SO, HOW DO YOU KEEP IT AFFORDABLE WHEN THE PRICE KEEPS GOING UP? by Elmer Freeman

When we get our checks from the Fed this summer to spend on consumer goods and services to try to resuscitate the struggling US economy, let’s all spend it on health care! Let’s join together in a collective strategy to suppress health care inflation in the Commonwealth, to ensure the success of the Massachusetts model of health reform. The Connector has already thought of this considering recent proposals that would jack up premiums… and shift more cost to consumers. These are short term budget fixes, not reform.

From my previous entries on this blog, you know I have not been enamored with the promise of reform in Chapter 58. The real opportunities for reform take a backseat to increasing access by expanding coverage and simply pumping more dollars into a system that is almost irreparably broken.

Yesterday I attended presentations by graduate students at Northeastern University who were among some 40-50 students who attended a two day seminar sponsored by the Massachusetts Health Policy Forum for graduate students from many local area universities studying medicine, nursing, public health, public administration and other disciplines. The student forum was held in January and included two full days of talking with policymakers, legislators, administration officials, practitioners, etc. all focused on Massachusetts’ great health care experiment, Chapter 58. The students consider it a success only if measured by the singular objective of increasing the numbers of Massachusetts residents with health insurance of some sort. However, it did not take long for them to realize the absolute impossibility of sustaining increased coverage in light of rising costs for everything from food, to gas, to prescription drugs and health care. They were all looking for the answer … how do you keep it affordable, when the price keeps going up?

Everyone knows we have to do something about spiraling health care costs or our experiment will fail. One of the key elements of Chapter 58 that could help, the Health Care Quality and Cost Council, remains dormant. The questions here are do we have the political will to “mandate” price controls and other reform strategies as we have done with coverage? And are we willing to penalize those that do not comply? Clinging to a market based ideology in health care makes no sense especially when market principles, such as the relationship between cost and quality, have no influence whatsoever on consumer decisions in the market of health care goods and services. Do we take lessons from the US automobile industry that didn’t realize that “quality is job one” until it was almost too late.

To meet the promise of universal coverage, we have to keep it affordable for it to be a success and everybody has to ROW HARDER. Under Chapter 58 we have witnessed a corporate take over of our health care system … and we need to take it back.

Elmer Freeman, Executive Director, Center for Community Health Education Research and Service, Northeastern University.