Wednesday September 19, 2012

Several Massachusetts hospitals trying to right a wrong in the state’s landmark six-year-old health care reform law have fallen through the cracks between two branches of government. With court remedy apparently no longer an option, they are dependent upon the Legislature to do right by them -- a long shot given the realities of the political power structure.

In an attempt to make the reform law numbers work, the Legislature and then-Gov ernor Mitt Romney reduced hospital payments for low-income patients and patients on Medicare and government programs. This put a huge burden on many hospitals in small to mid-sized cities that have a large number of patients in those categories. Berkshire Medical Center was among seven hospitals, including those in Holyoke, Quincy and Brockton, that filed suit in Suffolk Superior Court in 2010 in response to this imbalance in the law. BMC dropped out of the suit after it was dismissed and the state Supreme Judicial Court recently upheld this dismissal.

Romneycare has been of great benefit to the state, just as Obamacare has been and will continue to be of great benefit to the nation, but neither reform program is perfect. Both will need periodic tweaking, and the state reform law clearly fails to assure adequate government reimbursement for "disproportionate share" hospitals. As reported in today’s Eagle by Clarence Fanto, 67 percent of BMC’s patients are insured by government programs.

It is significant that neither the Suffolk Superior Court or SJC found that the hospitals’ concerns were without merit. Instead, both said that the issue of inadequate payments should be resolved on Beacon Hill, which is the preferred route of Berkshire Medical Center. The legislative leadership, however, routinely aligns itself with the big and politically influential teaching hospitals of Boston at the expense of smaller hospitals. Righting this wrong will not be easy, but it should be a priority of the Berkshire legislative delegation and other delegations representing hospitals asked to do too much with too little financial assistance.