Capping Costs
Capping a single leaking oil well seems like a simple task, but has proven exceedingly difficult.
Putting a cap on rising health care costs is clearly a much more vexing, multi-layered problem, and one that is just as maddeningly unsolved as the Gulf oil leak.
Reprieve
The recently passed national health-care bill did little to address the spiraling cost issue — clearly the most critical element of our health-care crisis. Likewise, the Patrick administration’s attempt to block planned increases in health-care insurance premiums for small business and individual plans has proven to miss the mark — based on the Insurance Division’s board of appeals decision handed down last week.
The appeals board gave Harvard Pilgrim, the first of four HMO plans to have their cases heard, the green light on all of its submitted increases.
While its initial finding in favor of Harvard Pilgrim is not a lock for the others, it certainly sets a precedent for Blue Cross Blue Shield of Massachusetts, Tufts Health Plan, and Fallon Community Health Plan to have their submitted increases approved as well.
The Patrick administration got it part right when it pushed for the rate rejection. The current levels of increases in health insurance premiums are unsustainable, particularly for small businesses. After all, it's small business that provides the backbone for the state and U.S. economy.
By going after the HMOs, the Patrick administration was just nibbling around the edges of the problem. After all, HMOs only represent about 10 percent of the total health-care cost structure.
A true solution can only be arrived at when all the players are at the same table — the insurers, the hospitals, the doctors groups and the regulators. Until the companies and organizations that make up the entire health-care food chain get on the same page, partial solutions like simply capping HMO increases will continue to miss the mark.
State's Role
For many years, the rapid rise in health-care benefits has been a top issue for all businesses — big and small. The federal reform, while laying the ground for some long-term efficiencies, did little to put any cost controls on place.
Massachusetts was a clear leader in health care, enacting groundbreaking reform. It’s time for the Bay State to renew its leadership role and forge ahead with a major effort to put in place disciplined cost controls that will bring the runaway line item labeled health care back into control.
Sometimes it takes a crisis to bring the right people together and forge a solution. For far too long the insurance, hospital and medical communities have pointed fingers at each other, leaving patients and businesses stuck in the middle of a no-win situation.
The truth is, the problem is the responsbility of all of them — and the state government has an important role in facilitating, and in some cases forcing, these disparate players to come up with a solution they can all live with. We’re not advocating that anyone be let off easy. For true cost control, all the players will have to share in the pain.
While the quality of health care in Massachusetts is high and many of our facilities are world class, the bottom line remains that we can’t afford the bill if it’s going up by double digits year after year.
While a federal solution should be called for, the state needs to act now and move ahead with the kind of progressive reforms that will immediately put the brakes on outrageous cost increases.
Those reforms will only be fruitful if all the players have a stake in the negotiations.
This cost crisis is bigger than politics as usual, and our leaders owe us a solution that transcends petty election-season posturing.
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