Editorial Health Care Reform: The Key Is Finding The Proper Balance

Gov. Romney recently announced to the state what most people already knew, or at least suspected: that he won’t be running for a second term.


In making that announcement, the governor sidestepped any and all speculation that he was eyeing a run for the White House, and instead said, in essence, that in less than three years he had already accomplished everything that he had set out to do — or would in the year ahead.

We assume that this latter list includes the broad, complex subject of health care reform, a matter that is currently the subject of debate and (hopefully) compromise between the governor, the House, and the Senate, each with their own versions of reform.

As a conference committee continues its work to hammer out a plan it believes will work, we have some thoughts on how reform should be addressed. Actually, it comes down to one word: Balance.

There are many constituencies and many needs to be addressed with the subject of reform. The task at hand is to balance the concerns of those constituencies — individuals without insurance; taxpayers, business owners, and health care providers — and craft a plan that’s fair to all.

Or at least more fair than the system that exists now and doesn’t work.

At the heart of the reform discussion is the mission to provide more, if not all of the state’s residents with affordable health insurance. With insurance, individuals are far more likely to seek the preventative care that not only saves lives, but ultimately lowers the ultimate cost of care that must be borne by everyone in the Commonwealth.

And with insurance for all will come — in theory, at least — the elimination of the state’s uncompensated care pool, or the free care pool, as it’s called by those who don’t fully understand the working definition of the word free. The pool was created to compensate hospitals for the care they provide to those who don’t have the means to pay for it. Most hospitals pay into the pool, and many, especially those in urban settings who serve lower-income populations, are given money from the pool.

The state, its hospitals, and private payers all pay into the pool according to a complex formula, which means no one likes the concept and everyone wants to eliminate it or make it much smaller.

To do so requires that people have insurance. But who pays for it? Proposals range from requiring all individuals who can pay for some kind of policy to do so (much like mandated — in theory, anyway — auto insurance, to expanding Medicaid for the needy, to mandating that employers pick up more of the cost of the care provided to their employees.

And this is where the real debate will take place. Business groups argue that employers are already bearing a significant burden when it comes to health care benefits (many would say the steady increases in these costs have been among their greatest challenges in recent years. Additional mandates, they say, will force some businesses to cut staff or postpone expansion programs, which will ultimately slow the economy. Meanwhile, business groups say the additional costs will be a disincentive to companies looking to relocate to or expand within the Bay State.

As the debate on specifics within the measures continues, we urge legislators to press for what we would consider responsible reform. By that, we mean a plan that is not done for the sake of reform (meaning political motivations) or done hastily in order for the state to qualify for matching federal funds to pay for provisions of the eventual bill.

Rather, the state needs a plan that properly insures the underinsured, and does not create more of the underinsured — a step that would hardly be considered progress — and that adequately reimburses hospitals for the care they provide, while not strapping business owners with mandates that will limit their ability to grow.

This is a tall order, and an assignment that will not be met easily.

But anything less — meaning a measure that is out of balance — cannot really be considered reform.