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Massachusetts Liberal

Observations on politics, the media and life in Massachusetts and beyond from the left side of the road.

Monday, June 27, 2011

At the front lines

Massachusetts has always been front and center in the health care debate, a spot most people think reflects the importance of health care delivery to the state's economy. But we often forget the biotechnology industry as one of the principal cost drivers too.

That's what makes the push by the Massachusetts Biotechnology Council to thwart a key cost control effort with the Affordable Care Act a significant threat in the effort to gut the law.

MBC boss Robert Coughlin cites importance of the life sciences to the Massachusetts economy as a reason to scuttle cost controls. Heck, he's downright patriotic:
"You wouldn’t see congressmen in Florida voting against the orange industry,’’ Coughlin said during an interview in Washington earlier this month. “How could anyone in Massachusetts vote against the biotech industry?’’
The argument goes that placing limits on Medicare costs would stifle innovation and hurt the Massachusetts economy. And the Commonwealth certainly has placed a bet on the sector as a key economic growth component.

But what's good for one Massachusetts sector may not be good for everyone else:
“You’ve got special interest groups feeling threatened by the Independent Payment Advisory Board because it would in fact impact their ability to influence members of Congress, especially with respect to payment issues,’’ said Alan Cohen, a professor of health policy and management at the Boston University School of Management who heads its Health Policy Institute. “This is a huge fight. What it comes down to is power and their pocketbooks. They are fighting to hold on to a system that has worked for them for decades.’’
Ah yeah, special interest groups, the folks who really run Washington with the millions that pass around in campaign contributions. So far, at least, they're not getting a lot of traction on this, at least from one Massachusetts senator.
“If we’re going to protect taxpayers and control costs, it seems a little bonkers to eliminate something the experts say is our best hope of doing that before we even have a chance to evaluate it,’’ said Whitney Smith, a [John] Kerry spokeswoman. That said, Kerry is open to making improvements to the board, Smith said.
That's good because his counterpart Scott Brown is already on record of scuttling the board, although as usual we have little to actually go on from our Silent Senator. Let's hear instead from a once-and-future foe, Mike Capuano, whose with Brown on this one.
“Hypothetically, this could destroy the Massachusetts health care economy,’’ said Capuano. “A small tweak could literally mean hundreds of billions of dollars going from Massachusetts to some other state.’’
Note the weasel word: "hypothetically." At stake here is billions of dollars in a zero-sum game. Future cures could be brewing in life science labs, but they can take decades and cost billions. In the meantime we have the reality that prices are choking our health care system.

Some sort of rationale compromise would seem to be in order that can recognize future hopes against today's costs. A professional board that evaluates those options would seem to be the rational course.

But rational and Washington are not words that go together well.

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