Blame government first as medical insurance explodes

Who and what are to blame for the soaring cost of medical insurance in Connecticut? Last week, a hearing held by the state Insurance Department heard opinions in response to more requests from medical insurers for premium increases, this time averaging 20% for individual policies and 15% for small group plans.

Of course, the country’s general inflation rate is a big part of the problem. But the costs of medical insurance are especially complicated, since for many years government’s intervention, necessary as it may be, has turned medicine into a carnival of cost shifting, so much so that people can hardly know the real cost of what they’re getting and who is really paying.

Elected officials blame insurers, who blame hospitals and doctors, who blame insurers and government. They’re all correct, though exactly how much each is to blame isn’t clear.

But start with government because of its direct accountability to the public and because government is the biggest purchaser of medical insurance — for its employees, for the poor via Medicaid and for the elderly via Medicare.

Government’s payments for Medicaid and Medicare patients are sharply discounted from rates paid by other patients. The point of this discounting was to shift costs to those other patients and hide them. Exactly how much costs are shifted is debated. But if government paid more for the poor and elderly, hospitals and doctors could charge other patients less and insurers could reduce their rates — at least theoretically.

But saving money in medicine and medical insurance may require competitive markets even as those sectors have greatly consolidated.

Most Connecticut hospitals are now owned by two chains — Hartford HealthCare and Yale New Haven Health — and hospitals have been acquiring or partnering with physician practices, further diminishing competition. This consolidation has been attributed to the growing burden of government regulation and the desire of doctors to do less paperwork and more patient care.

Meanwhile, insurance companies have merged and gotten bigger or left the medical insurance business. Only three insurers are selling individual medical policies on Connecticut’s Affordable Care Act exchange in Connecticut, and one insurer has reported big losses in the last two years. That company may not be looting its customers as much as the haters of insurance companies like to believe. But if medical insurers really have excess profits, government could always tax them away.

How hard are medical insurers negotiating with hospitals and doctors? At last week’s hearing, state Attorney General William Tong complained that insurers are not negotiating costs but rather building their rates on mere estimates of annual cost increases. Presumably state law could require insurers to seek specific rates from hospitals and physicians for a year or two in advance  if hospitals and physicians were willing and able to provide them and stick to them. They’re probably not.

Also driving up medical insurance costs are state government mandates for coverage that insurers must provide. Not all are necessities. Many are mainly matters of legislators seeking to gratify one constituency or another. Could state government reduce its medical insurance mandates? Not without a lot of shrieking.

(Meanwhile, state government’s medical insurance for its employees and retirees spends $1 million a year for erectile dysfunction drugs.)

Maybe the best suggestion at last week’s hearing was made by state government’s departing health care advocate, Ted Doolittle, who said insurance companies are serving as a “stalking horse for the hospitals,” the biggest parties in interest. Doolittle said hospitals should be interrogated just as closely as insurers and the hospitals raising costs most should be identified.

There’s a lot of money in medicine and insurance, with many executives paid spectacular salaries, and the search for medical and insurance coverage efficiencies is a largely political matter. So it should be the General Assembly’s job more than the Insurance Department’s.

Indeed, for just presiding over soaring medical insurance costs, government is most to blame for them. But then, which legislators have the courage to risk offending not just two huge industries but also their many constituents who are patients?

 

Chris Powell has written about Connecticut government and politics for many years. (CPowell@cox.net.)

The views expressed here are not necessarily those of The Lakeville Journal and The Journal does not support or oppose candidates for public office.

Latest News

Chion Wolf brings ‘Audacious’ radio show to Winsted with show-and-tell event
Nils Johnson, co-founder and president of The Little Red Barn Brewers in Winsted, hosted Chion Wolf and her Connecticut Public show “Audacious LIVE: Show and Tell,” which was broadcast on April 8, drawing a sold-out crowd.
Jennifer Almquist

The parking lot of The Little Red Barn Brewers in Winsted was full on Wednesday, April 8, as more than 100 people from 43 Connecticut towns — including New Haven and Vernon — arrived carrying personal treasures for a live taping of “Audacious LIVE Show & Tell.”

Chion Wolf, host and producer of Connecticut Public’s “Audacious,” and her crew, led by production manager Maegn Boone, brought the program to the packed brewery for an evening of story-driven conversation and shared keepsakes.

Keep ReadingShow less
Marge Parkhurst, the preservation detective

Marge Parkhurst with a collection of historic nails recovered from wall cavities during restoration work.

Photo courtesy of Marge Parkhurst/Cottage & Country Painting Company
Walls still surprise me. If you look hard enough, you can find buried treasure.
Marge Parkhurst

After nearly 50 years of painting some of Litchfield County’s oldest homes and landmark properties, Marge Parkhurst has developed an eye for the past—reading the clues left behind in stenciled vines, forgotten bottles and newspapers tucked into walls, each revealing a small but vivid piece of Connecticut history.

Parkhurst was stripping wallpaper in a farmhouse in Colebrook — the kind of historic home she has spent decades restoring — when she noticed something odd. Three layers of paper had already come off — each one a different era’s idea of decoration — and beneath them, just barely visible under dull, off-white plaster, a pattern emerged.

Keep ReadingShow less
Wings of Spring performance at the Mahaiwe Theater
Adam Golka
Provided

On Sunday, April 19, at 4 p.m., Close Encounters With Music (CEWM) presents On the Wings of Song at the Mahaiwe Performing Arts Center in Great Barrington.

The program focuses on Robert Schumann’s spellbinding song cycle Dichterliebe (“A Poet’s Love”), a setting of sixteen poems by Heinrich Heine that explores love, longing, and the redemptive power of beauty. Featured artists include John Moore, baritone; Adam Golka, pianist; Miranda Cuckson, viola; and Yehuda Hanani, cello.

Keep ReadingShow less
google preferred source

Want more of our stories on Google? Click here to make us a Preferred Source.

New climbing gym planned for Great Barrington

Photo by Alec Linden

A climber explores Great Barrington’s renowned bouldering areas, reflecting the growing local interest in the sport ahead of the planned opening of Berkshire Boulders.

Alec Linden

Berkshire Boulders, a rock climbing gym, is set to open in the Berkshires later this year, aiming to do more than fill a gap in indoor recreation — it could help bring climbing further into the region’s mainstream.

Its co-founders already have their sights set beyond the roughly 2,000 square feet of climbable wall planned for a site off Route 7, just north of downtown Great Barrington.

Keep ReadingShow less
Wind, tarps and trail wisdom: a day learning how to camp smarter

Mat Jobin teaches the group how to use a permanent platform to rig a tent. The privy and lean-to of the Appalachian Mountain Club’s Limestone Spring Shelter are visible in the background.

Alec Linden

A happy day on the trail all starts with a good night’s sleep the night before. That’s local trekking guide Mat Jobin’s mantra, and he affirms that a good night’s sleep is possible even if it has to be on the trail itself – with the right preparation, that is.

Jobin, of Simsbury, Connecticut, is a 16-year professional guide and the founder and owner of Reach Your Summit, an outdoor experiences company that promotes self-confidence and leadership skills through a variety of excursions and educational workshops in the forests of New England. On Saturday, April 11, Jobin hosted the inaugural Campsite Selection & Skills workshop just off the Falls Village section of the Appalachian Trail.

Keep ReadingShow less
Grandmother Moon: Wunneanatsu Lamb-Cason book talk in Torrington
Wunneanatsu Lamb-Cason (Schaghticoke/Ho-Chunk), an educator, traditional storyteller and author, will read from her new book Grandmother Moon, inspired by her grandmother, Indigenous educator Trudie Lamb Richmond, who lived on Schaghticoke land along the Housatonic River in Kent.
Provided

The story comes full circle when educator, traditional storyteller and author Wunneanatsu Lamb-Cason (Schaghticoke/Ho-Chunk) comes to Litchfield County to read from her new book, Grandmother Moon, inspired by her grandmother, Indigenous educator Trudie Lamb Richmond, who lived on Schaghticoke land along the Housatonic River in Kent.

On Saturday, April 18, from 2-4 p.m., the Torrington Historical Society at 192 Main St. will host the book talk and sharing of traditional stories.

Keep ReadingShow less
google preferred source

Want more of our stories on Google? Click here to make us a Preferred Source.

google preferred source

Want more of our stories on Google? Click here to make us a Preferred Source.