Deval Patrick - you're doing it wrong (again!)

Raise your hand if you want Health Care costs to go down (or stop going up)

Wow, that's just about everyone.  No surprises there.   Now raise your hand if you think capping insurer premium hikes without capping provider contract hikes is a financially viable way to control premiums.

Confused?   Well don't feel bad because the Governor of Massachusetts doesn't understand this either.  See, if 90% of premiums cover medical expenses and those expenses can rise by 10-12%  but the premiums can't rise higher than 4.8%, then there's a bit of a discrepancy on the bottom line. 

Simple-minded people like using lemonade stands for analogies and I like simple terms so let's try this one.   Little Cindy runs her lemonade stand and can only purchase lemons from Massachusetts lemon growers.   One of those growers is a massive conglomerate that has banded together most of the biggest lemon farms in the state for bargaining power.   They pretty much dictate what the costs should and will be for all farmers in the state.  Every year this massive group jacks up the cost of lemons by 10-12%.

Now, Deval Patrick doesn't like that every time he stops at Cindy's stand the cost for a glass goes up.  So he makes a law that says Cindy can't raise her lemonade cost but in the meantime the lemon growers can still demand the big increase because no law prevents that.   Eventually, where does Cindy's margin go?  How can she pay workers' salaries to squeeze the lemons and run the stand?   She can't and now little Cindy is on little kiddie unemployment.  

Look, from a free market perspective, telling the doctors they can't make money is no better than telling insurers they can't but by imposing this on the insurer side is treating the symptom but ignoring the cause.  The biggest mistake the general public makes is to constantly lay the blame solely at the feet of the insurers without ever asking why the docs' costs have to go so high every year. 

What can you do to help?  Well, unless you're a physician or a contract negotiator at one of the payers, you can't have a direct impact.   But indirectly you can be prudent about the care you utilize and push back on your doc when they order excessive tests or visits for ridiculous things.  

One of my bigger pet peeves was when my doc prescribed my a pump blocker for heartburn.  He told me when he wrote it that I would have to take this medication for the rest of my life.   But then when the script ran out, the office manager told me I had to come in for a refill?!  Huh?   We already know what I have to take and why and no magical new information can be garnered from the visit.  Why on earth would I be asked to come in for this needless formality?    Because it's in the doctor's best interest to schedule as many appointments as possible.  Straight Cash Homey.  Obviously I argued this point and established a standing order with my primary for the meds.   It's that easy.   

So be smart.  Ask questions.  Demand that your health care costs are being used in efficient ways.  You have the right and you certainly have reason to do so, if you want premiums to go down.