Most in Massachusetts want state push on health costs

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By Ros Krasny

BOSTON | Fri Oct 21, 2011 6:00pm EDT

BOSTON (Reuters) - Most Massachusetts residents want their state government to take action to reduce high healthcare costs that they blame on drug and insurance companies charging too much, a survey showed on Friday.

Massachusetts has almost universal healthcare insurance coverage thanks to a 2006 law driven by current Republican presidential candidate Mitt Romney when he was state governor.

Romney's rivals for the party's 2012 nomination have criticized the law as a government overreach that served as a pattern for the 2010 national healthcare law championed by Democratic President Barack Obama.

Eighty-eight percent of the 1,000 Massachusetts residents questioned in the poll in September said the state government should take "major action" to address rising costs.

Only 48 percent expressed confidence that the state government could take steps to reduce future healthcare costs, with Democrats more confident than Republicans.

Asked for reasons why costs are so high, survey respondents cited drug companies and insurance companies charging too much money, as well as waste and fraud in the healthcare system, hospitals charging too much, and people not taking good care of their health.

The poll, conducted by the Harvard School of Public Health for the Blue Cross Blue Shield of Massachusetts Foundation, found that 78 percent of respondents viewed the high cost of healthcare as either a crisis (25 percent) or a major problem (53 percent).

The Massachusetts law, popular in the state, did little to curb rising costs. That effort is now under way in the state legislature and by current Governor Deval Patrick, a Democrat.

"There is clear, overwhelming and bipartisan support to control healthcare costs in Massachusetts," said Nancy Turnbull, Harvard School of Public Health's associate dean.

"People ... support government taking big action, but are skeptical that it's going to work," added Robert Blendon, professor of social policy at Harvard School of Public Health, lead author of a report on the survey.

(Reporting by Ros Krasny; Editing by Will Dunham)

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Most in Massachusetts want state push on health costs

AppId is over the quota
AppId is over the quota
By Ros Krasny

BOSTON | Fri Oct 21, 2011 6:00pm EDT

BOSTON (Reuters) - Most Massachusetts residents want their state government to take action to reduce high healthcare costs that they blame on drug and insurance companies charging too much, a survey showed on Friday.

Massachusetts has almost universal healthcare insurance coverage thanks to a 2006 law driven by current Republican presidential candidate Mitt Romney when he was state governor.

Romney's rivals for the party's 2012 nomination have criticized the law as a government overreach that served as a pattern for the 2010 national healthcare law championed by Democratic President Barack Obama.

Eighty-eight percent of the 1,000 Massachusetts residents questioned in the poll in September said the state government should take "major action" to address rising costs.

Only 48 percent expressed confidence that the state government could take steps to reduce future healthcare costs, with Democrats more confident than Republicans.

Asked for reasons why costs are so high, survey respondents cited drug companies and insurance companies charging too much money, as well as waste and fraud in the healthcare system, hospitals charging too much, and people not taking good care of their health.

The poll, conducted by the Harvard School of Public Health for the Blue Cross Blue Shield of Massachusetts Foundation, found that 78 percent of respondents viewed the high cost of healthcare as either a crisis (25 percent) or a major problem (53 percent).

The Massachusetts law, popular in the state, did little to curb rising costs. That effort is now under way in the state legislature and by current Governor Deval Patrick, a Democrat.

"There is clear, overwhelming and bipartisan support to control healthcare costs in Massachusetts," said Nancy Turnbull, Harvard School of Public Health's associate dean.

"People ... support government taking big action, but are skeptical that it's going to work," added Robert Blendon, professor of social policy at Harvard School of Public Health, lead author of a report on the survey.

(Reporting by Ros Krasny; Editing by Will Dunham)

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HEALTH MANAGEMENT. High health care costs doctors due to high doctors fees and charges not practice

American doctors charge considerably more per service than their counterparts in other countries - orthopedic surgeons' fees are more than double what they are in five other wealthy nations, researchers reported in the journal Health Affairs. The difference between specialty care and primary care fees is of thus considerably greater in the US than in other industrialized countries.
These higher Fées, which give American specialist physicians higher incomes, are also the main reason why overall spending on physician's services in the United States is so much higher than elsewhere.
Miriam Laugesen and Sherry A. Member compared the fees received by primary care offices (general practice) and hip replacements from private and public payers in the United States, UK, Germany, France, Canada and Australia.
They found that, in comparison to the other five countries: U.S. primary care physicians received 27% (average) more from public payersUS primary care physicians were paid 70% more by private payers US orthopedic surgeons were paid 70% more by public payersUS orthopedic surgeons were paid 120% more by private payersMiriam Laugesen, who so what lead author, said:

"the gap between the fees paid for primary care and those for orthopedic services such as hip replacements is significantly bigger in the" United States than it is in other countries. For decades, policy makers and medical leaders in this country have debated financial incentives to spur more doctors to become primary care physicians. "Our work shows that continuing attention needs to be paid to the difference in payments across specialties, and how we can get better value for those expenditures."

Fees Columbine by doctors in the five countries varied widely, Laugesen and link found. In France, public fees paid for a primary care visit what $32, compared to $66 in the UK and $60 in the United States. Fees received by primary care practices from Medicare were more or less similar to those charged in the other five countries.
They found a very wide range of difference in Fées paid for hip replacements: Canada-$625 (public fees) United States $1,634 (public fees) France-$1,340 (private Fées) United States $3,996 (private Fées) the widest disparity in how much US physicians charge, according to this study, is in the private sector. The researchers gathered data on Fées paid by six large national health insurance companies in six US markets, and found that they pay approximately one third more to primary care offices and 50% more for hip replacements compared to what Medicare pays.
The authors say that private insurers have had more success when negotiating Fées with generalist physicians than with orthopedic surgeons.
Despite similar volumes of work, US doctors reported higher live than their counterparts in the other countries. The authors believe the differences in income are because American doctors are paid more for the time and skills. They stressed that their study was not involved in determining whether the extra pay what warranted.
Primary care physicians, average annual incomes: United States $186,582France-$95,585Australia-$92,844 Orthopedic surgeons, average annual incomes: UK orthopedic surgeons earn 30% less than their US counterparts and 50% more than those in the remaining countries...
In Canada, France and Germany, primary care physicians (GPs, general practitioners) earn about 60% of what orthopedic do in their countries, while in the United States primary care physicians' annual income is about 40% that of an American orthopedic surgeon.
This is not breaking news, the authors emphasize, that U.S. health care spending and fees are far higher than in other nations. However, their study shows that it is not such factors as volume of services, medical school tuition fees, or higher practice costs that drive up costs, but rather the higher fees physicians are paid, particularly orthopedic surgeons.
Perhaps policy makers should consider the findings of this study when looking for ways to control health care spending, the authors suggest.

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HEALTH MANAGEMENT. American families only $ 95 off better in 10 years because of rising health care costs

A median-income American family is only $95 per month better off today than ten years ago because rising health care costs have eliminated virtually all their income gains, researchers from the RAND Corporation revealed in the journal Health Affairs. Had health care costs risen in line with other goods and services those families would have had an extra $545 disposable income per month in 2009.
Economist David Auerbach, the study's lead author, said:

"Accelerating health care costs are a primary reason that the so many American families feel like they are just treading water financially." "Unless we reverse the trend, Americans increasingly notice that health will costs compromise their other spending options."

Between 1999 and 2009 in the United States: health care spending rose from $1.3 trillion to $2.5 trillionHealth care spending per person rose from $4,600 to just over $8,000.13.8% of country's GNP (gross domestic product) was spent on health care in 1999. It rose to 17.6% in 2009.These numbers may be sobering, but they do not translate to the daily routine of typical American families easily, mainly because health care costs are not all clearly visible, the authors wrote.
To describe the hidden burden that ever increasing health care expenditure placed on a median-income family consisting of two parents with two children, with employer-sponsored insurance from 1999 to 2009, Auerback and Dr. Arthur L. Kellermann gathered various data together from several sources.
American families can see health care costs in two ways: through the amount they have to pay every month on their private health insurance premiumThrough out-of-pocket expenditure for deductibles, drugs, copayments and other itemsHowever, the researchers say there are other less visible costs: for an employer to be able to pay a share of the worker's premium, his/her wages and other compensation are usually reducedA proportion of the family's income goes towards paying for federal and state taxes which are devoted to such health programs as Medicaid, Medicare and the military health had on annual income of $76,000 in 1999, care system the median-income family in the United States this grew to $99,000 in 2009, on increase of 30%. However, health spending increased at a considerably greater rate. Monthly health insurance for families rose from $490 to $1,115 (128%), and out-of-pocket expenses from $135 to $240 (78%).
Public expenditure on health rose by 76% at state level and 140% at federal level.
As federal tax rates dropped during the ten-year period, the portion of family's tax bill that went towards health care costs – from $345 to $440 did not fully reflect this increase.
Therefore, families had much less money to spend because of rapidly rising healthcare costs.
A typical family's income rose by approximately $1,910 during the decade. Over 40% of that went on higher health care costs. Increases in the cost of consumer goods plus non-health care taxes absorbed a further 53%, leaving the average median-income family with a mere $95 extra money in their pockets at the end of each month.
Kellermann said:

"The complex way that the United States pays for health care often obscures the consequences of health care cost growth for most American families." "This makes the challenge of controlling health care costs that much harder."

The researchers worked out that if health care costs had risen by 1% more than the annual GDP rise, the median-income family would have had $335 extra cash at the end of the month at the end of the decade, and $545 if health care costs had risen the same as the overall inflation rate during that period.
The target set by the affordable care Act is a 1% higher increase in health care spending than the increase in GDP.

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