Our Opinion: Baker push for better preventive medicine

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Gov. Baker has put forward a remarkably ambitious health care reform bill that tackles a variety of issues plaguing the state. If it becomes reality it will have a huge impact upon the health care of Massachusetts residents.

At a press conference Friday, the governor said the state had for too long neglected preventive services that keep people out of emergency rooms and it was time to "flip the script." Most significantly, the measure requires hospitals and insurers to increase spending on primary care and behavioral health care by 30 percent over three years. The governor, who served as CEO of Harvard Vanguard Medical Associates and later Harvard Pilgrim Health Care in between stints in public service, maintains that by spending more on prevention costly emergency room visits and hospitalizations will decline, saving money.

The bill would set aside $20 million for financially struggling providers, such as community hospitals like Berkshire Medical Center. It would expand authority for nurse practitioners in response to the shortage of primary care physicians, create a midlevel dental provider position, prohibit "surprise" bills from specialists who are outside the insurance network even if the facility the patient received care at was in-network, limit the use of hospital "facility fees," require urgent care centers to take low-income patients on Medicaid and penalize drug companies that sharply increase prices.

The governor also signed an executive order to form a study group to determine why health care costs are rising for small and mid-sized employers. Thanks to "Romneycare," a model for "Obamacare," Massachusetts has the lowest uninsured rate in the nation, but care continues to be more expensive than in most other states.

Some of the governor's proposals are already included in House and Senate health care reform bills but they have been unable to draft a compromise bill. The governor's announcement may indicate that he has grown tired of waiting.

The reaction to Mr. Baker's proposal by groups involved in health care in the state was generally positive and encouraging. The exception was the pharmaceutical industry, the credibility of which is suspect in light of its history of raising prices, sometimes dramatically, and opposing reform efforts.

Any health care reform bill this complex will run into snags but the governor earns praise for taking on difficult, long-standing problems in the state. Preventive care, for the good of patients and the good of a health care system awash in high costs, must be encouraged, and that encouragement is the fundamental strength of the Baker proposal.



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