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FRIDAY, JANUARY 30, 2004

NATIONAL REPORT FINDS MASSACHUSETTS

RETREATING FROM LEADERSHIP ROLE IN HEALTH CARE

WASHINGTON, D.C. (January 30, 2004) – An assessment of health care in the 50 states, released here today, finds that Massachusetts, long a national leader in many aspects of state-provided health care is in a dramatic retrenchment, which may threaten many of the advances made in the past. The report appears in the February 2004 issue of Governing magazine.

The authors point, for example, to the state’s decision to gut its successful anti-tobacco program, slashing its budget from $48 million to $2.5 million. Although some in the state argue that it is difficult to be certain of the precise benefits of this spending, adult smoking in Massachusetts had fallen from 22.6 percent of the population to 18.3 percent in 2001, and the state had posted some of the best successes in the country in preventing children from smoking.

“The cutbacks in the state’s tobacco program were particularly extreme,” says Katherine Barrett, co-author of the report. “But they were pretty typical of the retrenchment mode the state finds itself in. Fortunately, in most areas of health care, Massachusetts has been so generous for so long that even with the cutbacks it still looks better than many other states. For instance, we cited Massachusetts as a success story for having one of the country’s highest pediatric participation rates in Medicaid, a particularly low infant mortality rate and the highest rate of immunization.”

Efforts to curtail the number of citizens it covers through its public insurance programs include caps on enrollment in a program it funds for the chronically unemployed; cutbacks on coverage for immigrants and escalating premiums. “These cutbacks raised a storm of protest from health advocates,” Barrett adds. “But Massachusetts citizens have a greater chance of being insured, and have better access to care than in most other states. Citizens there just have to hope that the changes being made now are not part of a long-term trend.”

Ironically, the authors point out, even as the state is making efforts to save money on health care, it has not implemented a state bulk purchasing program for drugs that would have aggregated the buying power of virtually every state-funded group using prescription medications, including state employees and Medicaid recipients--the first of its kind to be legislated in any state.

Governing’s analysis of state-funded health care is part of the Government Performance Project, a six-year-old effort, funded by the Pew Charitable Trusts, to evaluate a wide range of state government management and policy functions. This year’s special report focuses on six critical health care problems facing states: long-term care, public health, mental health, prescription drugs, access to care for the uninsured, and care for children.

The Government Performance Project found and documented the inability of the 50 states’ health care system to deliver improvements in medicine fairly and consistently to many of their citizens. Health care in most states is not just inadequate, the study concluded--it’s deteriorating. “After exhaustive analysis and hundreds of interviews,” says Peter Harkness, Governing’s publisher and editor, “it became clear that there is a health care crisis in America. But it is in no way a medical crisis. It is a fiscal crisis.”

Governing is a policy and management magazine aimed at high-level state and local government officials. An online version of this report will be available at http://www.governing.com/gpp/2004/intro.htm as of January 29. Press releases for each of the 50 states can be found at http://www.governing.com/gpp/2004/press.htm.

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