As Washington axes aid for the most vulnerable, legislation in Mass. would tackle inequities
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This proposed legislation comes at a time when the Trump administration is seeking to limit diversity, equity, and inclusion programs and racial preferences. The work of the Health Equity Compact is not that. It's about finding practical solutions to address the health needs of places like Brockton, where the
according to the Atrius Health Equity Foundation.
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One of the Compact's specific proposals, for which this editorial board
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In general, anything the state can do to advance career ladders for health care workers is valuable. For example, UMass Chan Medical School just
The health equity bill allows the public health commissioner to have a role in creating 'stackable' credentials for health care workers, where one credential can be added to the next, creating a career path.
Another intriguing idea in the proposed bill is the creation of a trust fund to give grants to 'health equity zones,' specific communities with poor health outcomes. This is a model
The
In particular, at least for now, lawmakers should resist the temptation to pass new health insurance mandates.
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The bill would require insurance coverage for interpreters, community health workers, and patient navigators. It is important for hospitals and health centers to be able to employ staff who help patients, including non-English speakers, navigate a complex health care system. These positions are typically funded through grants and, in some cases, by insurance under negotiated agreements or payment models.
But a wide-ranging insurance mandate like the one in this bill would increase premiums for all payers — including those who can least afford them. In 2023, the Division of Insurance
The bill would also require insurers to reimburse equally for telehealth and in-person care for primary care and chronic disease visits. There is ongoing debate over reimbursement rates for telehealth, which exploded in popularity during the pandemic. It's worth studying the costs and benefits of telehealth in specific specialties before mandating payment parity because ideally, telehealth would provide opportunities for cost savings.
Those quibbles aside, the proposed health equity bill would move the state in the right direction. At a time when the federal government is cutting health care spending and eliminating benefits that help the poorest citizens, it would be a strong statement if Massachusetts were to take the lead in passing a bill to improve the health of people in communities that today suffer the most.
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Atlantic
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The Making of a Trump-Putin Summit
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Ukrainian President Volodymyr Zelensky, in a video message yesterday, angrily condemned the notion that Trump and Putin alone could decide Ukraine's future. 'Any decisions made against us, any decisions made without Ukraine, are at the same time decisions against peace,' he said. Trump, who has grown frustrated in recent weeks with Putin's lack of enthusiasm for compromise, had set a deadline for Russia to come to the negotiating table or risk increased tariffs and other punitive measures. He even threatened to move nuclear-armed submarines closer to Russia, and vowed to punish India—one of the largest buyers of Russian oil—for helping bankroll Moscow's energy sector. Trump had promised to end the conflict before even stepping foot inside the White House. As months passed with no deal, Trump finally came to believe that Putin was to blame. But signs that an end to hostilities between Ukraine and Russia was remotely plausible came the day after Trump's envoy to the Middle East (and beyond), Steve Witkoff, returned early this month from Israel. Through back-channel discussions with a close Putin ally, Witkoff—the real-estate executive who, like Trump, is more dealmaker than diplomat—received word of the Russian leader's new willingness to discuss ways to end the fighting. Witkoff had reason to believe that talks were in the making, but he did not want to discuss the details over the phone, according to two people who spoke on the condition of anonymity because the discussions weren't public. After giving his pilot a night off in Miami, Witkoff shuttled back to Washington to brief Trump, Vice President J. D. 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Zelensky's resistance risks provoking the ire of Trump, who often hails himself as a peacemaker in a world that, in his telling, had plunged into warfare and chaos during Joe Biden's presidency. There is real worry in Kyiv and Europe about the deal Trump may strike, especially as public opinion about U.S. assistance to Ukraine continues to sour, particularly among Republicans. At most, European and U.S. officials believe that Trump may walk away with some flimsy guarantees to freeze the conflict—meaning that Ukrainian territory captured by Russia since February 2022 will stay in Russian hands. That, according to Zelensky, is a nonstarter. Trump has disliked Zelensky dating back to their 'perfect call' in 2019 that ultimately led to his first impeachment, and he views Ukraine as undeserving of U.S. support. Trump also remains skeptical of the traditional transatlantic alliances prized by his predecessors, and he routinely calls out Europe for failing to share more of the burden regarding NATO's collective-defense agreement. Trump's skepticism of Ukraine was shaped even before he became president, when, in the thick of the 2016 election, the country's anti-corruption agency released information alleging payments to his campaign manager at the time, Paul Manafort. In White House meetings and talks with foreign leaders during his first term, Trump repeatedly described Ukraine as 'totally corrupt' and full of 'terrible people.' Trump has even repeated Kremlin talking points that Ukraine is to blame for the war. Trump has long believed that he and Putin share a special rapport. Allies say he felt that the two survived the 'Russia, Russia, Russia hoax ' together, and that Putin would respect his historic political comeback. Trump has been deferential to his Russian counterpart, fueling speculation about the true nature of their relationship in global capitals since his first term in office. At their introductory meeting in Germany, in 2017, Putin urged Trump to recognize Russia's claim of sovereignty over part of Ukraine, citing links dating to an 11th-century political federation located in modern-day Ukraine, Belarus, and part of Russia. Former officials with direct knowledge of the meeting said Trump listened intently to Putin's soft-spoken argument against Ukrainian sovereignty. But Putin, a shrewd former Russian-intelligence officer, has never quite returned the affection. He openly admitted, when asked during the leaders' 2018 Helsinki summit, that he had hoped Trump would win the election two years prior, although he never owned up to interfering in the contest on the Republican candidate's behalf. He has been at times cool to Trump in recent months, including being slow to congratulate him on his election. Administration officials like to note the state of play when Trump took office the second time, emphasizing how much the U.S.-Russia relationship has deteriorated since February 2022, with Putin isolated from much of the Western world, particularly after the International Criminal Court issued a warrant for his arrest in connection with the war in Ukraine (the U.S. is not a party to the Rome Statute of the ICC). Witkoff, officials say, has largely been responsible for restoring those direct lines—something you want intact when dealing with two of the world's biggest nuclear powers. Witkoff 'speaks directly for the president,' one person said. 'Trump is a chameleon, but when it comes to Witkoff, the two are in lockstep.' 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But the Kremlin balked at the subsequent summit, not wanting to legitimize Zelensky by putting him opposite Putin (Trump later said that Zelenky's eventual inclusion would not be a dealbreaker). White House aides are leery of dispatching Trump to meet with Putin without any guarantee of a deliverable goal—namely, a cease-fire or, at minimum, a real step toward the cessation of hostilities. U.S. and European officials were still gauging whether Russia was serious about curtailing the fighting or simply buying time for more attacks to strengthen its position for future negotiations. And though Trump believes his own personal negotiating skills could sway Putin, it is not clear that Russia would offer an agreement acceptable to Zelensky. Trump has long argued that it is always better to talk, regardless of who it is with, and he has especially emphasized that dialogue between nuclear-armed states, such as the U.S. and Russia, is imperative. 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