HEALTH CARE EXTRA CommonWealthCommonWealthPOLITICS, IDEAS, AND CIVIC LIFE IN MASSACHUSETTS SEARCHSEARCH FORFOR AA CURECURE HEALTH CARE COSTS ARE ON THE RISE AND QUALITY IS IN QUESTION. WHO HAS THE REMEDY? MAKINGMAKING SENSESENSE OFOF MEDICAIDMEDICAID ISIS MAINEMAINE LEADINGLEADING SPECIAL ISSUE 2004 $5.00 THETHE WAY?WAY? BRUDNOY:BRUDNOY: ONEONE PATIENT’SPATIENT’S STORYSTORY This special issue of CommonWealth has been made possible by more than two dozen sponsors, representing the entire spectrum of interests in the health care debate. We are grateful for their support. PROJECT SPONSORS AARP Massachusetts Massachusetts Health and Educational American Hospital Association Facilities Authority Americans for Health Care, a Project of the SEIU Massachusetts Hospital Association Associated Industries of Massachusetts Massachusetts League of Community Health Centers Beth Israel Deaconess Medical Center Massachusetts Medical Society Beverly Hospital McDermott Will & Emery LLP Blue Cross Blue Shield of Massachusetts Neighborhood Health Plan The Boston Foundation New England Regional Council of Carpenters Children’s Hospital Boston Partners HealthCare Delta Dental Plan of Massachusetts Recycled Paper Printing, Inc. Denterlein Worldwide Barbara & Stephen Roop Harvard Pilgrim Health Care Ropes & Gray LLP The Health Foundation of Central Massachusetts, Inc. William E. & Bertha E. Schrafft Charitable Trust The Heinz Family Philanthropies Tufts Health Plan Massachusetts Council of Community Hospitals PRESORTED STANDARD MassINC U.S. POSTAGE THE MASSACHUSETTS INSTITUTE FOR A NEW COMMONWEALTH PAID HOLLISTON, MA Publisher of CommonWealth magazine PERMIT NO. 72 18 Tremont Street, Suite 1120, Boston, MA 02108 Address Service Requested Visit MassINC on the World Wide Web at www.massinc.org What does a healthcare company look like when everyone’s on the same page? Nagatna Jean-Leger Carl Ascenzo Jennifer Gallo Abbie Spicer Janet Edmunson Member Service Representative Chief Information Officer Vendor Relations Manager Benefits Manager Prevention and Wellness, Seniors Scott Howard Linda Fitzgerald Linda Lynch Christopher Morris Walter Jackson Claims Processing Senior Care Director of Market Research Member Service Representative Printer Jennifer Perry Deanna Alexander Ron Romano Bruce Sinclair Jacqui Ivey Member Service Representative Member Service Representative Privacy Officer Member Service Representative Benefits Specialist Donna Fruman Larry Croes Steve Fox Welcome Pack Team Gigi Fioravanti Family-Centered Case Manager Director of Sales Director of Provider Relations Benefits Specialists Program Manager Blue Ribbon Wellness We’re lucky enough to know. Thanks to all our employees for working as one to provide our members with the highest levels of service. And thanks for making us one of the “Best Places To Work” in Boston. ®Registered Marks of the Blue Cross and Blue Shield Association. An Independent Licensee of the Blue Cross and Blue Shield Association. HEALTH CARE EXTRA 2004 CommonWealth 1 CommonWealth MassINC editor chairmen of the board Robert Keough Gloria Cordes Larson associate editors Peter Meade INTRODUCING… Michael Jonas, Robert David Sullivan board of directors art director Joseph D. Alviani Harold Hestnes Ian Bowles Joanne Jaxtimer Heather Kramer Andrew J. Calamare Jeffrey Jones design consultant Heather P. Campion Tripp Jones Ken Silvia Kathleen Casavant Elaine Kamarck contributing writers Neil Chayet R.J. Lyman Mary Carey, Christopher Daly, Vincent Cipolla Paul Mattera Mark Erlich Kristen McCormack Richard A. Hogarty, John E. McDonough, David H. Feinberg Melvin B. Miller Neil Miller, Laura Pappano, Robert Preer, Robert B. Fraser Hilary C. Pennington B.J. Roche, Ralph Whitehead Jr., Chris Gabrieli Michael E. Porter Katharine Whittemore C. Jeffrey Grogan Mark E. Robinson washington correspondent Steve Grossman Charles S. Rodgers Shawn Zeller Raymond Hammond Alan D. Solomont IssueSource proofreader Bruce Herzfelder Benaree Wiley Gina Hahn honorary editorial advisors Mitchell Kertzman, Founding Chairman John C. Rennie, in memoriam Mickey Edwards, Alex S. Jones, board of policy advisors Mary Jo Meisner, Ellen Ruppel Shell, economic prosperity: Everything you need Alan Wolfe Wayne M. Ayers, Peter D. Enrich, Rosabeth Moss Kanter, Edward publisher Moscovitch, Andrew Sum, David A. Tibbetts to know about Ian Bowles lifelong learning: Harneen Chernow, Carole deputy publisher A. Cowan, William L. Dandridge, John D. what’s behind John Donato Donahue, Michael B. Gritton, Sarah Kass, sponsorship and advertising Leonard A. Wilson today’s headlines. safe neighborhoods: Jay Ashe, William J. Lori Davis Febbo, Ben Geffen Bratton, Mark A.R. Kleiman, Anne Morrison circulation And it’s free. Piehl, Eugene F. Rivers 3rd, Donald K. Stern Colleen Lynch, Emily Wood civic renewal: Alan Khazei, Larry Overlan, interns Jeffrey Leigh Sedgwick Robin Delos, Erika Jones, Ben Schaefer president & ceo STUDENTS Ian Bowles CommonWealth (ISSN pending) is published development & community affairs director quarterly by the Massachusetts Institute Lori Davis Febbo for a New Commonwealth (MassINC), director of communications policymakers 18 Tremont St., Suite 1120, Boston, MA 02108. Telephone: 617-742-6800 ext. 109, Jennifer Armini fax: 617-589-0929. research director journalists Volume 9, Number 3, Special Issue 2004. Dana Ansel Third Class postage paid at Holliston, MA. deputy research director To subscribe to CommonWealth, Rachel Deyette Werkema concerned citizens become a Friend of MassINC for senior policy advisor $50 per year and receive discounts on Christopher Fox MassINC research reports and invitations to director of programs & operations MassINC forums and events. John Schneider Postmaster: Send address changes to Circulation Director, MassINC, outreach director IssueSource.org 18 Tremont St., Suite 1120, Boston, MA 02108. John Donato Letters to the editor accepted by e-mail executive assistant & operations director is the state’s most at [email protected]. The views expressed Colleen Lynch in this publication are those of the authors assistant outreach director extensive archive of and not necessarily those of MassINC's Emily Wood directors, advisors, or staff. deputy development director public policy issues. The mission of MassINC is to develop a Ben Geffen public agenda for Massachusetts that controller/it director promotes the growth and vitality of the mid- David Martin dle class. We envision a growing, dynamic center for education research & policy ADD IT TO YOUR middle class as the cornerstone of a new com- S. Paul Reville, Director monwealth in which every citizen can live the BOOKMARKS TODAY! Jennifer Candon, Assistant Director American Dream. Our governing Celine Toomey Coggins, Research Director philosophy is rooted in the ideals embodied by the American Dream: equality of MassINC is a 501(c)(3) tax-exempt charitable opportunity, personal responsibility, organization. MassINC’s work is published [ formerly 02133.org ] and a strong commonwealth. MassINC is a for educational purposes and should not be nonpartisan, evidence-based organization. construed as an attempt to influence any election or legislative action. 2 CommonWealth HEALTH CARE EXTRA 2004 PHOTO CREDIT The journey never ends. Massachusetts General Hospital and Brigham and Women’s Hospital have been the sites of many important medical breakthroughs. Essential work in the fight against disease and to improve the quality of medicine continues to this day. 1846 First public demonstration 1947 First artificial kidney of ether use during surgery machine in U.S. perfected — Massachusetts General Hospital — Brigham and Women’s Hospital 1883 First use in North First successful human America of antiseptic 1954 organ transplant during childbirth to protect — Brigham and Women’s Hospital mothers and newborns from deadly infections — Brigham and Women’s Hospital 1962 First successful surgical reattachment of severed limb 1896 First use of X-ray — Massachusetts General Hospital image for diagnosis in U.S. — Massachusetts General Hospital 2000 AIDS researchers at Mass General make groundbreaking 1929 First use of iron lung discovery in treatment of early to save polio victim detected HIV. — Brigham and Women’s Hospital — Massachusetts General Hospital A charitable non-profit organization Partners HealthCare includes Massachusetts General Hospital, Brigham and Women’s/Faulkner Hospitals, North Shore Medical Center, Newton-Wellesley Hospital, McLean Hospital, Spaulding Rehabilitation Hospital, Dana-Farber/Partners CancerCare, community health centers, and the community-based doctors and hospitals of Partners Community HealthCare, Inc. HEALTH CARE EXTRA 2004 CommonWealth 3 Information. Understanding. Empowerment. Three ways to improve health care and control cost. At Tufts Health Plan, we hospital quality. We also provide believe that when our members access to credible, in-depth health truly understand their options, information so members can gain a they can make smarter health care deeper understanding of important decisions. In the long run, this health issues and make smarter will help ensure the quality of the decisions. care they receive while reducing Our investment in innovative its overall cost. product designs, technology and That’s why we offer innovative educational materials is an invest- products that educate, empower ment in our members. It helps and reward members for taking them become stronger advocates control of their health care. for their own health, and, we Our newest Web-based