According to press accounts, the Governor will be initiating a compact today aimed at health care costs and collaboration across state government. This is great news. On the heels of public statements by the Senate President, a promising new proposal presented by the health plans, and suggestions by the Connector that non-subsidized plans increases should be kept to 5%, this initiative by the Governor is most welcome.

May we be so bold as to make a few suggestions to the Patrick Administration, particularly to the Division of Insurance, the Health Care Quality and Cost Council, as well as the Attorney General?

Let’s require real, extensive transparency for all receivers of our health care dollars, from insurers to hospitals. But let’s make it meaningful and useful for everyone. Transparency has been proposed by all sorts of people and groups. But the vital issue is what is being reported and what will it do to not only lower overall costs, but to also ensure that health care cost distribution is fairer to all purchasers. A comprehensive transparency initiative should collect information which will set about the pathway to further reform efforts on behalf of consumers, employers and taxpayers.

It isn’t enough just to report the costs and outcomes of procedures, or even excessive executive pay at non-profits-although all that is vital. Read more…

Entries in the Commonhealth blog in recent weeks referred to Senate President Murray’s encouraging words on getting at the escalating health insurance costs in order to make health care reform a long time success. On Tuesday at the Annual Meeting of the Retailers Association of Massachusetts, House Speaker DiMasi also focused on the issue of cost, much to the delight of the small business owners present at the meeting.

With major statements on health insurance cost from the leaders of both legislative chambers in recent weeks, we should all be encouraged that action will occur sooner rather than later to rein in the double digit premium increases small purchasers have seen over the last seven years.

As the employer and individual requirements under the law now begin to kick in, there is no question that increased access and universal coverage will only become long term realities if something is done to address the unrestrained increases by the big hospitals and big insurers. Read more…

When is it a crisis?

Here’s a snapshot of some recent headlines:

“Health insurance costs outpace wage increases,” AP, 9-12-07
“Health coverage rates will rise again,” Boston Globe, 9-13-07
“Dire prognosis: Health insurance costs continue to soar,” Worcester T & G, 9-17-07
“Health care spending highest in Northeast,” AP, 9-18-07
“Rising costs have attention of State Budget Chief, Connector Officials,” State House News Service, 9-20-07

And those are just a few…

The stats and figures come at us on almost a daily basis now. We’ve all seen them so it makes no sense to regurgitate them again here. Something simply needs to be done now about the costs of health care and our skyrocketing health insurance premiums. It should be clear to most from reading these articles that the answer cannot be to simply shift more of the cost burden onto employers and employees especially in light of the fact that employers are now looking at new, more expensive plan designs just to comply with the forthcoming stricter standard of minimum creditable coverage.

The housing market is down. Retail sales are down. Consumer confidence is down. And big health care just keeps on getting bigger, more profitable, and more powerful. They are consuming more and more of our disposable income, our tax dollars and our private sector profitability each year. We are staring at a potential 8th year in a row of double digit premium increases. If that occurs, many small businesses will see family premiums in Massachusetts rise above $20,000 next year. Where has all this money gone, and where in the world will the future money come from?

It’s time for answers and accountability. It’s time for all payers of health care dollars (employers, consumers and taxpayers) to put big health care under the microscope and stop accepting this money grab from our pockets to theirs. We must stop putting them in positions of public policy authority and labeling them as the “experts” on health care policy, or as “important parts of the employer community.” They have taken advantage of the payers for long enough, and our future economy demands that the dollars start flowing back in the other direction.

Jon B. Hurst, President
Retailers Association of Massachusetts

Perhaps the best and most important entry in recent months to the Commonhealth blog was submitted by Nancy Turnbull on July 9, titled “How About Some Transparency for Health Plans Too.” If you missed that entry, I strongly recommend that you go back and read Nancy’s common sense discussion. She correctly points out how the health insurers were big winners with health care reform, and while they talk a good game on transparency for providers, they conveniently leave themselves out of the proposals.

Small businesses couldn’t agree more. We firmly believe that “payers” of health care dollars (consumers, employers, taxpayers) deserve full transparency from all “receivers” of health care dollars (insurers, hospitals, doctors, etc.). Insurers should be mandated to make fully public the average premium cost of typical coverage for all types and sizes of purchasers. Read more…

A series of four regional small business seminars on the new health care law wrapped up last week in Haverhill, an instructive outreach effort co-sponsored by the Retailers Association of Massachusetts, the National Federation of Independent Business, numerous local chambers of commerce, Senator Steven A. Baddour and the Commonwealth Connector Authority. I would like to thank Jon Kingsdale and his outstanding staff, as well as the Division of Health Care Finance and Policy, the Division of Insurance, the Division of Unemployment Assistance and our corporate sponsor, Verizon, for their participation in this important educational effort.

This was the second round of seminars building on an earlier effort last fall by our organizations to attempt to reach out to very small employers in the small group market (50 & under.) Hundreds of small businesses were educated as to their responsibilities and options under the law. Approximately half of the attendees were very small employers with fewer than 11 full time equivalent employees – exempted from the mandates – but still impacted by the reactions of and the rising premiums for their employees. Attendees left well educated, yet still very nervous as to when the double digit increases to their premiums will end and concerned about how much their costs will rise this summer and fall as more and more of their employees opt into their small group plans.

As much as we educate our own members, I am still struck by the large number of small businesses across the Commonwealth that likely remain in the dark as to their new responsibilities on insurance offerings, Section 125’s, state reporting and the soon to be felt demands of employees. With July 1 less than two weeks away, the lack of education on the law to thousands of small employers raises the question on whether penalties for employers – like those for individuals – need to be delayed or mitigated. Read more…

Does it come as a surprise to anyone that just as the reform is ready to be implemented, some of those that benefit by putting more health care dollars in the system are starting to once again bash the employers that don’t happen to be taxpayer or insurance premium funded? Read more…

The recent loosening of the affordability standards by the Connector for our residents was an important step and acknowledgement that we need to go slow on this unique reform. The long term economic and political viability of the reform demands that we be patient, flexible and understanding as to the financial and personal needs of everyone affected.

It is difficult for many of us with generous health insurance coverage to be able to fully relate to the situation of those not currently insured. Those who cannot afford to make that investment need to have help and time to make the adjustment. There are also those that can afford coverage, yet do not take insurance because they view themselves as healthy and even “self-insured.” Understanding and flexibility should be granted to this large group of residents, most of which likely do not yet fully comprehend their coming responsibility under the law.
Read more…

Good news hit the papers in recent weeks on health insurance savings for certain key constituencies. First, there was the news of negotiated reductions with the incumbent Massachusetts health plans for the uninsured and likely individual customers of the Connector. Then there was the announcement Wednesday that the GIC was only facing a 5% increase for the new fiscal year. This was certainly good news not only for the state and state workers, but also for those cities and towns wishing to join in on the cost saving benefits of group negotiation and discounts available through the GIC.

Yet none of this news was particularly comforting to small businesses and other small group employers across the Commonwealth. Read more…