THE OVERRIDING MESSAGE from voters across the country to the political establishment could not be clearer: Level the increasingly tilted economic playing field. Stop giving 95 percent of the economic pie to one percent of our country. Provide hardworking men and women a fair, living wage.
Here in Massachusetts, the message has been similarly clear – pay the local, community hospitals where most of us bring our parents, have our children, and visit our doctors, their fair share and support their efforts to provide, quality accessible low-cost care in our communities. For far too many procedures, these community hospitals receive 50 percent, 25 percent or sometimes just 10 percent of what wealthy, academic medical centers get paid for the same quality of care.
That message is getting results.
On Beacon Hill, legislation from the Campaign for Fair Care is moving that would require private health insurers to negotiate new contracts with expensive providers, to bring greater fairness to health care prices. A recent report by the Center for Health Information and Analysis shows just how dramatically unequal the levels of health care reimbursement have become – in 2014, four hospitals received 36 percent of the dollars spent at all hospitals in Massachusetts by insurers.
On Tuesday at a State House hearing on this important issue, health care workers, community and faith-based organizations, and experts from the medical, insurance and business communities will be unified in their message: The growing gap between what community hospitals are paid in Lowell, Springfield, Lawrence or New Bedford and what many wealthy, academic medical centers in Boston receive is destabilizing our community health care system. Leading health care experts have recognized that these higher rates of private insurance reimbursement are not based on outcomes or quality of care.
A level playing field would mean that in most cases your local hospital will receive millions more each year – money that can be used for new technology, more nurses, and doctors, and staff, and better facilities. Since most of these hospitals are the largest employers in their region, that additional money will help to lift and sustain economies across the the Commonwealth and protect quality jobs.
Fair Care reforms don’t just protect community hospitals; they save all Massachusetts residents hundreds of millions of dollars every year by reducing excessive payments to a few of the wealthiest medical centers and by cutting consumer insurance premium costs by $267 million.
There is a growing recognition among legislators, especially those from Gateway Cities where many hospitals are struggling, that it is time to bring fairness to our health care financing system and to better support our community hospitals. But the Campaign for Fair Care – a group of health care workers and advocates that has proposed the legislation as a key way to address this problem – is also prepared to go to the ballot with a measure that, too, would bring community hospitals a fair share of health care spending.
Both the legislation and ballot initiatives prohibit health care providers and private health insurance companies from entering into contracts that would pay hospitals more than 20 percent above the average amount paid to similar health care providers for the same health care services. The measures also prohibit contracts that pay hospitals less than 90 percent of the average amount paid to similar health care providers – a boost to the bottom line for community hospitals.
This legislation and corresponding ballot question is an important way forward for addressing the needs of community hospitals and bringing fairness to hospital payments. There are certainly other solutions for ensuring a vibrant network of community hospitals that warrant consideration and deliberation. But we need immediate action.
The Campaign for Fair Care is going to deliver these much needed reforms either at the State House or through the ballot. And those important changes won’t just provide community hospitals with a shot in the arm. They’ll create a stronger health care system in Massachusetts and put hundreds of millions of dollars back into the pockets of consumers.
The time to act is now. Let’s finally bring fairness to Massachusetts’s hospital system.
Tyrék Lee Sr. is the executive vice president of 1199SEIU United Healthcare Workers East, which represents more than 52,000 health care workers throughout Massachusetts and over 400,000 workers across the East Coast.