Chair urges experts to focus on human impacts of health care costs
BOSTON >> The first of two days of the state's annual hearings on health care costs began with a warning of the "alphabet soup" of acronyms and technical jargon that could keep the hearings bogged down in the weeds.
Before the panels of health policy experts, insurance executives and health care providers launched into detailed reports on the costs of care in Massachusetts, Rep. Jeffrey Sanchez implored the Health Policy Commission to keep the attention of the two-day discussion on the patients and the impacts health costs have on Massachusetts families.
"The reason we are here is to understand where we are with our system so that each citizen of the Commonwealth doesn't have to make choices that may have to compromise their family's economic stability and well-being in every sense," Sanchez, the House chair of the Joint Committee on Health Care Financing, said Monday morning.
Total health care spending in Massachusetts in 2015 was $57.4 billion, a 4.1 percent increase over 2014 that surpassed the state's official benchmark of 3.6 percent, according to the Center for Health Information and Analysis (CHIA).
Spending on MassHealth was up 4.6 percent, and spending on commercial health insurance and Medicare were both up 5.3 percent last year, according to CHIA. And the net cost of private health insurance was up 12.6 percent in 2015.
Prescription drug spending of about $8.1 billion last year was one of the factors driving up health care costs, accounting for about 36 percent of the overall growth last year, CHIA reported.
Though the two-day cost trends hearing is slated to include feedback from health insurance carriers, care providers, lawmakers, consumer advocates and others, Sanchez used his introduction on Monday morning to shine a light on the human impacts of health care costs.
"All the regression analysis and discussion of all-inclusive stratified risk-adjusted capitated payment arrangements means absolutely nothing if we can't figure out in this commonwealth of plenty how we can help the most vulnerable among us to care for themselves," Sanchez said. "There are institutions that have figured out how to come up with blockbuster drugs and face transplants and hand transplants, but we need to make sure that we work on solutions that make a difference for people."
Providing the keynote on Monday was Gov. Charlie Baker, who served as CEO of Harvard Pilgrim Health Care from 1999 until 2009. Baker renewed his longstanding call for the health care marketplace to provide patients with pricing information that can be useful when selecting a provider.
After his remarks, the governor told reporters a lot of the work done on price transparency in Massachusetts is "more focused on serving what I would call sort of the policy and the research community and not so much the individual who's dealing with the health care system themselves."
"I do think we should spend some time creating a collaborative agenda — because there's a lot of different players in this, which is also part of the issue — and come to some agreement on what we think the best things we could do to make it easier for people to navigate the health care system," Baker said.
Sanchez provided opening remarks on the first of two days of hearings on health care costs at Suffolk University Law School. The hearings began in 2013 after the 2012 passage of a health care cost control law, and this year's hearings are expected to draw more attendees than previous years, according to HPC Executive Director David Seltz.
HPC Chairman Dr. Stuart Altman said the hearings are held to discuss "health care cost growth and to what extent it is meeting the benchamrk or exceeding it."
"And if it is exceeding it, why? And are there things we can do to continue the high quality health system we have here in Massachusetts and to do it in a way that everyone can afford," he said.
Renee Landers, a former Department of Justice lawyer who now runs the Suffolk University Law School's health law concentration, echoed Sanchez's remarks and said everyday citizens are now thinking more about the health care they need and the price tag on it.
"The public has a growing expectation that they will have access to having their important health care needs treated and addressed without causing financial ruin," Landers said. "The crisis over the increase in the price for EpiPens, the hepatitis C drugs, the newly-approved drug for Duchenne muscular dystrophy have made the public well aware of the problem of cost and access to drugs."
Sanchez noted that while more than 97 percent of Massachusetts residents now have health insurance, there is more for the industry and lawmakers to do "to make health reform work for everyone."
"Not only do we need to make health care more affordable, but most importantly, we need to ensure that people are able to effectively access the system to get the care they want and need," Sanchez said. He added, "We need to engage minorities, low-income residents, and other vulnerable populations to make sure health reform is working for them."
Sanchez, a Jamaica Plain Democrat, pointed to disparities between white Massachusetts residents and citizens of color in health care experiences.
While 92 percent of white Bay Staters reported having health insurance for the entirety of the last year, only 82 percent of Hispanic and African-American residents did, he said. About 25 percent of African-Americans and 28 percent of Hispanics reported not being able to get a medical appointment when they need one, compared to 19 percent for whites, Sanchez said, citing a 2015 health insurance survey.
"Leadership in health care does not reflect the breadth and experience of communities from the board room to the executive suite and most importantly from bench to bedside," he said, noting that in 2000 people of color made up 11 percent of the state's population and now account for nearly 20 percent. "I'm tired of the term culturally competent care. It is only with truly, relevant care that can patients be empowered."
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