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Volume 27, Issue 471 |
July 10, 2006 |
HEALTH-CARE FINANCING
Number One in the World
A report from the Boston University School of Public Health has given Massachusetts the dubious honor of providing “the world’s costliest health care.” Per capita health-care spending in the state in 2004 was $7,075, 33 percent higher than the national average of $5,313. New York was the second most expensive state with a $6,635 average. Lowest was Utah. The study also compared Massachusetts to the rest of the world and found that the Bay State outspends all other countries, on a per capita basis. The study attributes the high costs to the surplus of doctors in the commonwealth, combined with a lack of incentives for them to keep costs down. The state also relies heavily on teaching hospitals, which tend be costly because of their teaching and research missions and because they provide a large amount of care to the un- and under-insured. The study found that higher costs could pose problems for Massachusetts’ new universal health-care plan, because it will drive up the premiums paid by the state, small business, and the middle-class. Costs could also leave the state vulnerable during economic downtimes. Not all are concerned however. “Really what's happening is we're buying more stuff, and on average that stuff is good for our health,” David Cutler, a Harvard University economics professor who specializes in health care, told the Boston Globe. Joe Kirkpatrick, vice president of health-care finance for the Massachusetts Hospital Association, added, “Massachusetts health care is not only the most expensive, it's the best.”
If You Post It, They will Learn
Like a growing number of states, New Hampshire is looking into making health-care costs more visible. Sponsored by Rep. Neal Kurk, HB 1723 would require any licensed health-care facility to post the cash prices charged for services provided and the average reimbursement rate negotiated with insurers for each service. Kurk thinks the bill will encourage competition among providers, which in turn would lower prices. Rep. Stephen Stepanek, who heads the Commerce Committee that will study the bill, has said that some patients will benefit, especially those seeking elective surgery or general medical treatment. However, someone taken to an emergency room with a heart attack “probably wouldn’t have time to sit there and compare cost codes,” Stepanek told the Foster’s Daily Democrat. Opposition to the bill has come primarily from state medical associations. The New Hampshire Hospital Association opposes the bill because of its “vague” wording and says that such a system would be too complicated for most consumers. The association also pointed out that it already provides similar information to consumers. Its website http://www.nhpricepoint.org/ provides cost information on the 10 most common procedures in the state.
PRESCRIPTION DRUGS
To help residents find the best prices for prescription drugs, the state of Minnesota launched a new website that allows consumers to view prices online. The site provides information from more than 1,000 pharmacies in the state and some border towns in other states. The prices of 200 drugs are listed based on the amount the pharmacy charges to Minnesota’s Medical Assistance program. Consumers also can see differences between brand-name and generic medications. If a pharmacy did not seek state reimbursement for a drug, then no information is listed. “The prices aren't guaranteed, but they give consumers a starting point,” Kevin Goodno, commissioner of the Minnesota Department of Human Services, told the St. Paul Pioneer Press. Goodno also said that the site may encourage higher cost pharmacies to lower their prices, which is what has happened in other states. A second phase of this project, beginning in the fall, will allow pharmacies not currently enrolled to submit their pricing information. More about the site can be found at http://www.minnesotarxconnect.com/.
HIV/AIDS
The District of Columbia implemented a program June 27 that encourages all District residents age 14 to 84 to be tested for HIV/AIDS. The District currently has the nation’s highest rate of new AIDS cases, with an infection rate of 179.2 for every 100,000 residents per year. The average state infection rate is about 15 cases per 100,000. Approximately 10,000 D.C. residents—2 percent of the population—have HIV/AIDS, with African-Americans disproportionately affected. Studies have shown that people who are aware of their infection take measures to avoid infecting others. Additionally, early treatment of the virus can delay the onset of AIDS. The campaign uses oral tests that produce results in 20 minutes. Previously, patients had to wait two weeks, and many did not return to learn their results.
PAY OR PLAY
Wal-Mart Law Challenged
The Retail Industry Leaders Association (RILA) is challenging a new Maryland law that requires large employers to spend more on health benefits for their employees. Commonly referred to as the “Wal-Mart bill,” the law would affect only the discount retailer. The law requires employers with 10,000 or more employees to spend at least 8 percent of payroll costs on health benefits, or pay a penalty to the state to help cover the uninsured. “This law is highly discriminatory . . . this was intended and crafted to affect just one company,” Eugene Scalia, attorney for RILA, told the Philadelphia Daily News. RILA also asserts that Maryland’s law is invalid because the Employee Retirement Income Security Act (ERISA) preempts state regulation of employee health benefit plans. Gary Kuc, Maryland’s assistant attorney general, argued the law “doesn’t mandate benefits” and that Wal-Mart could pay the penalty instead, estimated at $6 million. Other states have considered similar bills, but none have been adopted as of yet.
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