Manufacturing still employs approximately 260,000 people or 8% of the workforce. And these people are working in good jobs at good wages – in the areas where manufacturing is still going on, wages in the industry are above the area median.

If you’d like to know more about manufacturing in Massachusetss, I’d encourage you to look at work by the state’s Commonwealth Corporation and Northeastern’s Barry Bluestone.

With Obama’s State of the Union, there’s increased attention to the industry. (I’m happy to see the attention paid to the industry but I’m far from convinced that his proposed tax credits are the answer.)

More important than government tax credits, US manufacturing is poised to regain at least some of its competitive position. A Boston Consulting Group report comes up with a surprising finding – the always-high (relative and absolute) level of productivity in the US is combining with rising labor costs in China to make US manufacturing competitive once again.

For Massachusetts, this may be the moment to secure existing jobs and create new ones in manufacturing. One place to start is addressing our high electricity costs. And I’m hopeful that the new community college/workforce development initiative from the Governor bears fruit (although inaction on years worth of comparative data makes me skeptical).

Contrary to the views of some, manufacturing remains an important employer in Massachusetts. Can we take advantage of this moment to make it even more so?

Crossposted at Boston Daily.

The Globe Spotlight Team and the Ware Report detailed the madness, absurdity, and outright corruption of the Probation Department. It’s tough to do it justice in a few words — rigged hiring, pay-to-play promotions, alleged quid pro quo between department leaders and legislators, and on and on.

On January 17, the Globe reported that the US Attorney’s office had “essentially completed their investigation” and indictments were imminent. Given the number of legislators mentioned prominently in the Ware Report, this had to be cause for concern.

Tick, tick, tick. Still waiting.

Ten days later, the Lowell Sun ratcheted up the pressure, stating that “two sitting senators and two sitting representatives could face criminal charges. Plus, one former state legislator and 10 outsiders could also face charges.”

Beacon Hill is still waiting for the US Attorney to make her move.

Crossposted at Boston Daily.

• In my humble opinion, Health Affairs has lost some credibility with the pieces they publish on Massachusetts. Editor-in-chief Susan Dentzer admitted the publication’s bias in a recent speech to the Massachusetts Association of Health Plans.

A New Era in American Health Care: What it Means for Health Plans, Providers, Employers & Consumers from Eric Linzer on Vimeo.

On the actual BCBSF report, just a couple of comments:

• The survey is a great way to capture a snapshot of what is taking place in Massachusetts, but the phone survey method should always be taken with a grain of salt.

• Self-reported ER visits are predictably unreliable. Individuals know they should not have gone to the ER for their care, so they are prone to underreport their true actions. One year of a slight decline in visits is not worth a major finding; only a multi-year downward trend in ER visits will be noteworthy. Most state data has shown the opposite for ER visits. So, survey results from one year and one state report using administrative data (cited in the Health Affairs article) should be cautiously interpreted. I hope the trend holds, but the survey data should not be used as a talking point in support of the Massachusetts law– yet.

• The study has a odd way to define affordability: “…there have been gains in the affordability of care for adults since 2006, as evident in a lower burden from out-of-pocket health care spending (excluding premiums)…”  Why would you exclude premiums in your definition? This exclusion is like celebrating a decrease in the price of printer ink while ignoring the increase in the price of the actual printer.

• The discussion section of the Health Affairs article contains a heavy does of spin and takes every opportunity to highlight a positive slant on the data. There is only minor passing mention of possible differences in states, and no mention of differences between the Massachusetts and Federal laws.

Taken together, Massachusetts’s experience under the 2006 reform initiative, which became the template for the structure of the Affordable Care Act, highlights the potential gains and the challenges the nation now faces under federal health reform.

….

Just as Massachusetts’s 2006 health reform legislation provided the template for the Affordable Care Act, so the state’s experience under that legislation provides an example of the potential gains under federal health reform. Of course, the trajectory of policy and health reform will vary across the states, given the wide differences in their political, economic, and cultural environments and the wide range in the different states’ starting points

The comparison has become a messaging tactic by liberals and supporters of the federal law, most recently illustrated by John McDonough in his Families USA piece. These folks want the public to think Massachusetts is the same as the rest of the country, and the ACA will have the exact same impact nationally as it has locally.

I will offer just two examples why this is unlikely:

1)      Do health policy officials really believe that the outcomes from a

high-income; geographically compact; historically heavily regulated insurance market; non-profit dominated insurer and provider market; medically and technologically advanced state, with a younger and more active demographic makeup; and a culture of health insurance

state, such as Massachusetts play out in the same manner in as a

low-income; geographically  spread out; drastically different regulated insurance environment; mixed with both private and non-profit insurers; dealing with scarcity in medical infrastructure; heavily employed in service and tourism industries;  ethnically diverse; and without a culture of insurance

state, such as New Mexico?

2)      Differences between the two health care laws will lead to significantly different behavior and outcomes. One example: In Massachusetts, if employees are offered employer based insurance, they are not allowed into the exchange. (The only way into the exchange is if employees were to go uninsured for 6 months.)

In the ACA, entry into the exchange is based on an “affordability” threshold of 9.5% of your income or an actuarial value of your employer based insurance of less than 60. In other words, it is much easier to access the exchange and the economics are very good for employers to dump their employees into the exchange. This is a completely different world in public policy and a much more expensive one at that.

So, it’s interesting to note that some of the most egregious breakdowns in public accountability over the past few years have occurred in that netherworld between bureaucrats and elected officials — the board of directors.

To be sure, the private sector has struggled with how to insure the accountability of boards of directors, but the public sector seems to be far behind in this area.

What are the key indicators of weak governance? Review the peformance of the Essex Country Regional Retirement Board, the Chelsea Housing Authority Board, and the Merrimack Special Education Collaborative Board.

In each case, a board appointed by elected officials has egregiously failed to protect the public interest — either through ‘capture’ by a powerful chief executive or an inability or unwillingness to understand what exactly they were approving.

Massachusetts’ public sector governance is marbled through with hundreds of appointed boards designed to protect the public interest. If we can’t solve the seeming intrinsic weakness of this level of oversight, we risk wasting more of the taxpayers’ money.