Junkfood Science: Money card holders

February 15, 2008

Money card holders

Health insurance coverage for everyone sounded so good, but few consumers realized what it would cost, not just in dollars but in their privacy and ability to access the healthcare they might want or need. The Massachusetts health insurance mandate just became exceedingly more expensive for consumers and healthcare providers.

As you may have read last week, the State’s mandated insurance coverage program, the Commonwealth Care program, is proving far more expensive than anyone had estimated. According to the Boston Globe, the program will cost taxpayers $1.95 billion this year and is expected to cost $1.35 billion annually by June 2011 — figures that “far outstrip the original plans.” As a result, the State is asking the Federal government to bail it out and cover half of the program’s costs from 2009 through 2011. “Even with federal backing, the state may not be able to afford the insurance initiative as it was designed.”

In order to contain costs, Massachusetts medical authorities approved a range of changes in December that will likely cut payments to doctors and hospitals, reduce choices and benefits for patients, and possibly increase how much patients have to pay.

Making it a state law that everyone purchase health insurance — plans approved by the state and that include a string of coverage mandates that everyone may not want or need, be cost effective or have medical efficacy — has been profitable for the insurance industry. Given control over consumers’ healthcare access and healthcare providers’ care, the state’s largest insurance company issued another mandate today that will raise costs even more. Blue Cross and Blue Shield of Massachusetts is now requiring every hospital in the state to use electronic medical records and medication prescribing in the next four years or lose $104 million in reimbursements. In other words, hospitals already strapped for funds, don’t really have a choice but comply.

The up-front costs to set up such a system is roughly $2.5 million for each hospital, according to the Boston Globe story. And 63 hospitals, mostly community hospitals, have not yet embraced the new technology largely because of the expenses that they don’t see as cost effective. So, community hospitals are wanting $30 million from the state to help subsidize the new systems for community hospitals. The State Secretary of Health and Human Services is looking at using the state’s Essential Community Provider Trust Fund, for this. This new insurance company mandate will also result in the creation of another layer of bureaucracy and additional expenses to train and license every doctor in the state as proficient in the use of the new electronic system. As the newspaper reported:

Money is not the only obstacle to the introduction of the new system in community hospitals, say researchers. Many physicians, particularly older ones, struggle to adjust to a system that requires them to type every medical order, even dietary restrictions for hospitalized patients. Initially, all medical staff members report some disruption to their established routines, researchers say.... State Senator Richard Moore, chairman of the Joint Committee on Healthcare Financing, said he wants the state Board of Registration in Medicine to mandate that all doctors seeking new licenses or renewals show a proficiency in using the system.

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