Wednesday, October 12, 2011

Going along to get along

The relative quiet since the state's largest insurer gave away a huge rate increase to the state's dominant health care system  --  a 2-3% increase on a base that is, what, 15 to 20% higher than the rest of the market -- is indicative of something here in Massachusetts.  After all, if there was ever a time for that insurer to challenge the market power of the provider group, this was it, with other hospitals and physicians waiting in the wings to serve the public at a lower cost and employers looking for lower priced products.

Year's ago, the CEO of this provider group said to a then-balking CEO of this insurance company, "This is what good health care costs."  The latter conceded, and the pattern was established.  The current team seems to feel the same way, even in the face of evidence from other parts of the region that such costs are not necessary to deliver high quality care.

Or maybe this was a case of going along to get along, slipping a story by a body politic and media that has lost the will or interest to focus on another large, implicit tax increase on the people and businesses of the state.


Barry Carol said...

I think more employers need to embrace tiered network and limited network insurance products even if employees prefer a broad network. Alternatively, employers could offer options that include Partners but require employees who want the broad network to pay the ENTIRE premium difference between it and the less expensive plans.

Anonymous said...

The political tragedy, as long as this situation exists, is that it gives the lie to Massachusetts' claim to be leading the country in dealing with cost and affordability issues surrounding health care. The message we out-of-staters receive instead is, either a) political contributions trump all, or b) governments are impotent against large health care interests - or both. As they say, follow the money.

nonlocal MD

Anonymous said...

Ironically, the insured who choose the highest cost hospital and providers are being duped twice: first, into subsidizing highly specialized procedures that they are exceedingly unlikely to ever benefit from (e.g. gene therapy and face transplants), and may or may not be able to access in any case; and, second, associating costs of highly specialized medicine practiced under the same roof with quality or safety of the care that they are most likely to receive (e.g.preventative care and lower invasive procedures). Instead of 'gee whiz' awe, patients should be watching whether their primary care doctor washes his or her hands. Or if instructions for medications are well explained.

There is a fundamental conflict between looking at every patient as a potential subject for the latest gadget, and practicing as if you hope to keep patients healthy at home and work until their next annual. The first kind of medicine is the one that got us in this mess to begin with.

Anonymous said...

This is a classic case of the Emperor's New Clothes. Our politicians appear to be more concerned with touting success, they fail to see our failures. But why hasn't the Attorney General spoken out on this subject given her excellent comparative cost analysis? This doesnt make sense. Just wait, the next thing we'll hear is that the high cost hospitals should be required by law to be in all limited networks and be in Tier One of all tiered networks....oh wait, I believe that proposal was made last week.