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Hoover at Stanford’s Stephen Kotkin on Stalin’s Tyranny, WWII, & the Cold WarApril 24, 2024 - 12:33 pm
Superior Court Judge Invalidates “Equity Theft” Law as UnconstitutionalApril 23, 2024 - 1:04 pm
Tax Man Confounded: Why High Rates Haven’t Yielded Higher RevenueApril 23, 2024 - 12:58 pm
Massachusetts’ Workforce Growing Older and More Diverse, Remains Highly EducatedApril 18, 2024 - 9:26 am
Johns Hopkins’ Ashley Berner on Educational Pluralism & DemocracyApril 17, 2024 - 2:53 pm
Why the secrecy? Pioneer Calls for Open Meetings Dealing with Steward’s Impact on Patient Care.April 16, 2024 - 1:59 pm
Industrial Policy Reimaged: Can Government Improve Free MarketsApril 16, 2024 - 12:34 pm
39th U.S. Poet Laureate Robert Pinsky for National Poetry MonthApril 10, 2024 - 12:16 pm
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Rethinking EMTALA
/0 Comments/in Blog, Healthcare /byOn the drive in this morning I heard an interesting idea being tested in Fort Worth Texas (isn’t that one of the highest health cost cities in the country?). See the link here http://www.nbcdfw.com/news/local-beat/Call-An-Ambulance-Get-a-Taxi-66723887.html. They are using EMTs as triage agents for patients who call 911 for an ambulance. In many cases, the EMTs are telling patients, “you don’t need to go to the hospital.” If the patient insists on visiting the ER, and it is not an emergency, the EMT calls a cab. Policymakers should re-think how EMTALA (the Emergency Medical Treatment and Active Labor Act) gets operationalized and whether it needs some updating to encourage appropriate use of our scarce resources. With the flu season upon […]
Just. Not. Smart.
/0 Comments/in Better Government, Blog, News /byThe Governor is now talking about layoffs. I suppose Pioneer is responsible for starting the discussion about headcount growth a year ago, when we suggested that the data is telling us that state government grew from 2004 to then by about 7500 positions. We said it in October 2008, January 2009 and then again in June 2009. Our view is that the addition of 1,100 safety net program positions during that period should be maintained but that an equivalent of the 6,400 new hires are not sustainable in the face of thousands of local layoffs and over a billion-dollar-plus structural deficit. That’s been the mantra over and over. Over the past five months or so we’ve been asking the state’s […]
Let the Patients Choose
/1 Comment/in Blog, Healthcare /by(Editor’s Note: Pioneer welcomes our Senior Fellow on Healthcare, Amy Lischko, to the blog. Amy will be writing on healthcare here from time to time, as well as working on research for Pioneer. Welcome.) It’s worrisome when the state tells us what kind of provider network we need. Today’s Globe article “Insurer told to hold off in Mass.” highlights one of the reasons behind our increasing health care costs. Carriers have often remarked that they have difficulty creating both tiered provider networks and narrow provider networks that offer lower costs. Why can’t the state (via the Connector or DOI) allow Centene to offer these plans to consumers and let the consumers vote with their feet? If no one signs up, […]
Running the Numbers, Stimulus Style
/0 Comments/in Blog, Blog: Better Government, News /byYou’ll forgive me for being a skeptic about job creation numbers. There’s a history there. So, the GOV’s announcement that Stimulus Act Spending had “created or retained 23,533 jobs” caught my eye. Reading the press release more closely, I saw this qualification: Stimulus spending has created or retained 8,792 full-time equivalents (FTEs), representing 23,533 individual citizens put to work. If we take the $1.9b already spent by the state on stimulus and spread it across the number of FTEs, that comes to a subsidy of over $200k for each preserved or retained full-time job. I don’t have a good frame of reference (and I’d be curious how other states are doing) but that strikes me as a pretty big number […]
Time to Activate the PAFNDAS
/0 Comments/in Blog, Blog: Better Government, News /byUPDATE BELOW What’s that? Why, its the Patrick Administration Friday News Drop Alert System. We noticed the habit of shuffling certain pieces of news out the door late on Fridays and so have others. So, I note that as of 10 AM on Thursday, the Governor’s Office has not released his Friday calendar (to SHNS, that is). Yet, the centerpiece of transportation reform, a central authority — MassDOT, springs to life on Sunday, November 1. MassDOT will be governed by a five member board that will take on a massive array of responsibility — oversight of transportation policy in general and, through incorporation, will take over the responsibilities of the former Turnpike and MBTA Boards of Directors. But we still […]