Q&A: MA Lawmaker on Cost Containment
Q. Why legislation? Why not let market forces work this out?
A. Well, the cost of healthcare is still increasing everywhere. Health reform here didn't add to the cost but it didn't save enough either. The average rate of inflation in the state is 3.6%; average healthcare costs are increasing by 7.2%.
That's not sustainable as we look over the next 10 to 15 years. The marketplace is continuing to increase the costs so the marketplace has to be incentivized to be part of the solution.
Not every payer or provider has worked successfully to get costs under control. We've set up the framework to do that without being overly regulatory. Everybody doesn't have to use the same plan but everyone has to get to the same goal.
Q. How did you get providers and payers to go along with this?
A. We have a very capable group of providers and payers. We've been working at this for a long time. We haven't denied coverage for pre-existing conditions and or capped coverage for years. Our insurance companies and providers have done pretty well even with those requirements.
Another thing is that our efforts have been bipartisan. We've passed healthcare reform under a Republican (Mitt Romney) and Democratic (Deval Patrick) governor.
Also, we've done it incrementally. My view of healthcare reform is that it's a dynamic process that has to be adjusted if something isn't working or has unintended consequences. I think the providers and payers know we listen to them.
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
- Resisting the Healthcare Consolidation Frenzy
- MGMA Urges 'End-to-End' ICD-10 Testing
- 1 in 5 CT Screenings for Lung Cancer Results in Overdiagnosis
- Scary Financial Challenges for 2014
- New G-Codes to Pay Doctors for Broad Array of Non-Face-to-Face Care
- Give Nurses in Wheelchairs a Chance
- MU Compliance Announcement Sparks Concern, Confusion
- 3 Better Ways to Market Bariatric Surgery
- HL20: George Halvorson—Expectations for Success
- Top 3 Health Plan Game Changers of 2013