Editorial: Health care and the race for governor

In the home stretch of the health care debate, President Barack Obama has turned up the heat on health insurance companies. There are several good reasons for this, all of them political.

First, while the rising cost of health care comes from many sources, they are mostly visible in big jumps in insurance premiums. People like their doctors and don't want bad things to happen to their hospitals. Well-paid insurance company CEOs and insurance company bureaucrats denying legitimate claims are far less sympathetic.

Besides, while the health insurance lobby backed Obama's health care reforms initially, it is now helping lead the opposition. The physician and hospital lobbies are, as far as we know, still onboard.

Gov. Deval Patrick, Obama's close ally, has been bashing insurance companies for these same reasons, and one more: Charlie Baker, Patrick's likely Republican opponent in November, happens to be the former CEO of one of the state's largest insurers.

Patrick was presented with new ammunition to use against Baker this week. A Boston Herald review found that health premiums for its most popular plans increased from 100 percent to 200 percent during Baker's 10-year tenure as head of Harvard Pilgrim, the state's second largest health insurance company.

During the same period, Baker's annual salary increased from $548,341 to $1.7 million. He made $1.3 million in 2009, before leaving Harvard Pilgrim last summer to launch his campaign for governor.

To be fair, Harvard Pilgrim was in financial straits when Baker took over in 1999. He is generally considered to have done a good job. And, to be fair, Baker's salary is not out of line with the paychecks earned by leaders of the state's other large not-for-profit insurance companies.

Whether any corporation that calls itself "not-for-profit" and operates under the supervision of the Attorney General's Division of Public Charities should be paying its managers more than a million bucks a year is something we look forward to hearing Baker address on the campaign trail.

On the subject of health care costs, there's plenty more to talk about. Patrick should address how little his administration has done to restrain cost increases from physicians and hospitals. The state's landmark health care reform bill, signed by his predecessor, improved access but did nothing to control costs, as Patrick noted when he ran for governor in 2006. Four years later, what has he done about it?

Baker should be asked the same question. He should also explain whether his company made deals with health care providers that resulted in the wide disparities in hospital charges spotlighted in a recent report from the Attorney General's office.

Meanwhile, a third candidate for governor, independent Tim Cahill, declared this week that health care reform was driving the state to "bankruptcy" and predicting Obama's proposal would "wipe out the American economy within four years." On the state program, it's not clear that Cahill is differentiating between the impact of rising health care costs in long-established programs like Medicaid, employee health care and retiree health benefits, and the more limited state subsidies for the previously uninsured through the 2006 health reform law.

Cahill's prediction about Obama's plan is even less credible. The nonpartisan Congressional Budget Office certified yesterday that the plan would reduce the federal deficit by $138 billion over the first 10 years, and by more than $1 trillion in the following decade.

That doesn't sound like bankruptcy to us, let alone wiping out the economy, and voters should expect more careful language from their state treasurer, especially when it comes to financial calculations.

Whatever happens in Congress as the fate of Obama's health care reform initiative is decided, there will still be work to do here in Massachusetts. The health care reforms of 2006 will have to be sustained and health care inflation must be contained. All the candidates for governor will be expected to defend their records on health care and explain their proposals for change.