He had passed up chance to blast rate-cap ideas
By Noah Bierman, Globe Staff | April 8, 2010
GOP gubernatorial candidate Charles D. Baker has come out strongly against Governor Deval Patrick’s move to cap health insurance rates, calling it an “election-year gimmick’’ that would lead to the demise of several insurance companies.
While Baker’s comments have framed the debate on a central issue in the governor’s race, his tone is new. He passed up several opportunities to criticize the idea before he became a candidate, and he served on a state panel that endorsed limiting rate increases by insurers as one potential strategy to combat rising health costs.
With health care dominating the political discussion, Baker, who ran Harvard Pilgrim Health Care until last year, and Patrick, the Democratic incumbent, have accused each other of doing too littlein their respective roles to curb costs since Massachusetts initiated its universal health care plan in 2006. In fact, Baker’s involvement in state health care policy is more complicated than either man has conveyed.
From 2006 until last July, Baker was a relatively active member of a government committee, created under the health care law, to study how to improve health care and lower costs. The Health Care Quality and Cost Council, which worked closely with the Patrick administration, listed regulating insurance and health provider rates as a primary issue to study in a 2008 report.
In January 2009, after Patrick convened a separate group of top health executives to discuss reducing costs, Baker was asked by a Globe reporter about the governor’s suggestion that he might use state authority to hold down insurance premiums. Baker did not embrace the idea, but he did not dismiss it or warn of dire consequences either, as he has recently.
“We’re going to hold hearings around rates and whether or not they’re excessive,’’ Baker responded at the time, repeating a proposal he had endorsed earlier on the Globe’s op-ed page.
Asked specifically to comment on the state using its authority to regulate insurance rates, Baker said, “All of the carriers basically said we would welcome that kind of investigation, if that’s deemed an appropriate thing to do.’’
Baker’s campaign spokesman, Rick Gorka, said that Baker has been a consistent, active public voice in calling for more transparency in health care costs and that Patrick’s rate cap solution is short-term and politically motivated. He denied that Baker’s position or tone on the insurance cap issue had changed.
“It’s fine to do it,’’ Gorka said. But, he added: “You only get temporary relief. You don’t actually solve what’s going on. It’s sweeping it under the rug.’’
Gorka also noted that the state panel on which Baker served had listed insurance rate caps as one potential strategy for fixing health care within a document of more than 60 pages.
“There are a lot of ideas in here that are great ideas to reforming health care,’’ Gorka said. “Unfortunately, the governor has ignored 99 percent of them.’’
Doug Rubin, a senior adviser to the Patrick campaign, faulted Baker and other health care executives for failing to do more on their own to attack the cost problem. He said Patrick was hoping after the January 2009 meeting that industry leaders would reach a consensus on a solution.
“They never reached a consensus,’’ Rubin said. “What you’ve seen recently is the governor finally saying, ‘Look, we need to bring some relief to working families and small businesses.’ ’’
“Talk that Charlie Baker and others had been involved in had not led to results,’’ he said. “At the end of the day, that’s the record.’’
Even as Baker’s tone has changed on insurance regulation, he has been consistently engaged in the issue of health care costs, despite Patrick’s recent suggestion that he has been “missing in action.’’
“He was an active participant in council discussions,’’ said Katharine London, former executive director of the state panel. “As CEO of Harvard Pilgrim, he had access to a lot of data, so he would bring in his views about what was actually going on and what was important to look at.’’
Baker was appointed to the Health Care Quality and Cost Council by Governor Mitt Romney. The group’s primary responsibility was planning and overseeing a website for consumers, which went up in December 2008, that spells out the specific cost of medical care from various hospitals and medical providers.
In 2008, the council approved a plan to recommend hiring consultants to study strategies for curbing costs. Among the strategies the group said warranted further examination was the regulation of rates for both providers and insurers, which was listed first among 12 approaches.
Minutes from the March 5, 2008, meeting, attended by Baker, show that the vote to approve the list was unanimous. There is no evidence that Baker lodged any dissent, either then or at a previous meeting during which rate regulation was also raised.
Gregory Sullivan, the state inspector general who also sat on the committee, said Baker agreed to include several ideas — including those that seemed at odds with his interest as an insurance executive — because he considered the problem so urgent.
“He said, ‘There’s something bad in here for all of us,’ ’’ Sullivan recalled.
Though the strategies later became part of a committee report, the council was never able to get the funding to hire a consultant. The group issued a report last fall recommending that health care providers get paid based on overall patient care, rather than for individual procedures, as part of a plan intended to cut medical spending by $50 billion over 10 years. Baker had left the committee by the time the report was issued.
Committee members and meeting minutes indicate that Baker was especially vocal on the need for greater transparency, under the theory that hospitals and other providers will face pressure as the public learns they often charge differing rates for similar procedures.
Marcella Bombardieri of the Globe staff contributed to this report.
