The bill purports to save $200 billion over the coming 15 years which works out to $13 billion per year. About 60% of employer-sponsored health insurance is self-insured and thus generally not subject to state control. The remaining 40% of “fully-insured” plans carry premiums of about $13 billion per year. How can that be? How could the bill save all of what small employers pay for health insurance?
Separately, the bill calls for the creation of boards and committees as well as several new requirements that data be collected and submitted to the state. This will increase costs for providers and insurers who are sure to pass those costs along to consumers. And the bill also calls for significant investments in health care information technology which is proven to both increase the accuracy of providers’ treatments and also increase utilization in situations where a provider sees additional possible causes for symptoms and thus orders more tests and the like. Cost containment is the overall objective of the bill, but nowhere have there been any meaningful attempts the calculate the COST INCREASES mandated by the bill.
Doing something is clearly better than doing nothing, now that the state has done a very good job of tackling the “access piece” of the healthcare conundrum. Still, it would be nice to have a circuit-breaker provision of some sort that calls for a reform of the reform if the new costs get out of hand at the same time the projected savings evaporate.
All this is 20:20 hindsight–assuming governor Patrick signs the bill–since most legislators probably have not read anything more than a page or two of the 250+ page bill. But, of course, an equally small number of our legislators in Washington read any important part of president Obama’s 2400 page Affordable Care Act.