The Future Of Healthcare Is Quite Bright
It is easier to think that insurance rates is like one's age
, it goes up and never comes down. Thankfully, there has been an actual reduction in health insurance rates in the state of Massachusetts, of all the states in the US - this must be some sort of miracle, right?
This is the part where you think; "Hmm, may be this must be due to the increased insurance rates under the compulsory coverage laws." Na ah! It is also not due to hiked preventive healthcare which resulted from zero dollar copay requirements.
Lastly, it is not because the insurance commissioner stood firm and stopped those money hungry insurance firms from increasing the insurance rates.
Seriously, the last shibboleth is truly the greatest sham of all those that were committed by the single-payer population. The carries in the state of Massachusetts such as HPHC, Fallon, Tufts, BCBS etc all earn lower than one percent (1%) and they are way more competent than any government organization.
The cause of healthcare insurance cost rises is basically as a result of increased rates from the healthcare providers, Hospitals, Doctors, Labs, Clinics etc.
Think about it, there has really been no cause for them not to unconscionably increase rates. This is because no one screamed blue murder at the rates they charged. Seriously, there was really no difference in what consumers' pay, regardless of what they did or what providers used. Wastefulness was rewarded; because it was not reprimanded.
Well, that changed a few years ago, all thanks to Blue Cross! Blue Cross where the only ones with the guts to attack the annoying sky-high rates (most times abysmal quality) that teaching and other clinics/hospitals in Massachusetts provide. Blue Cross was the BRAVE ones who said the following to the providers: We have meticulously grouped providers by quality and cost Those providers with poor quality will cost insured workers more to utilize
Those providers with exorbitant rates will cost insured worker more to utilize Those providers with low costs and or excellent quality will cost insured workers a whole lot less to utilize. In a couple of situations there is a 20 to 1 cost differential to the patient for utilizing high-end clinics/hospitals and physicians! Yes, that is supposed to get the attention of anyone.
It is the well- known 2 x 4 to get the mule's attention. Soon after, other carriers that did not want to be left out followed suit. And gradually, the high-end clinics/hospitals and physicians started to lose business - they did the smart thing after experiencing dwindling business; they responded. They reopened negotiations this spring and extracted themselves from the penalty networks. At the moment, BCBS and possibly other carries are providing what Blue Cross refers to as "Alternative Quality Contracts".
This is pretty much like, the old practice of paying fixed per-head rates to a doctor or hospital, regardless of the patient's health condition. It is then up to the doctor or hospital to get the patient healthy with the money that they have been given. In the past, the major issue is that healthcare providers just skimmed when it comes to treating patients; they avoided preventive treatment or proper maintenance care for health conditions that were chronic. They made a profit by doing less!
Under the new regimen; that act is not going to cut it. Now the carriers' imbursements to the health institutions are simply a function of the quality of the results that the providers get. Top quality results: huge incentive bonuses. Poor quality results: reduced payments - that is fair enough! For the very first time in history, the insurance company's, the patient's and the healthcare provider's objectives are all aligned - get the patients health in a quick and efficient way as possible.
That is simply the secret to getting reduced insurance rates - however, that is not the direction that is taken under the country's health reform. It is no secret that the politicians still strongly believe in beating down the prices and rationing healthcare, when money runs low. Well, that is not something that anyone wants to think about.
There is indeed a much better way to reduce health insurance rates and the state of Massachusetts has set a fine example - watch and learn!
by: James Edholm
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