BOSTON - four years after Massachusetts embarked on nation review of more ambitious health care Governor Deval Patrick and legislative leaders are stepping up efforts to restrain escalating costs of insurance.
These costs threaten to undermine the health care 2006 law mandated almost universal health coverage, providing a plan of action for the recasting of the national health, pushed by President Obama.
The next goal of wholesale, supporters say, is to find a way to slow down while maintaining or improving the delivery of health care premiums anxieties.
This is a breathtaking complexity task requiring cooperation between doctors, hospitals, insurers, regulators, State lawmakers and administration.
One way to head in this direction, supporters say, is gradually move away from a system that pays physicians and hospitals for the number and type of tests and procedures that they deliver and rather rewards them for the maintenance of the overall health of their patients.
To do so may not be easy, given the sometimes divergent interests of those involved in the process. Massachusetts has the highest percentage of residents insured of any State, largely due to the Act of 2006.
"We do not want to break the system we have, but we want to bear the costs," said the Senate President Therese Murray, D-Plymouth, which defends the revision of payment. "It's complicated." If you move a small piece, something arises elsewhere. »
Murray said legislators are aware they do between patients and their doctors. She hopes to introduce a bill designed partly to rewrite the way in which health care is paid for in Massachusetts, at the beginning of the new two-year session begins in January.
Patrick also stated that slow down the cost of health insurance is a priority of health for his second term.
Monthly premiums for individuals in Massachusetts have increased dramatically in the last decade. From 2001 to 2009, median monthly premium for individual health plans climbed by 76 percent, from $ 251 to $ 442.
Secretary of health and services Judyann Bigby said that while price increases were relaxed in the earlier part of the Decade, they are still climbing too quickly. She said away charges for services template won't be easy, but there need to reduce costs.
She admitted that these radical changes is a task that requires the participation of all those involved in the delivery of health care.
"The question is the speed with which can reform such a large system without errors and unintended consequences", said Bigby.
The growth of health care premiums is also key to State and city governments are struggling to pay for police, firefighters and teachers health coverage.
A report released this week by the Boston Foundation found that, from 2000 to 2007, fresh annual healthcare quality in education budgets arrow by 1 billion, then that State aid for schools, $ 700 million.
Doctors and insurers urged caution.
"Regardless of the process, it must be slow, it must be considered," said Dr. Alice Coombs, President of the medical society of Massachusetts, which represents more than 23 000 doctors and students. "Size does not match all."
Insurers are also recommend a cautious approach.
Massachusetts Association of health Plans President Lora Pellegrini said before pushing a system of "global payment" which requires more coordination among physicians patients, nurses, hospitals and other providers, the needs of Government, even how hospitals and doctors can make.
In the same market health care costs of similar tests and procedures can vary enormously. The State must create fairer, she says.
"Our key as a commonwealth goal must be that we are really to lower the cost of health care," she says. "I think the jury is still out on the best way to get that."
Some insurers have already to a global payment system.
This week, Blue Cross Blue Shield of Massachusetts and Beth Israel Deaconess Medical Center in Boston doctors signed an "alternative quality contract" designed to reduce costs by paying doctors and hospitals for quality, not quantity, of care they provide, including help patients control their diabetes and reduce their risk of heart attack.
Activists of the healthcare that legislators should not delay too long.
Amy Whitcomb Slemmer, Executive Director for the Massachusetts health care for all, rights group said that his group has seen a dramatic increase in the number of calls from people who are struggling to pay premiums for health.
The status quo, says, is not sustainable.
In Massachusetts, we were at the forefront of health care for almost everyone,"she says. "Now we have the opportunity to be the cost and quality of care that we receive."
Some critics of the Act of 2006 have argued that the explosion in price can be blamed partly on the Act itself, which requires that all those who can afford insurance must have a blanket or face penalties for tax.
Glen Shor, CEO of the authority of the Commonwealth connector insurance, overseeing the Act said finding a better way to provide care not only to improve outcomes for patients, but also reduce costs.
Roll back that the Act would be exactly the wrong approach, he said.
"The wrong way is to say that people should not have a coverage or to reduce the coverage as it is not true coverage", he said. "This is a moral commitment on the part of the community that everyone has access to care and coverage." He did y no exhaust valve.
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