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What can Boston teach us about national health reform?

September 9, 2010

The Center for Studying Health System Change asked that very question in a new report out today.

The study, funded by the Robert Wood Johnson Foundation, looks at what happened to Boston’s health care system after Massachusetts passed its health care reform law in 2006.

Many of the MA initiatives are similar to what the rest of the country can expect- including a requirement that most citizens obtain health insurance.

But the study authors are careful to note that Boston is in no way typical of the rest of the country.  A large percentage of residents already had health insurance before the law passed, and the city is wealthier than other parts of the US.

A few highlights of the report-

-Health reform didn’t mean cost reform.  Political leaders are  putting off hard decisions about how to slow down the price of medical care, which is still rising.

–Despite the recession, Boston has managed to mostly hang out to its high insurance rate (only 2.7% of MA residents were uninsured in 2009) but the state has had to sacrifice other promises, like increasing rate payments.

-The law hasn’t benefited all parts of the health system equally- community health centers are seeing an increase in business because of the coverage expansion, while so called “safety net hospitals” which  serve the highest percentage of uninsured patients are struggling. Government subsidies that typically went to those hospitals are now funding discounted or expanded health insurance coverage.

It’s not new, but the take away for me is  health reform still won’t solve our biggest problem- cost. And even in the new system there will be winners and losers.

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