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Brookline — Busy Thanksgiving Season

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Brookline has had a busy week. First, the town and its unions agreed to adopt the state’s Group Insurance Commission as their insurer for municipal employees — which should be a big source of savings. The longstanding position of the Town Administrator has been no movement from the current premium cost-sharing arrangement of 75% (i.e. the town pays 75% of the premium and the employee pays 25%) but, at the end, the town will end up paying 83% after three years. I don’t have access to either side’s numbers but it appears to be a win-win all around. Next, they’ve decided to take matters into their own hands and try to utilize stimulus funding to improve service on Bus Route […]

Design it first and then cost it out

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Or maybe the title should be “borne back ceaselessly into the past”. News reaches us that the Boston Convention Center Authority is looking to double its size, but ” they don’t know how much the project would cost or how it would be paid for” (from SHNS, sub req.) I’m going to go out on a limb and say that now is not a great time to be seeking additional funding, particularly with the inference of higher taxes. The planning approach reminds me of the Governor’s quote about his Readiness Project/education reform package: “We’re building a house,” he said. “You design it first and then cost it out.” The task of figuring out the details will reportedly fall to a […]

Flier and Saturday's Senate debate

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As noted here last week, the Wall Street Journal opinion piece by Harvard Medical School dean Jeffrey S. Flier was going to be important. Set aside for a moment the procedural vote on Saturday by the US Senate and consider the multiple references to Flier’s piece last week. Sure, the politics of a president’s approval rating going south of 50% matters, but having the dean of HMS pull the federal reform effort limb from limb did not help. Flier gave the federal reform effort merits a “failing grade.” Reasons? The bills being considered included “no provisions to substantively control the growth of costs or raise the quality of care.” He went so far as to say the effort did not […]

Overseas Surgery

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So, I’ve heard about the increase in Americans seeking expensive surgery abroad but today’s Wall Street Journal coverage of Dr. Shetty’s 1000-bed cardiac hospital in Bangalore, India was absolutely fascinating reading: (http://online.wsj.com/article/SB125875892887958111.html?mod=WSJ_hpp_MIDDLETopStories) Cardiac survey averages $2000 at Dr. Shetty’s hospital compared to between  $20,000 -$100,000 here in the US.  And it’s not just that India is a less expensive place to run a hospital.  It’s because Dr. Shetty has such high volume that he is able to achieve economies of scale unheard of in the United States.  He’s also able to drive hard bargains with manufacturers of cardiac supplies and equipment and his staff are incredibly productive.  What’s the quality like you ask?  Well, it has been well established that […]

Thoughts on the Route 28X Failure

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UPDATE BELOW What’s Route 28X? It was MassDOT’s attempt to turn the sloooow Route 28 bus route up Blue Hill Avenue into a Bus Rapid Transit Route. Sadly, it died due to neighborhood opposition — it appears 3 things felled it: 1) Lack of Neighborhood Input on Process – This was probably unavoidable as the state had to move quickly to apply for the federal funds and tried to backfill with ‘civic engagement’ but to no avail. 2) Resistance to Tearing Up the Median Strip on Blue Hill Avenue — To create a dedicated (as in faster than sitting in traffic) bus lane, it would be built on the median strip on at least a portion of Blue Hill Avenue. […]