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Mass. Senate to tackle health care payment plan

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BOSTON (AP) — Gov. Deval Patrick praised lawmakers Tuesday for tackling the high cost of medical care in Massachusetts while expressing reservations about some aspects of cost containment legislation, including a proposal to create a new state agency responsible for monitoring health care expenditures.

Patrick's remarks to a breakfast meeting of the Greater Boston Chamber of Commerce came hours before the state Senate was scheduled to debate a wide-ranging bill that seeks to reduce health care costs by more than $150 billion over the next 15 years. House leaders have also introduced a version of the bill, the most sweeping attempt at overhauling health care in the state since then-Gov. Mitt Romney signed a first-in-the-nation universal health care law in 2006.

Patrick said both bills have a "lot to like," but he said he was not convinced of the need for a semi-independent authority to oversee the health care market, as proposed by both chambers of the Legislature. The governor called the creation of such agencies that have less public accountability "a bad Massachusetts habit."

Patrick said he believed a new law could be effectively administered within the current framework of state government.

During a question-and-answer period with business leaders following the speech, Patrick also expressed reservations about a proposal in the House version of the bill that would charge an assessment to hospitals or other providers that charge rates more than 20 percent above the median rate in Massachusetts for similar services.

The idea, which has drawn comparisons to the so-called luxury tax assessed on high-spending Major League baseball teams, is aimed at smoothing over market disparities that Attorney General Martha Coakley and others have identified as one of the major drivers of soaring health care costs.

Patrick said he was not sure the assessment was necessary, adding that Coakley's office already had the tools to control unwarranted hospital rates.

"I am a capitalist," the governor said in his speech, assuring the gathering that included hospital and insurance company officials that he had no desire to punish the health care sector, the state's largest employer.

"But I am not a market fundamentalist," he added. "I don't believe the market always gets everything just right. And the health care industry is most certainly not a perfectly rational market."

Both the Senate and House versions of the bill would, generally, peg annual growth in health care expenditures to overall growth in the state economy. But the goals set by the two branches differ slightly. The Senate proposal would limit growth to the state's Gross State Product (GSP), while the House sets a more aggressive goal of half a percent below GSP.

Patrick said he tends to lean toward the more ambitious benchmark offered by the House.

"I think the industry can do better than GSP," he said.

Patrick unveiled his own health care cost containment bill in a February 2011 speech to the same organization. While he strongly backs the 2006 Massachusetts law, which became a blueprint for the national health care law, Patrick has focused much attention on making care more affordable.

The governor said while the industry has already taken a number of positive steps on its own to rein in costs, Massachusetts residents still spend between $13 billion and $20 billion more than necessary on health care each year. Also, he said, per capita health care spending has risen nearly three times as much as median family income in the past decade.

Patrick has encouraged providers to move away from a fee-for-service approach, which charges patients for each individual test and procedure, and toward an integrated or global payment system that stresses overall patient outcomes.

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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