Taxi turmoil

Plus, controlling local health costs
By EDITORIAL  |  March 17, 2010


Taxis are an under-appreciated and often little-considered component in urban mass-transit systems. They fill the gaps left by the MBTA and offer a sort of curb-to-curb, citywide Zipcar service.

The lot of a cab driver is a tough one. Negotiating the insanity that is known as Boston traffic for shifts as long as 12 hours per day may not be an Olympic-level achievement, but it should be.

The Boston City Council is now taking a look at the year-old system that mandates all city taxis be equipped to process credit cards.

These machines are a 21st-century necessity. Whether the passenger is a business traveler or an after-hours club patron heading home, credit-card swipes have become as ubiquitous as the Charlie Card.

The system, however, appears to place an unfair burden on drivers. Cabbies do not have easy access to fares paid by credit or debit card; in addition, they must pay handling fees of up to six percent for each fare.

Boston cabs are already among the nation's most expensive (as well as uncomfortable), so talk about raising fares should not be entertained.

In fact, fares were already raised in the summer of 2008, when gas prices were at punishing levels. But gas prices have since dropped a dollar per gallon. These are tough times for everyone — not just cabbies, but for their passengers, too. Maybe the fare hike should now be thought of as mitigating the costs of the new and vital card-swipe system.

Health costs
The nation's eyes are focused on the drama in Washington, where the Democrats' health-care-reform bill seems finally to be nearing passage. That will go a long way toward eliminating the national disgrace of our current system.

But in the bigger picture, the more important health-care work may be taking place in Boston, where officials in Governor Deval Patrick's administration have been holding hearings this week on cost containment. No government-supported health-care system — and frankly, no government, and few businesses — will be able to operate for long if costs continue to skyrocket.

Health-care-coverage reform solves the moral issue of access, but not the practical issue of costs, which are already busting the wallets of companies, individuals, and local, state, and federal governments.

Massachusetts, which birthed the health-insurance system now being copied at the national level, is the perfect laboratory for this next critical step. But the challenges and roadblocks may be even greater this time around.

For starters, there is little agreement on what is driving cost increases. Stakeholders and ideologues are pointing to a variety of culprits, based not on data but on self-interest and preconceived ideas.

This week's hearings are a welcome corrective to that noise. Attorney General Martha Coakley reported that, contrary to many expectations, health-care costs in Massachusetts are not being driven upward by increased use of services, or even by the much-maligned "fee-for-service" model. Instead — unlike the Medicare system, which is reducing many doctors' reimbursements — it comes from ever-higher prices being paid by insurers to certain hospitals and physicians' groups. These health-care providers do not necessarily provide better quality of care or greater complexity of services, but they have the market strength to demand higher rates.

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