I’m up in the Boston area today watching with great interest the coverage of the special election to fill the late Ted Kennedy’s U.S. Senate seat — the outcome of which holds important implications for healthcare reform. But whatever the result, Massachusetts already offers lots of lessons about healthcare reform. Notes Credit Suisse:
Up to this point Massachusetts healthcare reforms have focused entirely on expansion and not on costs, leading to a growing source of budgetary pressure for the state….According to the state, the monthly premiums for both the lowest and highest cost Commonwealth Choice Bronze plan have increased by 15% during 2009. Greater than expected enrollment in the subsidized Commonwealth Care program was the primary reason the state’s healthcare expenses exceeded budget by 20% in 2008….
In response, the state is undertaking numerous reviews and studies in order to develop cost containment strategies….The two basic approaches to reduce health care spending are (1) lowering unit costs through regulation of prices paid (rate setting, bundling payments) and/or substituting to less expensive services (limited service clinics, increase use of nurse practitioners), and (2) lowering utilization or volumes by providing incentives for more efficient care (pay for performance, increased adoption of health IT) and/or using regulatory mechanisms to reduce volume (decrease end-of-life care service intensity).
Tough choices. Now shift to national reform. The emphasis is also on expanding coverage, rather than controlling costs. So I wouldn’t be surprised to see the nation struggle with similar tough choices down the road.
The only thing worse would be no reform, which could conceivably happen if Republican Scott Brown wins the tight Massachusetts race over Democrat Martha Coakley. Hard to imagine all this was for nothing.
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