Massachusetts Takes On Health Costs
Give Massachusetts credit for setting audacious health care goals. It took the lead in guaranteeing near-universal health insurance coverage for its residents, providing a template for the federal reforms to follow.
Now a bill passed last week by the Legislature — and enthusiastically endorsed by Gov. Deval Patrick — aims to tackle the much harder problem of controlling health care costs. Massachusetts will be the first state to try to cap overall health care spending, both private and public, so that it will grow no faster than the state economy.
The state was able to reach near-universal coverage because the vast majority of its population was already covered by some form of insurance. It also could subsidize coverage for the uninsured using a big pool of money that had been used for charity care.
But when it comes to controlling health care costs, Massachusetts has no advantage, and in fact is starting behind most other states. Its costs are among the highest in the nation, and they have been growing in recent years at 6 percent to 7 percent while the economy has been growing at less than 4 percent. That bleak picture may be changing. The growth rate of health costs has slowed significantly over the past year or two, but nobody knows if this is a temporary or lasting change.
U.S. Officials Brace for Huge Task of Operating Health Exchanges
By ROBERT PEAR
WASHINGTON — Obama administration officials are getting ready to set up and operate new health insurance markets in about half the states, where local officials appear unwilling or unable to do so.
The markets, known as exchanges, are a centerpiece of President Obama’s health care law, and running them will be a herculean task that federal officials never expected to perform.
When Congress passed legislation to expand coverage two years ago, Mr. Obama and lawmakers assumed that every state would set up its own exchange, a place where people could shop for insurance and get subsidies to help defray the cost.
But with Republicans in many states resisting the creation of exchanges or deterred by the complexity of the task, federal officials are preparing to do the job, with or without assistance from state officials.
“We realize that not all states will be ready to establish these exchanges by 2014, so we are setting up a federally facilitated exchange in those states,” said Michael Hash, the top federal insurance regulator. “We are on track to go live in October 2013, which is the beginning of the first open season for the individual and small group markets.”
Governors of 13 states with nearly one-third of the United States population have sent letters to the Obama administration saying they intend to set up exchanges. Complete applications are due on Nov. 16, just 10 days after the presidential election.
Federal and state officials and health policy experts expect that the federal government will run the exchanges in about half of the 50 states — a huge undertaking, given the diversity of local insurance markets.
Only 10,000 Mainers see rebates as Obamacare provision takes effect
Posted Aug. 05, 2012, at 6:07 a.m.
LEWISTON, Maine — About 10,000 Mainers will benefit from a provision of the federal Affordable Care Act that went into effect Aug. 1, forcing health insurance companies to spend less on administration and more on the delivery of health benefits.
Nationwide, insurance companies last week issued more than $1 billion in rebates to about 13 million Americans.
Only one company, Connecticut General Life Insurance Co., known as Cigna, is required to issue rebates in Maine, said Doug Dunbar of the Maine Department of Professional and Financial Regulation.
Dunbar said in an email message that Cigna was required to issue about $2.6 million in rebates for 10,600 policies in their large group business in Maine.
“Because most employers pay a portion of the premium, the rebate will be split between the employer and the employee,” Dunbar wrote. “The rebate can be a premium credit or reimbursement.”
But while those on private insurance plans in many other states are starting to receive those checks or credits toward their insurance premiums — in some cases as much as $500 — most people on privately funded plans in Maine will see nothing.
Clinic on wheels provides health care for Maine’s migrant workers
Posted Aug. 04, 2012, at 12:46 p.m.
COLUMBIA, Maine — Meeting the medical needs of migrant farm workers is as much about education as hands-on care, says Dr. Cheryl Seymour, an Augusta family practice physician who serves as the medical director for the Maine Migrant Health Program.
“For some of the population of farm workers, we are their primary care home,” said Seymour, who will be spending most of this month overseeing clinical care services being offered to the migrants who stream into Washington County every summer to harvest the region’s thousands of acres of wild blueberries. “Many of these people never see a doctor somewhere else. So we try to educate them about managing chronic problems like hypertension, diabetes and asthma.
“I can give someone a bottle of hypertension meds, which will last for 30 days,” she said. “What’s more important is being able to teach them about managing high blood pressure by stopping smoking, eating less salt or exercising. I know that managing chronic diseases in a four-week setting is kind of crazy, but that’s what these people need.”
Seymour said her professional interaction with farm workers reminds her that health is a reflection of a 24/7/365 lifestyle, a basic realization that she says can slip away in a more pristine clinical setting.
“So much about health is not about the numbers — what your blood pressure is or the dosage of your prescription — but about how people live,” she said. “Life, social context and work impact people’s lives. It’s easy in an office setting not to focus on that. But when you see these people work, see the mechanics of how their bodies work, see the social context they live within, you cannot ignore it. It’s right in front of you.
“We are meeting their needs in a very fundamental but functional way that gives them more independence,” Seymour said Thursday between patients at a clinic on wheels parked by day at the Rakers’ Center established each harvest season on Epping Road, two miles north of the Washington County community of Columbia. “These are people who are completely neglected by society. They are also the people who harvest our food, and helping them deal with their medical needs is the least we can do.”
Maine Voices: Everyone deserves access to health care
On the 47th anniversary of Medicare, the writers call for an expansion and improvement to cover everyone and cut costs.
By JULIE KELLER PEASE, PHILIP CAPER and EDWARD PONTIUS
On the occasion of Medicare's 47th birthday, we urge the immediate expansion of Medicare to everyone in the United States
The High Cost of US Health System Dysfunction
While the human costs of our dysfunctional health system are staggering in terms of death, suffering, and financial trauma for patients and families, we pay a steep economic price over the long haul when we follow patients and discover the ongoing costs and the collateral damage to our economy. A patient whose care is compromised early on in their treatment often is much more costly to the system over time. Such is the case for me and millions of other insured, working Americans
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