It is an accepted fact that health reform will succeed only with focused attention on cost control. All stakeholders seem to agree that we will not be able to afford universal coverage unless health care costs are brought under control, and there are many worthwhile ideas about how best to meet this goal. Unfortunately, there are just as many, if not more, ideas that would increase costs.
When it comes to coverage, Massachusetts’ health insurers are heavily regulated. The rules were established with the best of intentions, but each new rule adds to the cost of coverage, either by requiring coverage for specified services or by making it more difficult for health plans to manage care.
The Health Reform Act recognized the impact of such requirements on the cost of coverage. It imposed, for instance, a moratorium on new mandated benefits until the Division of Health Care Finance and Policy completed a study of the cost impact of existing mandates. The Division has not yet released this important report.
Against this backdrop, it is surprising that some of health reform’s staunchest allies are supporting laws that would expand benefits further.
Ironically, many of these same stakeholders advocate for more waivers from the individual mandate on the grounds that no affordable coverage options exist for moderate-income individuals. We cannot have this both ways. An individual mandate premised on the availability of affordable products needs to give health insurers the ability to sell affordable products. Otherwise, our goal of universal coverage is an illusion.
We will not bring costs under control by adding new costs to the system. While this is not a cure-all for controlling health care costs, it would be a good starting point.
COO, Harvard Pilgrim Health Care
This program aired on June 27, 2008. The audio for this program is not available.