Level the playing field for all providers
Mike Collins & Eugene C. Wallace, Boston Globe, February 6, 2010

We heartily endorse the attorney general’s report on health care cost disparities and its compelling evidence of the extent to which community hospitals like ours have been shortchanged. Our communities count on us to treat everyone, regardless of their income or insurance status. Yet, as the report documents, private insurance companies pay us up to 25 percent less than wealthier hospitals - for no clear reason. And the state’s rates of payment are so low that many safety net hospitals are struggling to stay afloat even as more and more individuals in true need of health care look to us for treatment and the promise of “health care for all.’’ The payment system is not only unfair, it jeopardizes entire communities. Our safety net hospitals are located in some of the hardest hit areas of the state. We are often the largest local employer, major purchasers of goods and services, and offer programs from free flu shots to life-saving cancer screenings. The attorney general’s report is a clear signal that action is needed now to protect hospitals like ours. Our safety net hospitals have spent years perfecting the ability to provide high-quality care at a low cost. It is time to recognize and reward these efficiencies, and level the playing field. The writers are chief executive and interim chief executive, respectively, of Merrimack Valley Hospital and Signature Healthcare Brockton. © Copyright 2010 The New York Times Company

Put patients ahead of market power. Georgia Maheras, Boston, Boston Globe, February 6, 2010 All too often, patients are blamed for using too many services or being too sick and driving up health care costs. A new report by the attorney general shows this is not the case (“AG finds clout of hospitals drives cost,’’ Page A1). In their January 29 story, Liz Kowalczyk and Scott Allen wrote, “Massachusetts health care costs, which are growing by 7.5 percent annually, are mostly the result of rising prices, not patients getting more imaging tests, surgery, and other procedures.’’

This critical report highlights the significance of market power in setting health care costs. It provides more confirmation that there is a systemic problem with the design of our health care structure and we need a systemic solution. Patients cannot continue to be burdened with growing premiums, co-payments, and deductibles. Consumers are the heart of the care system and need to be treated as such. The writer is campaign coordinator for the Massachusetts Campaign for Better Care. © Copyright 2010 The New York Times Company

Capitation was already attempted in the market place without government involvement and it failed miserably. The majority of hospitals and providers function on 1%-2% operating margins. Non-profit institutions reinvest this margin into their organization by purchasing technology, facility improvements. If by chance this is a little left over, it is placed into the coffers. The institutions which are not mentioned, (CYA Martha), are sitting on endowment war chests which allow them to operate at a loss yet still accomplish their capital goals. One only needs to look as MGH/Partners' outreach to new facilities on 128 and the Patriot Place facility in Foxboro. Unfortunately the only reason this investigation occurred is in response to the Globe story on the back room handshakes between Partners and Blue Cross. Don't expect Martha and/or Deval to do anything about it. By the way ... What about the drug and medical device companies? - luchshel

The report did not identify insurers and providers by name, and Coakley declined to release the names of the highest-paid, saying she wanted to lay out systemwide problems, not blame individual organizations. Coakley not naming names is inappropriate. Health cost information needs the disinfectant of sunshine, disclosure, as much as possible. I always wonder how much of spiraling health care costs is caused by the disconnect between what consumers pay and their even knowing the cost of a procedure. I go in and pay my copay regardless of the cost of what I'm doing in the doctors office that day. - Kevin831