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An Interesting Idea — Behind the Counter Medications

A recent op-ed in the LA Times calls for certain medications to be prescribed by pharmacists. This suggestion is on a continuum with a few other ideas that move select portions of medical practice from its traditional delivery mode to more convenient and cost-effective (but still clinically rigorous) modes. Increasing the practice rights of nurse practitioners and allowing Minute Clinics are ideas along these lines. The gist of the idea is that for certain medications, it is a appropriate for a pharmacist to prescribe directly to customers who come in and complain of specific symptoms. This should be familiar to anyone whose ever gotten mildly ill in Europe — where the practice is widespread. Although this seems like common sense, […]

Murray’s Healthcare Moment

The prospect for dynamic reform on Beacon Hill seemed slight a week ago. New initiatives seemed to be breaking down in a familiar pattern — Governor proposes ‘bold, new’ (expensive) initiative, Legislature promises ‘careful, in-depth’ review (and plenty of revisions. Then, Senate President Murray gave her speech at Wednesday’s Greater Boston Chamber of Commerce meeting. She proposed the following: 1) Public hearings to document the causes of premium increases above 7 percent 2) Realigning of payment methodologies to encourage quality and efficiency, not just the volume of services provided. 3) Increased recruitment of primary care providers 4) Allowing nurse practitioners to serve as PCPs for some patients 5) Permit “limited service clinics” proposed by the Department of Public Health. 6) […]

Fixin for a fight

The Governor has frequently talked about his openness to lifting the cap on charter schools, but only with a financing fix, which certainly means reducing the funding to charters below the average per-pupil expenditures within the district school system. Say community X spends $10K per student in the traditional district schools, the new formula would halve that amount for parents of kids in the district who choose to go to a charter school. That’s what the Massachusetts Association of School Superintendents and Mass Association of School Committees want. The Governor has shown openness to this view, which of course makes charters financially unviable. I’ve often wondered about this proposal given all the court cases out there pushing for equitable funding […]

Home of the Bean, the Cod, and the Free Glass of Tap Water

As much of the Sun Belt dries up, we may have to revise our tally of regional economic advantages. For generations we’ve been told to flee the Northeast for some air-conditioned car-ported open-shop Elysium. Today, though, the Quabbin Reservoir is making me feel like an early-’70s Alaskan. If we get our water-policy act together, the Commonwealth’s natural resources may, for the first time since the whale-oil days, actually give us a competitive edge. Please, though: no pipelines.

Dear critic, Do you or don’t you

support the Massachusetts Health Care Reform? We get the question all the time, especially from other think tanks and national press outlets trying to figure out what this all means as the presidential election starts to show signs of life. (When presumed frontrunners of each party start hammering on each other, you know the line-up is soon to winnow down.) At the end of the day, Pioneer supports whatever will lead to better health care outcomes and contain the rising cost of care. It’s an empirical question, or to put it more colloquially, the proof is in the pudding. And anyone who’s been an in-patient knows it’s hard to be patient with what passes for dessert in the hospital. (Do […]