Thanks to the Globe editorial board for highlighting high and rising health care costs as a significant concern for many Massachusetts residents (“Getting a grip on health care costs,” May 30). We applaud the health care legislation the Massachusetts House passed last month for including important reforms to state oversight of providers, and we believe that as the Senate takes up the bill, legislators should consider additional policies to address high health care costs.
A new affordability standard for health plans during rate review is unlikely to be successful without additional tools to control spending. Remember, in Massachusetts, health plans are required to spend nearly 90 cents of every dollar on direct medical care for members. High and rising costs for hospital visits, doctors’ appointments, and pharmaceuticals are fundamentally what drive insurance premiums. The Senate should take steps to address these issues.
The Massachusetts Health Policy Commission for years has recommended price caps for the most expensive hospital systems in the state, which use market dominance to demand higher reimbursement rates and draw significant patient volume. Last year, the HPC reported that at least $3 billion of commercial health care spending was excessive, or double what Medicare would have paid for the same services.
Similarly, the Senate should continue its focus on controlling pharmaceutical costs, which continue to increase at more than double the state’s cost growth benchmark annually.
Health plans have a shared responsibility to promote affordability in our market, but we cannot get there alone. Expanding on the House bill could have a real impact on the underlying drivers of spending, which have made health care in Massachusetts both unaffordable and inaccessible to too many.
Cain A. Hayes
President and CEO
Point32Health
Canton
