Arguably the most pressing public policy challenge of our time is the need to control rapidly rising health care costs. We all know that the Commonwealth took a huge leap forward by expanding coverage, and now leads the nation with 97-98% of our citizens covered by some form of health insurance. We also know, however, that costs are still rising rapidly, much faster than the inflation rate and much faster than in many other parts of the country. In Belmont, Arlington and Cambridge, many of us enjoy access to some of the finest hospitals and health care practitioners in the country, but we have yet to solve the cost conundrum.


These costs adversely affect both the public and private sectors. Businesses large and small are heavily impacted by rising premiums for health insurance, hurting their bottom line year after year. Our state and municipal governments are sagging under the burden of paying current employee and retiree medical costs. In short, the current system is unsustainable.


Let’s face facts: the high cost of health care isn’t news and we didn’t arrive at this state of affairs overnight. It is a problem many years in the making and there is likely no one solution that will quickly solve this complex issue. There are, however, a variety of possible solutions that the Commonwealth can begin to implement. One idea that might show promise is to move away from a traditional fee-for-service cost structure and toward a so-called “global payments system” where healthcare providers are not paid for each individual test or procedure, but rather a flat fee based on the type of condition being treated. A recent study by a group of nine specialty medical boards representing almost 400,000 doctors, including the American College of Physicians, estimated that as much as one third of all medical spending is due to unnecessary testing and procedures and recommended that practitioners reduce the frequency of offering such tests in favor of other less expensive and equally effective diagnostic tools. Under a global payments system, health care providers will have an incentive to carefully control spending, while still delivering excellent quality care. Doctors, nurses, and other healthcare workers will continue to have additional insights on this issue, and we must work with them to continue to improve healthcare quality while we find ways to reduce costs.


We have solved the vexing problem of providing broad access to health insurance coverage. If we can now solve the other critical challenge – controlling health care costs – we will have addressed one of the greatest challenges facing modern society and can serve as a model for the rest of the country. Our businesses will become more competitive and profitable, and our state and local government will reap big savings. It would be an enormous triumph for all of us and, as your State Representative, I will make controlling healthcare costs a top priority.