Massachusetts Democratic Gubernatorial Candidate O’Brien Outlines Health Care Agenda

Massachusetts gubernatorial candidate and state Treasurer Shannon O'Brien (D) on Aug. 13 announced several health care reform proposals, which include creating a state office of women's health policy, studying disparities in health coverage for racial and ethnic minorities and reducing health care costs by "finding efficiencies" in the state's health care bureaucracy, the Boston Globe reports. To cut costs, O'Brien said the state should manage Medicaid beneficiaries' claims "more efficiently," make community health centers more aware of a federal law that allows them to purchase inexpensive prescription drugs and promote a Web site that could help reduce the state's drug costs by "combat[ting] the onslaught" of drug advertisements with objective information about new treatments. O'Brien added that she could save the state $100 million to $150 million annually by implementing a tiered drug plan to purchase Medicaid beneficiaries' medications. She also said that she would maintain current Medicaid eligibility levels, reversing a decision to deny services to 50,000 long-term unemployed state residents who are to be dropped from the program next year. However, O'Brien "stopped short of more sweeping proposals" made by other Democratic candidates, the Globe reports. "We're trying to be realistic in terms of cost and what we can accomplish. I think that making false promises would be the wrong thing to do," she said.

Candidate Back and Forth
O'Brien said that a proposal announced Aug. 12 by Democratic candidate and former U.S. Secretary of Labor Robert Reich to save money by allowing uninsured residents to purchase health coverage through an insurance pool for state employees and retirees was "somewhat optimistic." John McDonough, a Brandeis University professor and O'Brien adviser, added that Republican gubernatorial candidate Mitt Romney's plan to cut costs by charging some Medicaid beneficiaries copayments would not raise as much money as Romney claims. Reich criticized O'Brien's proposals on Aug. 13, saying that they lacked specifics and "don't give the public much sense of where [she's] going and why." Gubernatorial candidate and former state Sen. Warren Tolman (D), who supports universal health coverage, said O'Brien's plans are the "same old incrementalism" and would not significantly reduce the number of uninsured. "Sometimes some of my opponents forget they're supposed to be Democrats, and we're supposed to be expanding coverage on health care, not cutting back," Tolman said (Weiss, Boston Globe, 8/14).

O'Brien Downplays Past?
In related campaign news, bankruptcy documents filed by a for-profit health care company where O'Brien formerly worked show that the business owes millions of dollars to the Massachusetts, Maine and federal governments, the Boston Herald reports. O'Brien served mostly as vice president of external affairs at Community Care Systems Inc. for two years before running for state treasurer in 1998, and government officials allege the company "funneled" $15.5 million in Medicaid funds from Maine to Massachusetts during that time. O'Brien campaign manager Dwight Robinson said that she was not privy to the finances of the company and was unaware of its substantial debts. She added that any illegal financing that might have occurred at the company was "apparently a very closely held secret" among top officials. The Herald notes that O'Brien does not list her position at Community Care Systems in her campaign literature; campaign officials said it is included on her official resume and on her official state Web site. Some of O'Brien's gubernatorial opponents allege she is trying to "hide from her past," the Herald reports. Tolman said, "If you worked for two years in the health care industry and you don't talk about it ... it begs the question of what were you doing." Romney contends the information shows that O'Brien "has no credibility" (Guarino, Boston Herald, 8/14).

More Thought Needed
A Boston Globe editorial states that Massachusetts gubernatorial candidates need to focus more on reforming state human services, including health care. The editorial, part of a series examining various campaign issues, says that Reich "offers the most comprehensive analysis" of human services problems and recognizes the need to increase salaries for nursing home attendants, visiting nurses and home health aides. Tolman "brings a scrappy outsider's view" to the issue and would increase health workers' salaries based on inflation. Romney wants to "reorganiz[e] the alphabet soup" of human services agencies, creating a group of departments that deals only with public health, while O'Brien says the state must implement better budgetary planning, which would help the departments of Mental Health, Social Services and Medical Assistance increase services for low-income children with mental health problems. Senate President Thomas Birmingham (D), who is also seeking the Democratic nomination, would try to "smooth the years of glitches" that have stalled initiatives to move people with mental illnesses out of institutions and into community care settings. But the Globe states that missing from all the campaigns is a "day-one plan" for facing the health care crisis and concludes, "It will take long-term vision and immediate action to protect people in need" (Boston Globe, 8/14).