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Massachusetts has enacted one of the most far-reaching state health insurance reform packages in recent decades. Much attention has been focused on the act's unprecedented mandate that every resident obtain health insurance coverage. However, the act goes far beyond an individual mandate to radically change the way health insurance is bought and sold in the state. Many observers see Massachusetts's reforms as a model for the nation, but a closer look provides ample reasons to be skeptical. Among them: The individual mandate opens the door to widespread regulation of the health care industry and political interference in personal health care decisions. The act's subsidies are poorly targeted and overly generous. The Massachusetts Health Care Connector, which restructures the individual and small business insurance markets, is a form of managed competition that has the potential to severely limit consumer choice. The act imposes new burdens on business and creates a host of new government bureaucracies to manage the health care system. Health care needs more consumer control and freer markets, not more government regulation, controls, and subsidies. The Massachusetts reform takes us in the wrong direction.
Immigrant Learning Center, Inc.;
Immigrant entrepreneurs are co-founders in 25.7 percent of Massachusetts Biotechnology firms. In 2006, these immigrant-founded biotechnology companies produced over $7.6 billion dollars in sales and employed over 4,000 workers. The foreign-born founders came from across the globe but in larger numbers from Europe, Canada or Asia. Their firms specialize in the most complex, risky, life science-intensive aspects of biotechnology to seek knowledge directly applicable to human health. Biotechnology is a crucial industry for Massachhusetts and the evidence strongly suggests that immigrants have been key contributors to this industry by establishing new businesses as well as bringing intellectual capital and thereby contributing significantly to the overall economic growth of the Commonwealth.
Immigrant Learning Center, Inc.;
Health care in Massachusetts is a $9 billion industry, vital to the state's economy. It employs almost half a million people, who work in 16,353 establishments. With 72,480 job openings projected between 2000 and 2010, health care has also been an industry needing a continuous stream of new employees as well as workers who can be steadily moved up to more demanding jobs. Immigrants have a robust presences across the spectrum of health care in Massachusetts, filling critical vacancies. Clustered at the high-end skill level are medical scientists (52 percent immigrants), pharmacists (40 percent immigrants )and physicians and surgeons (28 percent immigrants). They bring millions of dollars in education and training to the state. Immigrants are also clustered in lower skilled occupations. They may serve as aides in nursing, psychiatry and home health care and may remian stuck in those jobs because of inadequate education and English skills. A concern for communities is the wasted potential they represent. In an industry where worker shortages loom, immigrants could be trained to help fill the gaps. While workforce development policies have not been able to keep pace with the changing needs of the health care labor market and its workers, there are a number of promising practices and models meant to improve the labor market outcomes for immigrant health care workers. They are reviewed in the study
R. Michael Alvarez of the California Institute of Technology and Jonathan Nagler of NYU analyze the likely impact of Election Day Registration on voter turnout in Massachusetts.
When Massachusetts passed its pioneering health care reforms in 2006, critics warned that they would result in a slow but steady spiral downward toward a government-run health care system. Three years later, those predictions appear to be coming true: Although the state has reduced the number of residents without health insurance, 200,000 people remain uninsured. Moreover, the increase in the number of insured is primarily due to the state's generous subsidies, not the celebrated individual mandate. Health care costs continue to rise much faster than the national average. Since 2006, total state health care spending has increased by 28 percent. Insurance premiums have increased by 8-10 percent per year, nearly double the national average. New regulations and bureaucracy are limiting consumer choice and adding to health care costs. Program costs have skyrocketed. Despite tax increases, the program faces huge deficits. The state is considering caps on insurance premiums, cuts in reimbursements to providers, and even the possibility of a "global budget" on health care spending -- with its attendant rationing. A shortage of providers, combined with increased demand, is increasing waiting times to see a physician. With the "Massachusetts model" frequently cited as a blueprint for health care reform, it is important to recognize that giving the government greater control over our health care system will have grave consequences for taxpayers, providers, and health care consumers. That is the lesson of the Massachusetts model.
The Carsey Institute;
New England's population stood at 14,270,000 in July of 2006, a gain of 347,000 residents since 2000. This gain of 2.5 percent is less than half that of the nation as a whole and lags far behind the fast growing South and West. The modest overall population gain in New England masks sharply contrasting demographic trends within the region.
The Carsey Institute;
New England is a generally prosperous region and its residents are doing relatively well economically (see Table 1). Yet, between 1989 and 2004, the region experienced the largest increase in income inequality in the country. Much of this widening gap between rich and poor was driven by growth among the top earners, but the changes are not simply the "rich getting richer." Rather, they reflect the hollowing out of the middle caused by significant changes in the nation's economy. The loss of manufacturing employment for low-skilled workers has been coupled with increased demand, and rewards, for high-skilled and high tech employment. These shifts were more pronounced in New England because of the region's highly educated population, strong research and development base, and relatively high cost of business operations, which pushes low-skilled jobs elsewhere.
Residential property management is easiest to do well and profitably when a large number of units are concentrated in a small number of properties located in close proximity. Many managers of residential rental property consider 150 to 200 units a minimum threshold for undertaking the management of a property. Many managers of affordable housing throughout New England and elsewhere, however, are operating without these advantages: their portfolios are modest in size; individual properties typically have less than 50 units and are often scattered over a large geographic area.Economies of scale can prove elusive for small properties or small portfolios. It is difficult to deploy management staff to administer and maintain properties over large geographic regions. Finally, many rural communities in New England have faced declining populations and softening real estate markets in recent years, creating further obstacles to profitable property management.We visited seven property management firms, both non-profit and for-profit, who are widely regarded as doing good work even in difficult environments to learn how some property managers faced these challenges successfully. They have portfolios that range in size from 65 to 2,000 units and from one to 65 entities. (An entity is any building or number of buildings that have the same ownership structure. All but one of the organizations manage less than 1,000 units. We also spoke with four firms in other parts of the country that face similar challenges. We found that while it may not always be possible to turn a profit, a well-run company can sustain high-quality affordable housing even in the face of these challenges.This article will highlight some of the successful strategies we observed are significant in managing small, rural or scattered properties.
Immigrant Learning Center, Inc.;
Asian-owned businesses are following a very rapid growth trajectory in Massachusetts. In the last economic census from 1997 to 2002, they increased by 44 percent. This growth is nearly double the national gain of 24 percent for all Asian-owned firms in the United States and astounding when compared to the overall growth rate of 5 percent for all Massachusetts firms. Sales and receipts increased 20 percent in the same period, three times greater than the increase for all firms in the state. The growth in the number of paid employees was also three times greater than the six percent increase for all firms in Massachusetts. By 2002, there were 18,081 Asian-owned firms with sales and receipts of $5 billion and employing over 37,000 people. Professional, scientific and technical services had the largest annual payroll, followed by accomonations/food services, health care and retail trade. Whether as publishers, developers of healing and wellness centrs or as hair salon owners, Asian Americans in these businesses, and in countless other entrepreneurial pursuits, are changing the face of business ownership in the Bay State.
Earn a reputation for achieving results and, more often than not, your organization will face a flow -- perhaps even a flood -- of requests to expand. Responding eagerly to as many as possible is a natural reaction, not only because it seems like the right thing to do, but also because saying "no" can be so very hard. But, altruism aside, saying "yes" to any and all comers has its problems. It effectively puts others in the driver's seat when it comes to your strategic direction and priorities.Consider the experience of MY TURN, Inc. Over its first 20 years, MY TURN had grown to be a leading provider of vocational and educational services to youth in southeastern Massachusetts, largely by responding to requests from neighboring communities. With documented proof that the MY TURN model worked and multiple national awards for excellence in serving youth, its management and board were ready to accelerate growth and expand regionally. But faced with more opportunities than MY TURN possibly could take on, they wanted to understand which to seize and which to let pass by.
Data from the American Community Survey suggest that marriage equality has a small but positive impact on the number of individuals in same-sex couples who are attracted to a state. However, marriage equality appears to have a larger impact on the types of individuals in same-sex couples who are attracted to a state. This study shows that in Massachusetts marriage equality resulted in an increase of younger, female, and more highly educated and skilled individuals in same-sex couples moving to the state.
Immigrant Learning Center, Inc.;
Immigrant Workers in the Massachusetts Health Care Industry is the first ILC-commissioned study about immigrants as workers. It is a groundbreaking study that provides basic and new data about immigrants' presence across the spectrum of health care providers and the vital role immigrants play in this essential industry to Massachusetts. The study also examines the breadth and scope of the health care industry across the state, its current and future workforce needs and promising models for developing the future workforce. The importance of immigrants as a pipeline for this future workforce is examined in depth.