Waiting for changes in the health care atmosphere

“A great deal has been said about the weather but very little has been done,” Mark Twain is said to have famously remarked. Sometimes, it feels like the cost of health care is a similar force of nature that cannot be reined in despite the constant gnashing of teeth.

The Kaiser Family Foundation earlier this week issued a report that showed Massachusetts, along with Vermont, has the highest health insurance premiums in the country at over $400 per month per member.  That’s nearly three times the states with the lowest average monthly premiums.

Of course, everyone has a reason and they vary as much as the view of the person offering it. Dr. JudyAnn Bigby, the state’s secretary of Health and Human Services, attributes it to the high cost of living in Massachusetts compared to other places.

“When you look at all of the contributors to increased cost in Massachusetts, about 15 percent of those increased costs are attributed to the higher cost of living in Massachusetts,” Bigby told lawmakers at a State House hearing yesterday. “We’re in a high-cost region.”

Yes. And no. While Massachusetts cost of living is higher, what individuals spend as a percent of their income is among the tops in the country as well. If higher cost of living was the biggest factor, one would think the disparity of what percent we are spending would be nearer the national average, not leading it.

Bigby says the state’s higher costs predated the 2006 health care reform and says the change should “theoretically” bring costs down. But consumers are paying more out of pocket for higher premiums, higher copays and higher deductibles. Massachusetts regulations have a higher level of mandated coverage than many other states and, since 1996, the state has required coverage regardless of preexisting conditions.

According to a recent federal report, the average cost of deductibles for a family PPO plan rose 30 percent between 2008 and 2010. But for small firms, it was even higher, increasing by 64 percent in the same timeframe.

The Kaiser report, while acknowledging that cost-of-living is a factor, says some of the other factors include state insurance mandates and age and health of the state’s population. On both counts, Massachusetts bears a heavier burden. The recent Census data shows an aging Massachusetts population, with a median age of 39.1, nearly two years above the national median. In addition, the Bay State’s population of  45 to 64 years old is 27.7 percent of the total state population, putting us in the top five in the country.

The Division of Insurance finally released guidelines for tiered plans at least 12 percent below the least expensive plan from health insurance providers but the legislation was written so vaguely, its implementation has yet to be widespread. Some insurers have ramped up tiered offerings but much of it is simply shifting the burden, not hitting the root of the cost problems.

Earlier this year, Gov. Deval Patrick proposed cost containment legislation, but so far, there’s been no action in the Legislature, with key leaders eyeing next year at the earliest to take it up.

Twain may have been on to something with his observation about grumbling about the New England weather but his other famous remark clearly does not apply to the health care dilemma.

“If you don’t like the weather in New England, just wait a few minutes,” Twain said. The wait continues for other changes.

                                                                                                                                                                           –JACK SULLIVAN
BEACON HILL

Lawmakers have gutted the state’s anti-tobacco funding by 90 percent, paid for through the tobacco mega-settlement, over the last 10 years, leading to fewer retail spot checks of sales to minors, reductions in smoking cessation programs for low-income residents and vanishing prevention programs.

Judicial officials say they are moving ahead with court closures, relocations, and layoffs, but say the worst could be avoided with an extra $32 million in funding, the Worcester Telegram (via State House News) reports.

Pending legislation would set up a revolving loan fund to help dam owners repair the structures.

Lt. Gov. Tim Murray calls Sen. Scott Brown a “last minute Larry,” reports CommonWealth (via State House News).

Two county sheriffs – Bristol’s Thomas Hodgson and Plymouth’s Joseph McDonald – sign on to Secure Communities, an immigration program rejected by Gov. Deval Patrick.

MUNICIPAL MATTERS

The Lowell Sun, in an editorial, asks why sex offenders are drawn to the city. The newspaper’s conclusion might surprise you.

A former Boston firefighter on trial for disability fraud testifies that he started weight lifting to relieve back problems.

Ipswich agrees to a $21,250 settlement with the family of a 5-year-old child who was allegedly molested by a 13-year-old fellow camper at a town day camp last summer, the Salem News reports.

Boston, and Mayor Thomas Menino, go ga-ga over Ellen Degeneres, NECN reports.

Weymouth officials are hoping small businesses take advantage of a grant program that gives them up to $4,000 to improve their buildings’ exteriors in an effort to spruce up the town’s commercial areas.

Williamstown officials protest against the state’s outdoor water use ban and say that the limits are unnecessary.

The Bay State Banner goes on the campaign trail with City Councilor Ayanna Pressley. Pressley is also profiled in this week’s Phoenix.

NATIONAL POLITICS/WASHINGTON

Jon Keller says the congressional “super committee” charged with reducing the nation’s deficit is off to a bad start, if the initial appointees and their partisan rhetoric are any indication.

The Berkshire Eagle says that Sen. Scott Brown needs to stop resorting to Tea Party rhetoric and reach across the aisle to work on problems like the debt.

Herald columnist Margery Eagan belatedly endorses Hillary Clinton’s presidential candidacy – a fact that gives Suffolk County Sheriff Andrea Cabral a good laugh.

ELECTION 2012

Unhappiness with the debt deal forms the background in Iowa for tonight’s GOP presidential debate, the Globe reports. Meanwhile, Republicans are warming up to the fact that President Obama probably won’t face a primary challenge and is more vulnerable to defeat than ever.

What’s next? Impeach Obama!

The Anti-Obama: Why Rick Perry poses a major threat to Mitt Romney’s White House dreams. The former Bay State governor grudgingly returns to Iowa, while Perry plans to make his New Hampshire debut this weekend.

Stephen Colbert’s super PAC airs its first campaign ad in Iowa, urging Ames Straw Poll voters to write in “Rick Parry, with an A, for America.” In the aftermath of a Supreme Court decision allowing independent corporate campaign expenditures, the Federal Election Commission recently ruled that the comedian’s PAC can accept unlimited resources from his employer, Viacom.

BUSINESS/ECONOMY

The market takes a pounding, again. Worried consumers are reining in spending, a development not helpful to economic recovery or hiring, the Globe reports.

BRA Director Peter Meade is talking with the mayor’s least-favorite developer, CommonWealthreports.

TRANSPORTATION

The ground beneath the I-90 Big Dig tunnel is shifting in ways not anticipated by the project’s engineers — but state transportation officials insist there’s nothing to worry about.

ENERGY/ENVIRONMENT

A Department of Energy panel headed by MIT professor John Deutch recommends ways to build trust in fracking, the practice used to extract shale gas deep underground, WBUR reports.

Climate change: Philadelphia’s hot new normal sounds similar to Boston’s. Time has a video report.

Shark sightings produce a nighttime swimming ban in Chatham.

CRIMINAL JUSTICE

A fatal shooting a Boston elderly housing development.

LONDON RIOTS

Time reports on how the UK community of Croydon consumed itself in riots. It was a combination of looting and savagery, but one person sympathetic to the rioters warns there will be more riots as the underclass struggles against the bankers and government officials who worship money. “You remember the French Revolution? The Russian Revolution? People killed all their leaders. That’s going to happen here,” he says.

The Daily Beast blames the London riots on a lack of parenting and teenagers who are not held accountable when they should be.

MEDIA

Rupert Murdoch reports surprisingly good financial results for News Corp. and names Chase Carey as his heir apparent, The Daily Beast reports.

Mother Jones enjoys big spike in website visits and ad revenue, the Nieman Journalism Lab reports.

Fox’s Juan Williams talks about his firing from NPR.

SEPTEMBER 11

More tourists visit the Flight 93 National Memorial in Shanksville, PA.