massachusetts Education Commissioner Mitchell Chester in the wake of a Channel 5 story showing that Chester accepted free and discounted travel from groups with an interest in issues before him. Rick’s piece leans hard on references to a supposed Salem Witch Hunt (yup, that’s right in the title of his blog) and the piece just goes downhill from there. Building your case on a Salem Witch Hunt frame is a sure sign of overheated passion. It’s not just people in Salem who shake their heads at the hackneyed reference (as if that great merchant city’s history begins and ends […]

Joshua Archambault

Decrease Insurance Premiums or You’ll Be Sleeping with the Fishes

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A study released this morning may lay out the possible future of state intervention in premium increases for health insurance. The Kaiser Family Foundation examined the different methods by which each state reviews proposed health insurance rates. They found: Many states use subjective standards to guide the review and approval of rates, such as that rates cannot be “excessive, inadequate, or unfairly discriminatory” or that “benefits are reasonable in relation to premiums charged.” Such standards give states more flexibility, but can make the process appear arbitrary and opaque to consumers and the public. Does this sound familiar in Massachusetts? The election year– small businesses health care bill– granted the executive branch the authority to reject premium rate increases if they […]

Steve Poftak

Choice for me but not for thee?

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The Globe’s op-ed page has been featuring several ‘guest’ columnists, including Junia Yearwood, a retired BPS teacher. One of her recent columns is a pretty vicious attack on charter schools — categorically accusing them of creaming students, ejecting difficult students, and making her former school a ‘dumping ground’. So, given her egalitarian views and support for the district schools, I was intrigued to learn that, for her own child, she sends them to the suburbs to be educated through the METCO program.

Elizabeth Prasse

Tax-Exempt Organizations 101

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During this year’s election season, controversy arose regarding disclosure requirements for tax-exempt organizations that spend money on political advertisements. In particular, the Chamber of Commerce and the identity (or lack thereof) of its donors came under scrutiny. This debate is just the tip of the iceberg in a very important area: government regulation and oversight of tax-exempt organizations. Organizations that are created under Section 501(c)(3) and related provisions of the Internal Revenue Code are generally exempt from paying federal income taxes, and under Massachusetts law, they are also generally exempt from paying state and local taxes. In other words, we have decided as a society that certain types of organizations are worthy of public support and should be excused from […]

Jim Stergios

Ryan & Rivlin on containing health care costs

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This week’s Economist has an article worth reading on the various proposals to curb the burgeoning federal deficit. In it, you can view a comparative table of deficit cutting options (would include it here but it’s worth reading the whole thing). As Economics 21 notes, Many critics have taken Bowles-Simpson to task for “hand-waving” at Medicare cost growth by declaring an intention to cap Medicare to a growth rate of GDP growth + 1% while retaining its defined benefit structure. Given that Medicare has grown at a far faster rate in recent years, the idea is that this is a highly unrealistic projection. Happily, left and right have come together, respectively, in the persons of Paul Ryan (WI) and Alice […]

Steve Poftak

Groupon for the Public Sector?

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Groupon (and its group-buying competitors) are all the rage in retail right now. There’s a pretty healthy debate going on regarding the pros and cons of the Group-on model (see here, here, here, here, here and so forth), so I was intrigued a few weeks back when I saw that a quasi-public entity was the featured Boston Groupon of the day. Zoo New England runs the Franklin Park and Stone Zoos and receives a subsidy from the state of several million dollars. Its CEO, John Linehan, was kind enough to speak with me about the Zoo’s thinking behind the Groupon offer. (See Disclosure below) Much of the criticism of Groupon centers on several themes – does it draw new customers […]

Jim Stergios

Does the heroic reform model work?

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School Choice Models & Public School Reform from Mike Dean on Vimeo. With the recent electoral defeat of Mayor Adrian Fenty, a strong advocate of school reform and school choice, and the subsequent resignation of DC schools chancellor Michelle Rhee, many have reflected on the attempt to fix the DC schools from within. The recent release of the film Waiting for ‘Superman’ has, while drawing attention to the plight of children trapped in mediocre public schools, also advanced the motif of the “heroic superintendent.” I’ve never been terribly convinced by the “heroic superintendent” line of thinking. And my guess is that the long line of foundations and private investors who have bet the house on a single personality’s heroic endeavors […]

Jim Stergios

Questioning the Convergence on National Standards

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The Southern writer Flannery O’Connor’s Everything that Rises Must Converge is a collection of tragicomic pulp fiction stories about dangerous human flaws and the “blind wills and low dodges of the heart” found in everyday life. People have failings. That’s the way we’re built and that’s the way of the world. But there are “game days” when a lot is riding on decisions and you have to muster the courage of your convictions for the benefit of all. This summer, that game day came on a scorcher in late July and concerned whether Massachusetts should or should not adopt national standards. In exchange for $250 million in federal support over four years (about 1/144 of overall school spending over that […]

damittell

Pete Peters

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Four things come quickly, indelibly, to mind about the life of Pete Peters. First is the power of a single committed human being to effect good in the world. This represents the final rejection of determinist nonsense that, for example, the sonnets of Shakespeare were all written in the primordial universe that emerged from the Big Bang. In human affairs, there are choices, and those who choose to do for others can create innocence out of cynicism. When they are gifted and persistent, as Pete was, they can palpably improve the world. Secondly, Pete had faith, as Lincoln put it at Cooper Union, that “right makes might.” He put his faith in reason and in the ability of ideas to […]

Joshua Archambault

Massachusetts Health Care Transparency: Bright Enough Spotlight?

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Massachusetts officials published online this week a database containing “payments drug companies and medical device makers made to hospitals, doctors, nurses, pharmacists, and other health care providers in the state.” This is a move in the right direction for transparency, but I have to wonder why these two industries were the sole targets. I know the Legislature has focused on gift restrictions in past legislation, but why the narrow focus. While it is nice to be able to download the data in a spreadsheet and manipulate it yourself, the site is not the most user-friendly. For example, it took me 10 clicks deep to get to an individual report. There is much more work ahead before an average consumer would […]

Jim Stergios

Rumblings of an earthquake in national education policy?

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With Rick Perry said to be a shoo-in for the head of the Republican Governors Association, the Council of Chief State School Officers (CCSSO), which was one of a handful of lead groups pushing states to adopt national standards, may find itself in deep trouble. In fact, Perry, as the head of the RGA, may force the National Governors Association, which together the CCSSO, Achieve Inc., and the Gates Foundation, acted as cheerleaders for national standards, to revisit its position in support of national standards. Here’s why. Governor Perry opposed the national standards because Under the program’s rules, Washington gives preference and dollars to states that agree to adopt national standards that haven’t even been written yet. Texans strongly support […]

Joshua Archambault

Pioneer Senior Fellow on PBS's NewsHour

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Pioneer’s Senior Fellow on Health Care, Amy Lischko, was interviewed on PBS’s NewsHour for a series on the reform law here in Massachusetts. I personally think the report glosses over the connection between increased costs for small businesses and policy decisions by the Legislature and the Connector.  You can read more about this in a Boston Globe op-ed by Jim and Amy. For more history you can read my report from the Heritage Foundation “The Impact on Small Business of Health Care Reform in Massachusetts“. Please check out the video below, or click the link NewsHour Amy appears at 7:44.

Jim Stergios

Time to Remember

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Lovett C. Peters died Thursday, November 11, at the age of 97. After a fall this summer that led to a fractured hip, it was his hopeful determination that took him from hospital emergency room to rehab center, to his home, to a walker and even a cane. In October, Pete came to the office and attended board meetings. His death came after a fall at the theater, when his walker got caught on a carpet. His was a great life—a hopeful, principled, determined, and undiscouraged life. We were all touched by it, as were thousands and thousands of children in the Commonwealth and elsewhere in the country, because of his work to improve the academic excellence and equality of […]

Joshua Archambault

Health Care Costs Crushing States– Is the Solution to Drop out of Medicaid?

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The headline says it all. “States’ Woes Spur Medicaid Drop-Out Talk” An article in The New York Times today highlights the serious consideration by at least a dozen states to withdraw from the Medicaid program. Supporters are arguing for either a state financed Medicaid program to allow for maximum “flexibility in benefit and cost design” or a federal waiver for states to make some changes on their own. At first glance, leaving the Medicaid program would seem illogical given the federal match that would be left on the table. However estimates that have been conducted– both by think tanks and independent sources– highlight a budget busting tidal wave on its way if the status quo is followed. Lanhee Chen has […]