Massachusetts' health-care costs have escalated at an unsustainable rate. Consumers experience these increases as higher deductibles, copayments, and
out-of-pocket costs. We've begun to get a good picture of what was contributing to the rising cost of health care -- and a clear indication that spending
more was not necessarily contributing to our overall health.
For the first time on a statewide scale, we will move away from the current fee-for-service system, which pays for every procedure, test, and office visit,
but does not pay for phone consultations, e-mail exchanges, home visits, health education, or wellness and nutrition education. In short, the system pays
when stuff is done to us, but it does not support efforts to keep us healthy.
Your doctor is paid when you have an office visit, but if you have a question about whether or not you need to be seen, she will not be
paid for that phone conversation. And if you need to be seen after hours, what happens? You are sent to the emergency room, where you will receive the most
expensive care in our system. Chances are that the treatment that you receive or the tests that are performed to diagnose you will not be reflected in your
overall medical record: you will be responsible for self-reporting to your primary care doc, or more often than not, tests will be repeated in a different
The law signed by Patrick will change the way doctors, hospitals, and other providers are paid so that they are paid to keep us healthy. If your doctor was
able to save you a trip to the ER, to take just one example, they will be rewarded for saving the whole system money -- as they aren't now.
In the improved delivery system, the relationship between the primary-care provider and the patient is highly valued. The expectation is
that providers will have more time with each patient, and we as patients will be more engaged in our care. Efficiency will come as doctors and other
providers organize to deliver team-based care that is better integrated and patient-centered.
Our new law also establishes a first-in-the-nation Prevention and Wellness Trust Fund: a four-year commitment to community-based public health initiatives
that have proven track records, as demonstrated in improvements in overall health statistics for participating jurisdictions. At Health Care For All, a
consumer-advocate organization that has worked to guarantee high-quality health care to everyone, we expect this investment -- a down payment on improving
our populations' health -- to return rapid results.
The transition required by this legislation will not be easy. Just as we've learned lessons that other states can learn from in the past six years, we will
learn new and important lessons for other states along the way. One of the wonderful opportunities included in this health reform legislation is that the
newly formed governing body of the state's cost-control efforts will have health-care consumers as members, and its inaugural charter requires that all
members be free of conflicts of interest. This was a controversial provision. But as consumer advocates, we believe that this decision-making body will be
empowered to make principled choices focused on the bottom line of saving money and improving health care quality.