For your consideration: Health care cost increases have slowed nationally, but are still rising sharply in MA. A spokesperson for the health care industry in MA says it’s because we don’t have Consumer Driven Health Care, i.e. where the patient is supposedly responsible for spending health care dollars wisely:
Health spending in Massachusetts between 2000 and 2004 increased at 8.5 percent, compared to average annual increases of 5.7 percent between 1990 and 2000. In Massachusetts, healthcare spending for each resident was $7,075 in 2004, compared with the $5,313 spent nationally.
Massachusetts healthcare insurance premiums have also increased more quickly than the national average, averaging more than 10 percent for the past seven years, and doubling the amount most workers pay for healthcare coverage.
“In Massachusetts, we have not shifted the healthcare costs to employees the way they have in the rest of the country,” said Wendy Everett, president of the New England Healthcare Institute, a local think tank. “That is a way to control medical costs.”
Well, shifting costs onto the employee does not “control costs” in an absolute sense — it forces them onto the employee, either in money or in health. Furthermore, satisfaction ratings for Consumer Driven Health Care are worse than typical plans.
So … do you want health care costs to rise slowly, or do you want good health care? (Or do you want both, with single-payer?)
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It does force the cost onto the employee, which in turn, IMHO, would save costs:
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Mass: Here’s your insurance.
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The Solution: Here’s some money for your insurance. Shop wisely.
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Many employers have adopted this approach, but I think it would take a fiscal crisis to compel the State and Municipalities to do so.
“Shop wisely today, so Humana can skyrocket your premiums tomorrow when you aren’t looking?”
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Studies show that consumers who make “decisions” about healthcare to save costs are just as likely to deny themselves needed care as frivolous care. And why not? Are we all supposed to go to med school or become actuaries to make healthcare decisions?
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And we should all go to auto mechanics school to buy a car. Or not.
I wonder if the fact that health care expenditures in other states rising less quickly is a result of the economy in other states not performing as well as in Massachusetts.
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Mass has a very high percentage of well paying jobs relative to other states. Most of these folks get good (not cheap!) health care. I’m not just talking about CEOs — I’m talking about union jobs with health care, office jobs in general, university jobs, etc.
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Maybe we pay more because we get more? Could it be that simple?
That would explain the high per capita, but not the inflation rate. (i.e. mass has had mediocre wage inflation)
Because of the abundance of specialists in Mass (think teaching hospitals), patients in Mass. are very likely to see specialists.
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Specialists are reimbursed for doing procedures. They are not reimbursed for not doing procedures. So they perform lots and lots of procedures. I’ve seen stats (which I might be able to dig up, if anyone is interested) showing that Mass. residents lead the country getting in many high-priced procedures.
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At first, this sounds like a good thing for our health – but it’s not neccessarily good. For example, in the US, 2/3rds of cardiac angioplasties are done on folks for whom there is zero evidence of benefit. And we know which ones will not benefit – but might be harmed. But at $40,000+ in total revenue for a 1-2 hour outpatient procedure… you get the picture. Virtually all prostate removals are in patients for whom the evidence indicates the procedure will do nothing whatsoever to improve outcome. (And they have a lot of rally nasty side effects). But we do them anyway.
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You might think that the insurers would stop this behavior – they’ve tried, but, in the US, the doctors actually have almost all of the power.
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To drive down costs, we need a rational healthcare system that focuses on bang for the buck, rather than coming up with a yacht payment. Let’s do the procedures on those that will benefit – but not on those for whom no benefit has been demonstrated.
Well, shifting costs onto the employee does not “control costs” in an absolute sense…
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What you really want to say is “shifting costs onto the individual does not “control costs” in an absolute sense.” And that would be true, regardless of whether the individual is an employee or just Joe Shmoe off the street. Just how much bargaining power does an individual have in negotiating prices with his or her health care provider? Somewhere between slim and none.
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One might believe that, if an individual eschews some forms of remedial health care, that the costs, in general or for the rest of us, might go down, but, query, do they really? Whether or not someone is an employee, if him or her has developed an acute condition (possibly because he or she eschewed treatment earlier) he or she will likely still get some form of health care, if only to protect the rest of us (public health, anyone?), which would likely be more expensive than if he or she had sought treatment earlier.
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I’ll refrain from the “what about the children” bit, but you get what I mean. Children oftentimes suffer the perceived deficiencies of their elders.
I would love to see corporate-sponsored euphemisms like “Consumer-Directed Health Care” get the same treatment as people give to phrases they think are too “politically correct”. Based on what this really means, can I assume that the man living in a cardboard box under a bridge is engaging in “Consumer-Directed Housing”?
We’ll never get anywhere close to solving this until we agree/convince voters that HC should be treated like public health, fire and police services, and other programs that inherently exist to serve the public good and that are essential to life liberty and the pursuit of happiness and the maintanance of a civilized caring society.
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“Of all forms of inequality, injustice in health care is the most shocking and inhumane” -Martin Luther King, Jr.
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did you know that in the late 1800’s and maybe later, if you did not purchase fire insurance then your house would be allowed to burn down? seems pretty uncivilized (snd stupid), huh? well, we’re still stuck in that place r/t HC insurance and timely access to care. and now that such HUGE SUMS OF MONEY ARE MADE from treating HC as a commodity, rather than as a public good guaranteed to all (and provided in as cost-efficient a manner as possible), we are experiencing a disinformation campaign of equally huge proportions led by the insurance-medical-industrial complex as they fight to protect their riches and their roles in the biggest rip-off going in this state and this country: OBSCENELY HIGH HC COSTS (and the unimaginable amount of preventable disease, suffering, and death that result).
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The BU-based Health Reform Program is a valuable resource to look at if you want facts, not rhetoric, on this topic.
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BTW “consumer driven care” options are already proving to be a failure in controlling health costs. The Commonwealth Fund did a study looking at this recently that’s discussed in this article: Consumer-driven health care is a false promise, by Elise Gould
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The 101 MA legislators who chose to break the law on Jan. 2, 2007, and not vote on the HC Amendment committed a travesty of justice that will cost this state not only billions of dollars but also thousands of lives. The constitutional guarantee for comprehensive, affordable and equitably financed HC was meant to provide the legal and political tool that is so obviously lacking for us as a society to successfully tackle this vital economic and public policy and social justice issue: Affordable quality health care for all.