Legislators ought to be very wary of allowing the state bureaucracy to interfere in negotiations between private entities, even when the parties involved are health care providers and vendors such as hospitals and physician groups.
There's nothing wrong with conveying to enterprises like Blue Cross Blue Shield of Massachusetts and Partners Health Care — to name two industry behemoths — the fact that employers and consumers are extremely frustrated with skyrocketing costs and confusing billing practices. But to a person, the heads of local health care facilities who spoke at a North Shore Chamber of Commerce event in Danvers this week said they get the message already.
Indeed, the potential for consolidating certain services and offering patients the full range of treatment options within a single organization, helped drive the recent merger of Lahey Clinic and Northeast Health System, parent company of Beverly Hospital. And whereas at one time there was concern over the long-term future of "community" hospitals like those in Salem and Beverly, both now find themselves safely ensconced within larger organizations — Partners, whose affiliates include the world-famous Massachusetts General and Brigham & Women's hospitals, in the case of the former; and more recently in the case of the latter, Lahey Clinic, which has a large campus in Burlington and a smaller facility near the Northshore Mall in Peabody.
Though there's been a significant loss of local hospitals over the past several decades (Hunt in Danvers, Cable in Ipswich, J.B. Thomas in Peabody and Mary Alley in Marblehead), residents can still count themselves fortunate in having easy access to two major medical institutions with stellar reputations.
In our view, the quality of care is better; and while visiting a sick relative might require a trip to another community, in most instances that visit does not require a drive to downtown Boston. And this has all been accomplished by hospital boards acting in the best interest of their patients and institutions, rather than by government fiat.
Thus we look skeptically on bills such as the one filed this week by House Majority Leader Ronald Mariano, D-Quincy, that would force health insurance companies to increase payments to struggling hospitals, like the one in his city that recently declared bankruptcy; while requiring hospitals that can command higher compensation from the insurance companies to lower their rates.
Robert Norton, CEO of the North Shore Medical Center (parent of Salem Hospital), told the packed house at Wednesday's business breakfast that he and his colleagues understand the frustration and are doing everything they can to deal with it.
He noted as particularly promising the recent effort by those in the industry to promote "global" payment systems over the old "fee-for-service" model, which tended to reward providers for treating people after they became ill rather than for taking measures that would keep them from getting sick in the first place. He pointed also to the growing popularity of "accountable care organizations" or comprehensive care networks like Partners and the new Lahey Health System as a means of improving quality while keeping costs down.
It's important to keep in mind during this debate, however, that while costs are high here relative to the rest of country, not only do Massachusetts residents have access to some of the best surgeons and most advanced types of treatment, the medical industry itself is a major driver of the state's economy.
Sandra Fenwick, president of Children's Hospital Boston, which recently opened a major satellite facility in Peabody, made clear that her organization is as sensitive as any to rising costs and the need to keep premiums affordable.
But she also noted that every parent wants the best care possible for their sick child.
This does not come without a certain price, which is something everyone, including lawmakers, must keep in mind as they seek to keep health care affordable.
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