Friday, August 8, 2014


We are fortunate in Massachusetts to have two excellent Democratic candidates for Attorney General.  With just 30 days to go until the primary election, you'd have thought the local press would have asked them for their opinions of the proposed deal inked by the current AG and Partners Healthcare System.  After all, it is the biggest antitrust and health care matter currently pending in the state, and the one with the biggest financial impact on businesses and consumers.  Wouldn't it be good to know if the candidates support the deal as written and also feel comfortable in their potential role of enforcer of the agreement over the coming years?

Well, finally the questions were asked, at a forum held by the Newton-Needham Chamber of Commerce.  The answers were captured on tape, which can be viewed here.

Warren Tolman spoke first (at minute 45:14 or so).  Here are some outtakes:

I have some misgivings about the agreement.

I have some concerns about it, frankly.

First, when I look at price controls and you have a disparity in prices in year one and you lock into [that] ... the disparity in prices will grow over time.  And that increases the power of the have's over the have-not's.  So that's one area that is of concern to me.

Secondly, I believe we need to promote transparency in health care, above all other things.  Consumers ought to know [about pricing differentials] as they make their health care decisions.  The disparity in prices is not reflected in a disparity of quality.

Third, [and here he diverges in the problem of substance abuse.]


Fourth, [on enforcement] a real challenge and commitment of resources. Some of the provisions are going to be very difficult and awkward at best.

Maura Healey was next (at 47:42):

This is a really important issue.  The agreement is now before the Court and the public has been invited to submit comments, which I think is really good because I think it's really important that this decision be made thoughtfully and carefully.

The next Attorney General is going to have a critical role to play in terms of monitoring and taking action in the health care space.

I have some concerns about this agreement.  There's a lot of frustration out there given what we all are frustrated about, which is the high cost of care in this state; but I know that what this agreement tries to do is to put some time limits on it and some caps, put some price limits on things; and it's going to require really vigilant, aggressive monitoring by the next Attorney General, and I would make sure that happens.

I agree with Warren's point that we need transparency.  I am committed to making sure that we are there to provide facts and transparency.  This is going to require vigilance and aggressive monitoring by the next Attorney General.

So, there you have it . . . so far.  This was not a very extensive discussion, but it was a start.  Tolman seems to understand the structural flaws in the agreement.  Healey didn't elaborate on her concerns.  Both understand the complexity of enforcing the agreement.

We have yet to hear from the Republican candidate, John Miller, but perhaps these initial comments from the Democrats will provoke some interest by area reporters to ask more questions of all the candidates.

I wonder if any of the candidates will publicly ask the current Attorney General to pull the proposed settlement from consideration by the Court and defer the entire matter to her successor.  After all, it would be only fair to let the next Attorney General help frame the enforcement requirements of the agreement, rather than inheriting terms set by his or her predecessor.

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