Massachusetts found out that expanding coverage was relatively easy, sort of.  Paying for it is not.  Why?  Because a large number of the uninsured have significant illness and often suffer from serious compliance issues when it comes to medical care as well as lifestyle choices.  The Massachusetts experiment in extension of health coverage is a lesson for the nation as a whole.  Lacking some personal mandate for personal responsibility, costs will escalate beyond control, and the only option will be rationing.  So called de facto rationing does occur currently.  But that is an issue only if one assumes that access to equal health care choices is a right of all.  Many do not feel this to be the case.  Currently all do have access to basic care, if only via emergency room doctors and nurses.  Expansion of the pool of health providers will ease these burdens somewhat, but will not make up the difference if coverage is extended to all. In the end, federal bean counters will do what they always do, cut expenditures to those individuals and entities on the front lines providing the care that they wish to take credit for providing and attempt to limit choices of those covered.  That is why it is essential that America maintain a vibrant private health insurance industry as well as robust private health care system.  Government control is never the best outcome.  Our plan has from day one offered common sense regulatory oversight coupled with maintenance of a vigorous free market.  The Congress would do well to consider our proposals as the debate a compromise . . . obi jo  and jomaxx

Rein in health costs, Massachusetts urged

Massachusetts has the most expensive family health insurance premiums in the country, according to a new analysis that highlights the state’s challenge in trying to rein in medical costs after passage of a landmark 2006 law that mandated coverage for nearly everyone.

The report by the Commonwealth Fund, a nonprofit health care foundation, showed that the average family premium for plans offered by employers in Massachusetts was $13,788 in 2008, 40 percent higher than in 2003. Over the same period, premiums nationwide rose an average of 33 percent.

The report did not break out how much premiums have increased in Massachusetts since the 2006 changes went into effect, so it does not show whether the law affected the rate of price increases. Still, with the state’s law often cited as a model for a national health care overhaul, advocates on various sides of the issue said the report underscores the urgency of including cost controls in any large-scale federal or state overhaul.

While expanding coverage was the logical first step in Massachusetts, cost control is equally as important,’’ said Andrew Dreyfus, an executive vice president at Blue Cross Blue Shield of Massachusetts, the state’s largest private insurer with 3 million members. “And if you don’t face the cost issue directly, then you can jeopardize the progress you’ve made in expanding coverage.’’

President Obama has championed a national health care overhaul that includes cost controls, as well as coverage expansion to nearly every American. But critics have questioned some of his administration’s projected savings, and his proposal for a public insurance plan to compete with private insurers is faltering in Congress.

In Massachusetts, brokering the 2006 overhaul was such a delicate and years-long undertaking that the disparate interest groups – insurers, businesses, consumers, hospital and doctors organizations – all agreed to first tackle health coverage expansion and leave the cost question for a later date.

Bay State health insurance premiums highest in country – http://www.boston.com/news/local/massachusetts/articles/2009/08/22/bay_state_health_insurance_premiums_highest_in_country/

www.commonwealthfund.org

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