Controlling health care costs continues to vex consumers, employers, insurers, government officials and the medical community.
Those rising costs provide fuel for critics of the federal Affordable Care Act and MassHealth and other reforms. Whether there’s justification for the criticism or not, health care costs continue to demand attention — and solutions designed for slowing down increases while providing the necessary care the public deserves.
That’s one message coming from Blue Cross Blue Shield of Massachusetts Foundation’s annual survey: “Health care affordability continued to be a problem for Massachusetts families in 2015, despite implementation of the state’s 2012 cost containment legislation. Nearly one in five full-year insured adults reported problems paying family medical bills in the past year, and more than one in five reported having medical bills they are paying off over time.” The foundation found that costs “caused problems” for more than 43 percent of insured adults last year.
Rising costs are the result of a number of factors, including increases in drug prices and the number of people who now have health insurance coverage following the implementation of the Affordable Care Act and individual state efforts, like those seen in Massachusetts where, for example 95.7 percent of working-age adults have coverage.
Fewer people are using the emergency room as their first choice for non-emergency medical help. That is said to reduce costs. But more people are taking advantage of medical services through their insurers, causing increasing costs.
That demand in Massachusetts, says the survey, is causing other issues as well. They include difficulty getting appointments or finding health care providers willing to accept their insurance. And these issues cut across the income spectrum, though the foundation says the poor and those with existing health issues feel it more acutely.
Admittedly, the ACA and the Massachusetts system are not perfect. But they were not expected to be. As Drew Altman, president and chief executive officer of the Kaiser Family Foundation, recently wrote in the Wall Street Journal, “while the ACA expands coverage and has changed pieces of the health system … it did not attempt to reform the entire health care system. Medicare, Medicaid, and the employer-based health insurance system each cover many more people.”
Altman goes on to say that all the attention paid to the ACA has diverted scrutiny from other cost-related issues, such as increasing deductibles and drug prices.
Having reduced the number of uninsured in Massachusetts and elsewhere, it’s time to turn attention to other private and public factors of the health care equation. Some would argue that the answer is a single-payer system, what’s called “Medicare for all.” The state Joint Committee on Health Care Financing heard support this week for a single-payer bill filed in the Legislature. Whether this legislation comes to fruition, it’s still up to the public to demand the health care community, insurers and government to find the strategies that work toward slowing down rising costs without hurting the care people deserve.