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.
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SEPTEMBER 11More tourists visit the Flight 93 National Memorial in Shanksville, PA.