On health care issues, legislators acted both wisely and emotionally
It wasn’t one of the high-profile policy issues sorted out on Beacon Hill before the legislative session ended late Sunday, but for thousands of nursing aides doing vital work at roughly 400 nursing homes in Massachusetts, a last-day vote by lawmakers means they’ll get an overdue pay increase. The Legislature put back into the state budget a $35.5 million appropriation to boost the wages of aides whose average starting rate is just $11 an hour. Most of them are women between the ages of 18 and 44, and many are single parents.
Governor Charlie Baker had cut the funding by about half to help close a budget deficit, but legislators made the right decision in restoring the full amount. Nursing aides’ incomes fall far short of their responsibilities, which can include helping residents bathe, use the bathroom, brush their teeth, dress, and eat. The constant physical labor and poor compensation add up to a high turnover rate — only 70 percent of certified nursing assistants stay on the job for a year or more, according a Massachusetts Senior Care Association survey. That’s disruptive for residets, and invariably affects the quality of care.
Funds for the pay increases will come from boosting an existing “user fee” assessed to individual nursing homes. Through a complex formula, those fees are supplemented by the federal government. Let’s hope doling out the money won’t be equally as complicated. Precisely who gets a raise — and how much they receive — remains unclear, but the Legislature, responding to pressure from 1199SEIU United Healthcare Workers East, wisely included a provision requiring an audit of how the additional funds are spent. There’s also this reality: Since the $35.5 million is a one-time allocation, nursing aides could effectively face pay cuts next year. When legislators convene for a new session, they should move to make the increases permanent. Nursing home workers deserve more than a 12-month relief program.
ANOTHER HEALTH care-related vote on Sunday was the equivalent of bad — or at least unproven — medicine. The Legislature overrode Governor Baker’s veto of a bill requiring insurers to cover long-term antibiotic treatment for Lyme disease. The problem is that most medical specialists say there’s no clinically proven basis for using powerful antibiotics over months or years to combat chronic aftereffects of the illness — such as joint pain and overwhelming fatigue — that affect a minority of patients. Studies have shown that the tick-borne bacteria itself almost always is killed by a two-to-four week antibiotic regimen. In a letter to State House leaders, the Massachusetts Infectious Diseases Society — representing more than 500 doctors — said long-term intravenous antibiotic treatment is not only ineffective, it “may actually be dangerous.”
Patients, and groups advocating on their behalf, have told moving stories about the debilitating nature of what the US Centers for Disease Control and Prevention calls “post-treatment Lyme disease syndrome.” No one doubts them — some people suffer terribly for years. But more research is needed to figure out the true cause of their ailments. Anecdotes, no matter how compelling, aren’t a substitute for scientific evidence. By mandating health care coverage based on emotion, legislators have set an unfortunate precedent.